Diagnostic and monitoring devices for diabetes (Formulary)

Inappropriate glucose monitoring should be changed in line with the guidance below and stopped if it is not required.
Patients who SHOULD monitor glucose Patients who do NOT need to monitor glucose Patients who should be CONSIDERED for glucose monitoring

Individuals with insulin treated diabetes or being considered for insulin

Individuals with type 2 diabetes at risk of hypoglycaemia

Individuals who require to undertake blood glucose monitoring under DVLA regulations (www.gov.uk/diabetes-driving)

Pregnant women with diabetes.

Patients with type 2 diabetes managed with:

Diet and exercise

Combinations of:
metformin, pioglitazone, SGLT2 inhibitors (dapagliflozin, empagliflozin) DPP-4 inhibitors (sitagliptin, linagliptin) and GLP-1 analogues (liraglutide, exenatide) in the absence of medication known to cause hypoglycaemia, ie sulfonylureas and insulin.

On steroids

At risk of hypoglycaemia

Elderly on sulfonylurea

At initiation of therapy

Renal impairment

High alcohol intake

Agreed management plan.

 

Testing UPTO 4 times per day is appropriate for: Testing MORE THAN 4 times per day may be required for: 

Patients with type 2 diabetes using or being considered for insulin injectable therapy

Patients advised on an individual basis by an appropriate health care professional

Patients requiring short-term glucose testing.

Patients with type 1 diabetes

Children

Evidence of impaired hypoglycaemia awareness

During pregnancy (including gestational diabetes)

Patients managed with a continuous subcutaneous insulin infusion (CSII by pump)

Control is poor or unstable; reduce testing frequency again when control is improved

Specific patients as advised by the specialist team

Patients who are carbohydrate counting

Other selected circumstances, eg for occupational reasons.

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