Diabetes letter initiation (west Essex)
RAG rating
Amber initiation
Document type
Prescribing guideline
West Essex
Output type
Pharmacy / Prescribing

Dexcom ONE

Dear Doctor

Your patient was seen on at the Diabetes Specialist Clinic and is deemed suitable for NHS funding of the Dexcom ONE Continuous Glucose Monitoring (CGM) system, having met the following criteria for NHS funding as assessed by the diabetes specialist:

  • Type 1 diabetes and clinically indicated as requiring intensive monitoring >8 times daily
  • Any form of diabetes, on haemodialysis and insulin treatment, requiring intensive monitoring >8 times daily
  • Diabetes associated with cystic fibrosis on insulin treatment
  • Diabetes Type 1 and pregnant
  • Type 1 diabetes unable to routinely self-monitor blood glucose due to disability
  • Type 1 diabetes with occupational or psychosocial circumstances that warrant 6-month trial of Dexcom ONE
  • Type 1 diabetes with recurrent severe hypoglycemia or impaired awareness of hypoglycaemia
  • 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 initially be for a 6 month trial period and will only be continued at the discretion of the diabetes specialist team if there is sustained benefit in patient outcomes whilst they are using the device. Your patient/their carer understands that NHS funding may be withdrawn after 6 months if no benefit is seen but they will have the option to continue to self-fund use of the device.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 in a quantity to cover regular three times daily testing for Type 1s who are carb counting and to allow for occasional daily use in other circumstances. A maximum of 3 x 50 pots of strips should be prescribed- which might reduce to 2 x 50 per month once new testing regime in place and monthly usage established. Lower cost strips as listed on formulary are suitable for use in this patient.

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 Add:

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

This is sufficient for a 30-day supply – please allow maximum of 6 prescriptions.

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

This is sufficient for a 90-day supply – please allow maximum of 1 prescription.

We have supplied a starter kit containing one sensor (lasts 10 days) and one transmitter

(lasts 3 months). We will advise you if continuation beyond 6 months is appropriate

o …………………………..(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 Continue: o …………………………………………..

Initial prescription of glucose strips provided : o Yes          o No

Please Stop: o …………………………………………..

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