Hundreds of children with type 2 diabetes who currently manage
their condition with the ‘burdensome’, ‘tiring’, and ‘stressful’
task of finger prick testing several times a day could be offered
a choice between two ‘life changing’ technologies to virtually
automate the process, NICE has said.
For the first time new guidance from NICE recommends the use of
real-time continuous glucose monitoring (rtCGM) or intermittently
scanned glucose monitoring (isCGM) devices for some children
living with type 2 diabetes who are currently using finger prick
testing and insulin therapy.
Our committee was told that children being offered the technology
would be subjected to the ‘burdensome’, ‘tiring’, and ‘stressful’
task of finger prick testing several times a day, and instead
technology could automate this process.
The devices have already been recommended for children with type
1 diabetes.
The technologies give a continuous stream of real-time
information on a smartphone allowing better/quicker management of
the condition.
A sensor is attached discreetly to the body to monitor current
and previous glucose levels. It also shows a prediction of where
the glucose levels are headed meaning they can inject themselves
with insulin to stabilise their levels if necessary.
If a patient or their family has a preference for which
technology they wish to use, they could opt for an intermittently
scanned glucose monitoring (isCGM) device – also known as flash
monitoring – as an alternative to real-time devices, picking the
technology that will work best for them.
Research has found both real-time and flash devices help a person
in maintaining optimal blood sugar control.
The recommendation comes following changes to NICE’s guideline on
the diagnosis and management of type 1 and type 2 diabetes in
children and young people published today (Thursday 11 May,
2023).
Dr Judith Richardson, programme director in the Clinical
Directorate at NICE, said: “Type 2 diabetes in children
is the most aggressive form of the disease and recommending new
technology is a clear step towards giving children on insulin
therapy the ability to manage their own condition in a less
invasive way, and to live happier and healthier lives.
“We’re focused on bringing the best care to people fast, while at
the same time ensuring value for money for the taxpayer. This
technology can take away the burdensome task of several finger
prick tests a day, which can be tiring, stressful and have a
negative psychological impact on the child.
“Improvements made in managing a child’s diabetes at an early
stage can reduce the health impact of the condition later in
their lives, and the potential impact on the health service.”
Health Minister said: “Type 2
diabetes is increasingly being diagnosed in children, many of
whom face the constant stress of needing to monitor their blood
glucose levels by finger prick testing – often multiple times a
day – just to stay healthy and avoid complications.
“Offering children glucose monitoring devices will relieve some
of this burden on hundreds of children and empower them to manage
their condition more easily.”
Nikki Joule, policy manager at Diabetes UK,
said: “We are pleased to see the new NICE guidelines
recommending that continuous glucose monitoring devices are made
available for some children with type 2 diabetes.
“Diabetes is a relentless condition, requiring constant, careful
management, which can be really challenging for children and
young people. It’s important that these devices are now rapidly
offered to affected families to help them manage their child’s
condition well. That will require healthcare systems to swiftly
make plans to equitably roll out these devices to children who
are eligible.”
The guideline committee has also recommended the technology is
offered to children and young people with type 2 diabetes, if
they:
- have a need, condition or disability (including a mental
health need, learning disability or cognitive impairment) that
means they cannot monitor their blood glucose by finger prick
testing
- would otherwise be advised to self-measure at least 8 times a
day
- have recurrent or severe low blood sugar levels
- have impaired blood sugar awareness.
Those eligible should speak to their diabetes team to access
real-time or flash monitors on prescription.
ENDS
About the guidance
- Putting recommendations into practice can take time. How long
will vary from guideline to guideline, and will depend on how
much change in practice or services is needed. Implementing
change is most effective when aligned with local
priorities.
- When exercising their judgement, professionals and
practitioners are expected to take this guideline fully into
account, alongside the individual needs, preferences and values
of their patients or the people using their service.
- It is not mandatory to apply the recommendations, and the
guideline does not override the responsibility to make decisions
appropriate to the circumstances of the individual, in
consultation with them and their families and carers or guardian.
- The guideline is published on nice.org.uk/NG18 at 00.01 BST
on Thursday 11 May 2023.
- An embargoed copy is attached.
- These recommendations are for England, Wales and Northern
Ireland.
