8 March 2019

Fewer finger pricks for people with diabetes

Diabetes

Thousands of people with type 1 diabetes will be able to access continuous glucose monitoring (CGM) thanks to a $100 million boost in funding by the federal government.

The government provided $54 million in funding in 2017, but access to subsidised CGM systems was restricted to people with type 1 diabetes under the age of 21.

The $100 million package is in addition to the original funding and expands access to CGM to women actively planning pregnancy, as well as patients over the age of 21 who have a high clinical need.

CGM systems cost around $5,000 a year, but with government funding the technology would be free for eligible people. 

CGM systems are wearable devices that measure glucose levels in the interstitial fluid through a sensor that is inserted under the skin.

The advantages of CGM over traditional blood glucose monitoring strips is that the technology can immediately alert the person if their glucose levels are too low or too high. In addition to allowing greater stabilisation of glycaemic levels, the early warning helps avoid dangerous episodes of hypoglycaemia.

For patients who required intensive control of their diabetes, who otherwise needed to conduct finger prick  tests up to seven
times a day, CGM represents a major benefit as wearers only need to draw blood twice a day to calibrate the system.

The CGM system could be quite reassuring for some people with type 1 diabetes who had become hypo unaware as well as for those people who were very fearful following a history of hypos, said Diabetes Australia CEO Professor Greg Johnson.

Under the new program, the federal government would subsidise CMG for adults who were both hypo unaware and had a history of severe hypoglycaemia within the last 12 months, with evidence of significant cognitive impairment requiring external third-party assistance for recovery.

Having access to real-time information was particularly important during pregnancy, especially around the time of conception, where significant fluctuations in blood sugar levels were known to be associated with poorer outcomes for both the fetus and the mother.

Not every person with type 1 diabetes would be appropriate for CGM; some people disliked the idea of always have access to their blood sugar level and might find continuous glucose monitoring anxiety-inducing.

However, for the majority of people with type 1 diabetes now eligible for subsidised CGM – children, women wanting to fall pregnant, unstable diabetics and those at high risk of serious hypos – the freedom from finger-pricking and the safety net that the device provides is likely to be seen as being of great benefit.