Dexcom one

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steveo

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Relationship to Diabetes
Type 1
Hi All

I've not posted for a while but am due to change pump from an insight to a t slim shortly but have been told by my CCG I'm not entitled to the Dexcom as I'm using the libre 2 sensors. I thought I would be entitled because without the Dexcom I'm not using the pump to it's full capability.
 
steveo said:
I thought I would be entitled because without the Dexcom I'm not using the pump to it's full capability.
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I don't think that's ever been a rule. Lots of people with pumps seem to self fund the corresponding sensors!

However, the guidelines for CGMs have changed and (slightly to my surprise) it seems to me that at least Partha Kar is serious in expecting that CGMs (like Dexcom G6) ought to be as easily available as Libre 2. (You wouldn't get both at the same time, of course, but if Dexcom made more sense for you then my impression is that he thinks you ought to challenge any refusal to offer it.)

https://twitter.com/x/status/1548968348905619456
 
Do you meet the Nice criteria for a dexcom? That is the critical issue. If you do, then I agree you would have a strong case for requesting switch to G6
 
Saoirse said:
Do you meet the Nice criteria for a dexcom? That is the critical issue. If you do, then I agree you would have a strong case for requesting switch to G6
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What is the criteria?
 
Pumper_Sue said:
What is the criteria?
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As with so many things, this information is easily available with a quick internet search:

News item:

https://www.diabetes.org.uk/about_us/news/nice-guidelines-recommend-wider-use-for-flash-and-cgm for news article
and full guidance is here:

Overview | Type 1 diabetes in adults: diagnosis and management | Guidance | NICE

www.nice.org.uk www.nice.org.uk

"Continuous glucose monitoring​

NICE's diagnostics guidance on integrated sensor-augmented pump therapy systems for managing blood glucose levels in type 1 diabetes is being updated. The guidance is being updated as a multiple technology appraisal and will assess hybrid closed loop systems.

1.6.10Offer adults with type 1 diabetes a choice of real-time continuous glucose monitoring (rtCGM) or intermittently scanned continuous glucose monitoring (isCGM, commonly referred to as 'flash'), based on their individual preferences, needs, characteristics, and the functionality of the devices available. See box 1 for examples of factors to consider as part of this discussion. [2022]
1.6.11When choosing a continuous glucose monitoring (CGM) device:
  • use shared decision making to identify the person's needs and preferences, and offer them an appropriate device
  • if multiple devices meet their needs and preferences, offer the device with the lowest cost. [2022]"
there follows a box illustrating the factors that should be considered.

@Bruce Stephens If you read through the twitter thread you have quoted, you will see that in the replies the Professor himself mentions 'the q is the reason for the cgm'. I may indeed be wrong, and happy to be corrected if so. The good Professor is on a much-deserved holiday, perhaps you or the OP can write to him on his return, and report back.
 
OP, as a supplement, I notice in your thread title, you specifically mention dexcom one. Just to note, this is not on prescription in the UK yet, but will be soon (as opposed to the Dex G6, which has been prescribable for a while)
 
Saoirse said:
@Bruce Stephens If you read through the twitter thread you have quoted, you will see that in the replies the Professor himself mentions 'the q is the reason for the cgm'.
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Yes indeed, and having a pump which can use a particular sensor seems like an excellent reason for wanting that kind of sensor. (And yes, NICE is evaluating closed loops separately but I don't think that's a reason for denying a sensor for an existing pump user.)
 
Bruce Stephens said:
Yes indeed, and having a pump which can use a particular sensor seems like an excellent reason for wanting that kind of sensor. (And yes, NICE is evaluating closed loops separately but I don't think that's a reason for denying a sensor for an existing pump user.)
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All I can do is humbly suggest that anyone about to discuss this with their clinic reads the guidance.
 
Saoirse said:
All I can do is humbly suggest that anyone about to discuss this with their clinic reads the guidance.
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Of course, yes.

And when you're rejected (and when he's back from vacation) ask Partha Kar what he thinks. (Because I'm still not entirely sure. I assumed the intent was that (for adults) isCGM would be easy to get and you might need to fight a bit to get rtCGM because of extra cost. But his recent tweets strongly suggest I was wrong and that there isn't such a cost difference so rtCGM ought to be available to more people than I expected.)
 
My understanding is the Dexcom One is/will be a lower cost CGM to compete with the Libre.
It has some functionality removed compared to the G6 such as, I thought, the API.
Therefore, I don't think it will be appropriate to use with the t-slim.

I may be wrong with this and would be happy to be corrected but I recommend confirming either way before kicking up a fuss about getting the Dexcom One and then finding out it does not satisfy your requirements.
 
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