Technology is now allowing some patients to reduce the frequency with which they conduct finger prick tests. Flash blood glucose monitoring uses a sensor, which needs replacing after around 14 days, sitting just under the skin. A hand-held monitor held above the sensor can upload readings uploaded via an app onto a device such as a smartphone. A reading every eight hours is recommended to give the full glycaemic picture.19

In July 2018, the Scottish Health Technologies Group endorsed the FreeStyle Libre device for use in the NHS in Scotland. The recommendation is for €individuals with diabetes who are actively engaged in the management of their diabetes and who intensively manage their condition with multiple daily insulin injections or insulin pump therapy.€

As at September 2018, the product was still being assessed by NICE, but its statement a year earlier noted the outcomes of five key studies. Three had indicated €results ranging from 84% to 88% accuracy and from 99% to 100% clinical acceptability.€ A further study €reported device accuracy and acceptability of 97% to 99% compared with venous blood sampling.€

€The evidence suggests that using FreeStyle Libre for up to 12 months reduces time spent in hypoglycaemia compared with self-monitoring of blood glucose using finger-prick tests, and reduces the average number of finger-prick blood glucose tests needed,€ said NICE.

Glucose blood testing reagents cost the NHS in England £175.7 million in 2017.22 NICE is still assessing the economics of endorsing flash glucose monitoring. €The resource impact is uncertain, and depends upon the extent to which improved glucose control through the adoption of FreeStyle Libre translates into fewer complications, reduced emergency admissions and less use of glucose test strips,€ it said.21