The NICE Guidelines For Managing Type 1 Diabetes With CGM In Adults

1.6.22 You may wish to consider real-time continuous glucose monitoring for adults with Type 1 diabetes. They should be willing to commit to using it at least 70% of the time and to calibrate it as needed. This applies to those who have any of the following despite the optimised use of insulin therapy and conventional blood glucose monitoring:

  • More than 1 episode a year of severe hypoglycaemia with no obviously preventable precipitating cause.
  • Complete loss of awareness of hypoglycaemia.
  • Frequent (more than 2 episodes a week) asymptomatic hypoglycaemia that is causing problems with daily activities.
  • Extreme fear of hypoglycaemia.
  • Hyperglycaemia (HbA1c level of 75 mmol/mol [9%] or higher) that persists despite testing at least 10 times a day (see recommendations 1.6.11 and 1.6.12).
  • Continue real-time continuous glucose monitoring only if HbA1c can be sustained at or below 53 mmol/mol (7%) and/or there has been a fall in HbA1c of 27 mmol/mol (2.5%) or more. [New 2015]

1.6.23 For adults with Type 1 diabetes who are using real-time continuous glucose monitoring, employ the principles of flexible insulin therapy with either a multiple daily injection insulin regimen or continuous subcutaneous insulin infusion (CSII or insulin pump) therapy. [New 2015]

1.6.24 Real-time continuous glucose monitoring should be provided by a centre with expertise in its use, as part of strategies to optimise a person’s HbA1c levels and reduce the frequency of hypoglycaemic episodes. [New 2015]

NICE Guidelines For Managing Type 1 Diabetes In Children With CGM

1.2.62 Offer ongoing real-time continuous glucose monitoring with alarms to children and young people with Type 1 diabetes who have:

  • Frequent severe hypoglycaemia
  • Impaired awareness of hypoglycaemia associated with adverse consequences (for example, seizures or anxiety)
  • The inability to recognise, or communicate about, symptoms of hypoglycaemia (for example, because of cognitive or neurological disabilities). [new 2015]

1.2.63 Consider ongoing real-time continuous glucose monitoring for:

  • Newborns, infants and pre-school-aged children
  • Children and young people who undertake high levels of physical activity (for example, sports at a regional, national or international level)
  • Children and young people who have comorbidities (for example anorexia nervosa) or who are receiving treatments (for example corticosteroids) that can make blood glucose control difficult. [new 2015]

1.2.64 Consider intermittent (real-time or retrospective) continuous glucose monitoring to help improve blood glucose control in children and young people who continue to have hyperglycaemia despite insulin adjustment and additional support. [new 2015]

Find the full guidelines for adults here, and children here.