Quality statement 4: Continuous glucose monitoring in type 1 diabetes

Quality statement

Children and young people with type 1 diabetes who have frequent severe hypoglycaemia are offered ongoing real‑time continuous glucose monitoring with alarms.

Rationale

Continuous glucose monitoring helps children and young people with type 1 diabetes and their family members or carers (as appropriate) to respond more quickly to changes in blood glucose levels throughout the day. For children and young people with frequent severe hypoglycaemia (particularly those who have difficulty recognising or reporting it), continuous glucose monitoring can help to improve their control of blood glucose and HbA1c levels.

Quality measures

Structure

Evidence of local arrangements and written clinical protocols to ensure that children and young people with type 1 diabetes who have frequent severe hypoglycaemia are offered ongoing real‑time continuous glucose monitoring with alarms.

Data source: Local data collection.

Process

Proportion of children and young people with type 1 diabetes with frequent severe hypoglycaemia who are offered ongoing real‑time continuous glucose monitoring with alarms.

Numerator – the number in the denominator who receive ongoing real‑time continuous glucose monitoring with alarms.

Denominator – the number of children and young people with type 1 diabetes who have frequent severe hypoglycaemia.

Data source: Local data collection.

Outcome

a) HbA1c level of 48 mmol/mol or lower.

Data source: Local data collection and 2013–14 National Paediatric Diabetes Audit.

b) Quality of life.

Data source: Local data collection and 2013–14 National Paediatric Diabetes Audit.

What the quality statement means for service providers, healthcare professionals and commissioners

Service providers (secondary care providers) ensure that systems are in place to offer ongoing real‑time continuous glucose monitoring with alarms to children and young people with type 1 diabetes who have frequent severe hypoglycaemia.

Healthcare professionals (such as consultants) offer ongoing real‑time continuous glucose monitoring with alarms to children and young people with type 1 diabetes who have frequent severe hypoglycaemia.

Commissioners (NHS England regional teams) commission services that offer ongoing real‑time continuous glucose monitoring with alarms to children and young people with type 1 diabetes who have frequent severe hypoglycaemia.

What the quality statement means for children and young people and their parents and carers

Children and young people with type 1 diabetes who have frequent severe hypoglycaemia (a hypo that they need help from someone else to treat) are offered ongoing real‑time continuous glucose monitoring with alarms. This is special equipment that checks the person's blood glucose all the time, without them having to do finger-prick tests. It sounds an alarm if blood glucose levels fall too low.

Source guidance

Definitions of terms used in this quality statement

Frequent severe hypoglycaemia

Having low blood glucose levels that require assistance from another person to treat. 'Frequent' is when this is happening often enough to have a significant impact on school, work or quality of life.

[Expert opinion and Diabetes.co.uk]

Ongoing real-time continuous glucose monitoring with alarms

A type of system for continually monitoring glucose. 'Ongoing' means the device is used for weeks, months or longer. 'Real‑time continuous' means the device takes real-time measurements for as long as it is worn.

[Expert opinion and Juvenile Diabetes Research Foundation]