Indication
Diabetes letter continuation (west Essex)
RAG rating
Amber initiation
Document type
Prescribing guideline
Place
West Essex
Output type
Pharmacy / Prescribing
Document
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Dexcom ONE

Dear Doctor

Your patient was seen on at the Diabetes Specialist Clinic and was assessed for suitability for continuation of the Dexcom ONE Continuous Glucose Monitoring (CGM) system. It has been assessed that they are achieving sustained benefit in one or more of the following criteria and, therefore, qualify for ongoing NHS funding:

  • Reduction in severe/ non-severe hypoglycaemia episodes
  • Reduction in HbA1c of 0.5%/5 mmol/mol or more within 6 months
  • Agreed reduction in use of self-monitoring blood test strips.
  • Reduction in diabetic ketoacidosis
  • Reduction in admission to hospital
  • Pregnant patients with T1DM
  • The person has type 1 diabetes or insulin treated type 2 diabetes who are living with a learning disability and recorded on their GP Learning Disability register
  • 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. 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.

Use of the Dexcom ONE CGM system will only be continued at the discretion of the diabetes specialist team if there is continuing sustained benefit in patient outcomes whilst they are using the device. Your patient/their carer understands that NHS funding may be withdrawn if no on-going benefit is seen but they will have the option to continue to self-fund use of the device.

Please also be aware that they will continue to require blood glucose test strips for driving and if they are on pump therapy.

a) I would be grateful if you would make the following changes to their repeat prescription items, at your earliest convenience. This has been discussed with the patient.

Please Continue:

  • Dexcom ONE sensors (PIP CODE: 421-4722) – 1 pack of 3 sensors

This is sufficient for a 30-day supply – please allow up to 6 to 12 repeat prescriptions.

  • Dexcom ONE transmitter (PIP CODE: 421-4730) – 1 pack of 1 transmitter

        This should be sufficient for a 90-day supply - please allow up to 4 repeat prescriptions

We will advise you if/when to discontinue

  • ………………………(Blood Glucose Testing strips)

        maximum of 3 x 50 –patients may only require 2 x 50 ongoing if only testing three times a day.

Please Stop: …………………………………………..

b) Please continue all other items as currently prescribed.

c) They will be followed up by the specialist team regularly and will be required to share their CGM data via Dexcom Clarity for ongoing support.

Thank you for your help.

Yours sincerely


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