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Diabetes 


FreeStyle Libre System

The FreeStyle Libre, a flash glucose monitoring device, was added to the Scottish Drug Tariff at the end of 2017. The entry in the tariff stipulates that this device can only be initiated following assessment by an appropriate specialist in the treatment of Diabetes Mellitus and in accordance with local and national guidance.

As of May 2018, it has been agreed that NHS Lanarkshire will begin to provide FreeStyle Libre for patients who fall into the 2 categories below.  All patients will be assessed to ensure that the device is clinically appropriate option for them.

  1. People with Type 1 diabetes who are testing over 8 times per day.
  2. People with Type 1 diabetes who have impaired hypo awareness.

NHS Lanarkshire Health Board is also aware that the Scottish Health Technology Group (SHTG) is due to publish a review / appraisal on the FreeStyle Libre, which will be published between June and August 2018. This review will include clinical, safety and cost effectiveness evaluation for this device. This report will be a very valuable source of advice on which NHS Lanarkshire will base it’s final decision on how FreeStyle Libre is prescribed in the longer-term.

NHS Lanarkshire is committed to concluding a review of the use of this technology once the SHTG publishes it’s review.

(Adapted from a statement by Iain Wallace, Medical Director, NHS Lanarkshire – 7th May 2018)

NB Please note that the specialist teams will be commencing small groups of people on the FreeStyle Libre over the coming months.  This process will take time and we thank our patients, families and carers for their ongoing patience and understanding during this time.

 

Diabetes types

There are two main types of diabetes and some other less common types. These are:

Type 1

Type 1 is caused by failure of the pancreas to produce insulin. This results in an insulin deficiency which means that there is too much glucose in the bloodstream. People with Type 1 diabetes require treatment with insulin to survive. 

It can occur at any age but onset is most common before the age of 40. Type 1 diabetes accounts for approximately 13.1 per cent of all people with diabetes in Lanarkshire.

Type 2

Type 2 is caused by a combination of insulin resistance and a reduction in insulin production. It requires management with varying combinations of lifestyle management, oral or injectable medication. This type of diabetes usually appears in people over the age of 40, though in South Asian and African-Caribbean people often appears after the age of 25. However, recently, more children are being diagnosed with the condition, some as young as seven. Type 2 diabetes is the more common of the two main types and accounts for 86.5 per cent of all people with diabetes in Lanarkshire.

Gestational Diabetes

This is a type of diabetes that can develop during pregnancy. It affects approximately two to three in every 1000 pregnancies and 95 per cent of cases require intensive management with insulin and lifestyle intervention. It can be an indication that diabetes will develop in the future.



You can also develop diabetes due to other conditions such as:

  • Pancreatic disease
  • Endocrine disease
  • or induced by drugs called steroids or thiazides.

The management of this type of diabetes is the same approach as in Type 2 Diabetes.