New guidance from NICE recommends greater access to continuous glucose monitoring (CGM) sensors for people with type 1 diabetes who are having problems with hypos on insulin pump therapy.
The guidance (diagnostic guidance 21), published on 12 February 2016, is a positive step forwards for people that are already on insulin pumps. It will allow greater access to technology that can prevent hypos occurring on a regular or unexpected basis.
Under the new guidance, the Medtronic MiniMed Paradigm Veo System has been recommended as the pump and CGM sensor combination of choice. The recommendation of the Paradigm Veo and its sensors is based on evidence that the pump prevents severe hypos from occurring thanks to it’s low-glucose suspend feature.
The low glucose suspend feature allows the Paradigm Veo to respond to low sugar levels by switching off insulin delivery until sugar levels have returned to normal again. The feature is particularly useful for preventing night time hypoglycemia.
The Medtronic MiniMed 640G has an even more advanced system for preventing hypos. However, this pump was made available too recently to be included in the guidance. As a result, the MiniMed 640G will not be routinely recommended, but it may be made available to patients on a discretionary basis.
The Animas Vibe, combined with Dexcom G4 CGM sensors, was reviewed in the guidance but there was found to be “insufficient evidence” to recommend this combination for routine use on the NHS. However, it can also be made available to patients on a case by case basis.
The type 1 diabetes charity JDRF UK has welcomed the new guidance, with Karen Addingto, CEO of JDRF UK, stating: “Hypos are what many people with type 1 diabetes hate most. They can rob people with the condition of a stress-free night’s sleep. We want everyone who could benefit from new technology to be able to get hold of it.”

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