People living with diabetes can use continuous glucose monitoring, often shortened to CGM, to check their sugar levels during the day and night.
CGM can either give you sugar readings in real-time, or they can be scanned using your smartphone or a reader. When you scan your CGM sensor, this is known as flash glucose monitoring.
Generally, people with type 1 diabetes should be offered a CGM or flash glucose monitor and some people with type 2 diabetes may also be offered flash glucose monitoring or CGM to help manage diabetes.
There is only type of flash glucose monitor currently available: the FreeStyle Libre 2 Plus. Some CGM eligibility guidance refers to flash or “intermittently scanned” CGM alongside real-time CGM, but this distinction is less relevant as technology has progressed.
In this guide you’ll find what you need to know about the eligibility criteria for CGM in England, Scotland, Wales and Northern Ireland.
These are guidelines only. Diabetes healthcare teams may have a local policy which they have to use in line with national guidelines as a minimum.
Who can get access to a CGM on the NHS?
If you think you're eligible for tech for the first time, speak to your healthcare team when you're next due to see them and ask what the guidelines mean for you.
The guidelines to CGM access on the NHS differ depending on your age, diabetes type, and where you live in the UK.
Children and young people under 18 with type 1 diabetes
Guidelines from the National Institute for Health and Care Excellence, NICE for short, say that children under 18 years old living in England or Wales should be offered a CGM.
For children under 18 and living in Scotland, national guidelines say they should be offered a CGM.
If your child is under 18 and you’re in Northern Ireland, you’ll need to check the guidance with their healthcare team.
Adults with type 1 diabetes
If you’re 18 and over, live in England, Scotland or Wales and have type 1 diabetes, you should be offered a CGM. You should also be offered CGM if you are pregnant and have type 1 diabetes.
Adults with type 2 diabetes
If you have type 2 diabetes, live in England or Wales and use insulin two or more times a day, you should be offered flash glucose monitoring to help you check your blood sugar levels, also called blood glucose levels, if any of the below apply, say NICE guidelines:
- You have recurrent or severe hypoglycaemia, also known as hypos or low blood sugar
- You have impaired hypoglycaemia awareness
- You can't monitor your own blood sugar levels but you could use a scanning device or someone else could scan for you
- You would otherwise be advised to do a finger prick test at least eight times a day.
NICE guidelines also say that real-time continuous glucose monitoring can be considered as an alternative to flash glucose monitoring for adults with insulin-treated type 2 diabetes if it is available for the same or lower cost. You can talk to your diabetes team about your options.
Adults with type 2 diabetes in England or Wales who use insulin and would otherwise need help from a care worker or healthcare professional to monitor their blood sugar should be offered flash glucose monitoring.
Guidance in Scotland from 2018 recommends flash glucose monitoring for people with type 2 diabetes on multiple daily injections (MDI) or insulin pump therapy, but there is no explicit guidance for CGM, so it’s worth asking your healthcare team about this.
CGM should be available during pregnancy if you use insulin, and should be considered during pregnancy generally.
Children and young people under 18 years old with type 2 diabetes
NICE guidelines say that children and young people with type 2 diabetes in England, Wales or Northern Ireland should be offered CGM if any of the following apply:
- They have a need, condition or disability (including a mental health need, learning disability or cognitive impairment) that means they cannot monitor their blood sugar levels by finger prick testing
- They would otherwise be advised to self-measure at least 8 times a day
- They have recurrent or severe low blood sugar levels.
CGM should also be considered as an option if they are using insulin.
And flash should also be considered as an alternative if a child and their family present a clear preference for it, or it meets their needs better than CGM.
In Scotland, there are currently no national guidelines on the use of CGM in children and young people with type 2 diabetes and you should speak to your healthcare team to find out more.
Pregnant with diabetes
If you’re pregnant, live in England or Wales and have type 1 diabetes, you should be offered a CGM.
If you’re pregnant and have type 2 diabetes or gestational diabetes you may be offered CGM if you are using insulin and have severe hypos or unstable blood sugar levels, say NICE guidelines for England and Wales.
If you live in Scotland you should be offered a CGM if you’re pregnant and have type 1 diabetes or have type 2 diabetes and are using insulin. You can also be considered for CGM if you’re pregnant and have type 2 but don’t use insulin.
There are currently no national guidelines for CGM use in pregnancy if you have gestational diabetes in Scotland.
If you’re in Northern Ireland, check the guidelines with your healthcare team.
Can people with other types of diabetes get a CGM?
There is very limited NICE guidance on tech access for other types of diabetes such as Latent Autoimmune Diabetes in Adults, know as LADA for short, or those caused by another illness or rare genetic condition. But do check with your healthcare team.
Depending on how you manage your diabetes, you may or may not qualify for a CGM. Your healthcare team are likely to apply the guidance for type 1 diabetes or type 2 diabetes based on the type of treatment you’re receiving for your blood sugar levels.
Which continuous glucose monitor can people get on the NHS?
These are some of the CGM devices available to buy or available on the NHS:
- Dexcom G7 - licensed for those aged two and over
- Dexcom One + - licensed for those aged two and over
- Dexcom G6 -licensed for those aged two and over
- FreeStyle Libre 2 Plus- licensed for those aged two and over
- FreeStyle Libre 3 Plus - licensed for those aged four and over
- Glucomenday iCan - licensed for those aged six and over.
Some CGM devices work with insulin pumps - you can ask your healthcare team for advice on which devices can connect with each other.
The CGM you might be offered will depend on many factors, such as:
- Your individual needs.
- Your frequency, awareness, severity and anxiety of hypos.
- The functionality of the CGM, such as whether a device has alerts or alarms indicating low blood sugar, and if these need to be shared with a family member or carer.
- How easy it is to use and take readings from, including for people with limited dexterity.
- Whether a CGM requires up-to-date smartphone software to work.
- Your current insulin treatment, such as whether you use injections or a pump, and how a CGM could be integrated into your treatment.
- How data can be collected, compatibility of the device with other technology, and whether data can be shared with your healthcare provider to help inform treatment.
- Whether using a CGM may affect your ability to do your job.
- How frequently the sensor needs to be replaced.
- If you have sensitivity or a skin reaction to the sensor.
- Body image concerns.
- The cost of the CGM.
If you have questions or concerns about any of these factors above, please contact your healthcare professional for more information.
If you get a CGM on the NHS, you should also get the other things you need like sensors and replacement parts.
It’s also worth knowing that sensors only work for individual products, so sensors for one CGM won’t work for another CGM.
What can I do if I’ve been denied access to a CGM on the NHS?
If you don’t qualify for tech
We know it can be frustrating if you don’t meet the criteria set out by the NHS to access your tech. But there are steps you can take to try and change this.
Firstly, you can make your case to your healthcare professional, explaining how and why using a CGM will help you to manage your condition.
Sometimes they can loan you a device for a short time to see how much difference it makes to your quality of life – or give some insights on what is affecting your blood sugars so you can make positive changes to help manage them.
If you want a second opinion on the treatment you’re getting, your healthcare team will be more than happy to ask their colleagues to see you. Or you can ask your GP for a new referral to a new team.
Individual funding requests
Sometimes local policies mean you may not get access to the technology you need.
You can ask your healthcare professional if they can help you submit a request for individual funding – an approach used to ask local decision-makers to fund technology outside of their normal policies.
Your healthcare professional should know what the process is for your part of the UK and whether this is the right approach for you.
Write to your ICB or health trust or board
If this doesn’t help, you can also write to or email your Integrated Care Board (ICB), Health Trust or Board and outline why you should be provided with the tech you want.
When making your case for any type of tech, include answers to the questions below if they’re relevant, giving as much detail as possible.
- If you’ve been self-funding your tech, what did you notice about your diabetes management before, during and after using the device?
- What are the challenges you’re currently facing with your diabetes management?
- How do you think using the tech would help you with your blood sugar levels?
- Do you test as often as you have been advised or would like to? If not, why is that?
- Do you experience regular hypos and what are the effects of this on your day-to-day life?
- How does your lifestyle make it hard to monitor your diabetes without tech?
- Do you struggle to perform finger prick tests regularly as part of your everyday routine?
- Do you work in an environment where it is difficult to perform finger prick tests regularly? Can you explain why?
- How would tech benefit you if you regularly play sport?
Find your ICB or health board
England
Integrated care boards (ICBs) replaced clinical commissioning groups (CCGs) in the NHS in England in July 2022.
You can use the ICB finder on the NHS England website, which will list your local services and their contact details.
Wales
There are seven Local Health Boards across Wales. Find out which Board covers your region on the NHS Wales website, along with more information and contact details.
Scotland
There are 14 Health Boards covering all of Scotland. Find the full list and contact details on the NHS Scotland website.
Northern Ireland
In Northern Ireland, there is a Health and Social Care Board (HSC) and five Local Commissioning Groups (LCGs). Find your local group and their contact details.
What happens to my CGM if I move area?
If you move areas and you’re registering with a different hospital, you may be under a new ICB or local health board.
ICBs and health boards are responsible for local NHS services and budgets. Each has its own guidelines on diabetes tech, so your new area might offer different tech to your previous one.
If you want to continue using the CGM you currently have, or there’s a specific model you’d like to use, you can ask your GP to refer you to a clinic where that CGM is used. You can also ask the manufacturer which hospitals their insulin pumps are used in.
If there aren’t any hospitals in your new area that offer the CGM you’d like, or there’s a lack of choice of other CGM devices, ask why this is the case.
It might be that the staff have only been trained on one type of CGM so they might be willing to get training on the model you want. It might take some time for this training to happen.
If the lack of choice is because of the ICB or health board’s policies, you might be able to submit an Individual Funding Request through your diabetes team. This is when an application for the funding will be sent to a panel for review.
Self-funding a CGM
If you don't qualify for a CGM, your main option is to self-fund.
In some circumstances, you may be able to submit an Individual Funding Request. Speak to your diabetes team for more information on this.
Whatever type of diabetes you have, if you are interested in using an CGM, talk to your healthcare team. They can help you decide if a CGM might suit you and, in some cases, offer advice on different types of CGM devices.
How much does a CGM cost?
CGM devices cost approximately £50-£150 per month, depending on the device. More information can be found on the manufacturers’ websites.
Get support from our helpline or online forum
Please give our confidential helpline a call if you’re looking for more information, advice or just someone to chat to.
Whether you’ve got specific questions about the different types of tech available, or just want to talk through your options with someone, our highly trained advisors are ready to help.
Or head over to our online forum to join hundreds of members talking about their experience with diabetes tech. You can ask questions, read conversations between existing members, or share your own knowledge and help others.
What we’re doing to help everyone get the tech they need
Everyone with diabetes should be able to get the tech they need to live well with diabetes and we won’t rest until that happens. But nearly half of those who have tried to get diabetes tech have been refused it at some point.
We know that the emotional impact of not being able to access the tech you want and need can be difficult. That’s why we want you to know we’re here for you.
Improving access to diabetes tech has the potential to impact many millions of people with diabetes.
That’s why our strategy focuses on working towards a system where both existing diabetes tech, and the new innovations that become available, are accessible to all those who could benefit from their use.
Through campaigns like Diabetes Tech Can’t Wait, we’ve called for everyone living with diabetes to have fair and equal access to the diabetes tech they’re eligible for. Find out more about our Tech Can't Wait campaign.
