Flash glucose monitoring


Brand Name(s):Freestyle Libre

Indication:Glucose monitoring system



Review Date:Feb-24

MHRA is aware that some users of the FreeStyle Libre flash glucose monitoring system are applying barrier creams, patches and sprays before attaching the sensor to reduce skin reactions. These barrier methods have not been tested by the manufacturer and may therefore affect the performance of the device. Please refer back to prescriber for additional information.
Flash glucose monitoring system, FreeStyle Libre is available via the NHS for TYPE I Diabetes patients (aged 4 and above), including pregnant women in Doncaster and Bassetlaw area who fulfil the current recommendations by RMOC3, ABCD and ACDC4 which are based on NICE MB1105.
The Criteria for initiation is as follows;
1. Those already performing 8 or more SMBG (self-monitoring of blood glucose) per day; Flash Glucose Sensor (FGS) is cost equivalent at 8 blood tests per day.
2. Those who meet current NICE criteria for insulin pump therapy (HbA1c 69 or more mmol/mol or disabling hypoglycaemia as described in NICE TA151) where a successful trial of FGS may avoid the need for pump therapy, therefore demonstrating a cost saving.
3. Those who have recently developed impaired awareness of hypoglycaemia. A trial of FGS can reduce hypoglycaemia and may prevent future need for Continuous Glucose Monitoring (CGM), demonstrating cost saving. It is noted that for persistent hypoglycaemia unawareness, NICE recommend Continuous Glucose Monitoring with alarms, not FGS.
4. Frequent admissions (more than 2 per year) with DKA or hypoglycaemia, on assumption FGS trial could prevent future admissions.
5. Those who require third parties to carry out monitoring and where conventional testing is not possible.
6. Children who have significant fear or anxieties of multiple finger prick testing. [This is any child who is diagnosed when aged 16 years or less. These children should fulfil continuation criteria to continue with FGS]
Patients are to be assessed and initiation undertaken in specialist Diabetic clinics with results communicated to the GP. Transfer of prescribing responsibilities to GPs can be considered 1 month after initiation in adults and children. Link to guidance; http://medicinesmanagement.doncasterccg.nhs.uk/wp-content/uploads/2019/09/Flash-Blood-Glucose-Monitoring-Guidance-v3.0.pdf