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How CGM Could Save the NHS Billions
Ensuring that people living with diabetes are healthy and that they have an excellent quality of life is beneficial for everyone. When more people are in good health, it lightens the load on medical care workers and reduces the cost of providing healthcare overall so resources can go towards medical advancements and improving access to care for everyone. Investing in better diabetes prevention and management, such as continuous glucose monitoring (CGM), improves the lives of those who live with the condition—and it may save the NHS billions of pounds.1,2
What Reducing NHS Costs Means for Healthcare
In the UK, the National Health Service (NHS) works to deliver exceptional care and positive health outcomes for patients and communities. The NHS provides critical medical services through taxpayer’s funds, ranging from hospital stays to regular doctor’s visits.
Reducing costs to the NHS isn’t about cutting funding to the services that support people living with diabetes. In many cases, it’s about finding ways to reduce the need for its services through improving people’s health. For the most part, individuals who can effectively manage diabetes are less likely to require the services the NHS covers, particularly emergency care and treatments for preventable complications, such as diabetic retinopathy and diabetic ketoacidosis. This means it’s in everyone’s best interest to invest in programmes and technology that help support health and well-being.3
These types of programmes and technologies do cost the NHS money, but when it comes to diabetes, prevention and effective health management may be more cost-effective than treating emergencies and complications down the road.1 This preventative approach may also help reduce the burden on medical care workers as the population grows and possibly provide high-quality care to every individual.
The Cost of Diabetes to the NHS
About 10 per cent of the yearly NHS budget is used for diabetes treatment, which is around £10 billion.2,4 Most of that budget is spent on treating preventable diabetes complications.2,4 People living with type 2 diabetes (T2D) are more likely to need treatment for complications, while those living with type 1 diabetes (T1D) are more likely to require support from diabetes specialists, both of which represent significant costs for the NHS.1 Hospital care for diabetes-related incidents costs the NHS about £3 billion per year, and emergency hospital visits account for just under half of this cost.1
The NHS is already invested in finding ways to reduce the cost of diabetes treatment. This includes initiatives such as the NHS Diabetes Prevention Programme (NHS DPP) to reduce prediabetes and T2D in England, which successfully lowered the number of new diagnoses of T2D by 7 per cent between 2018 and 2019.5 Diabetes technology like Dexcom CGM Systems is yet another tool that can help the NHS make supporting those living with diabetes more effective and economical.
How CGM Enhances Healthcare Across the UK
Reducing the cost of treating diabetes is really about improving the lives of people living with diabetes and ensuring the healthcare system can take care of everyone. Just a few of the impacts continuous glucose monitoring (CGM) can have on individuals and, in turn, the healthcare system in the UK include:
1. CGM can reduce the need for emergency care
Experiencing severe hypoglycaemia can be scary, especially if you need to call an ambulance and stay overnight in the hospital to recover. CGM helps people living with diabetes spend more time in their target glucose range, making it less likely that they will experience extreme lows in the first place.6,7 Dexcom ONE+ enables you to create custom alerts that let you know when your glucose is above or below your target range. Dexcom G6 and Dexcom G7 Systems provide a predictive Urgent Low Soon alert and Low Glucose alarm (≤3.1 mmol/L), which have been shown to reduce the amount of time spent in hypoglycaemia.8-10 Consequently, fewer critical hypos lower the cost of emergency care for the NHS and free up hospital beds for other people who need urgent treatment.
2. CGM can help improve glucose control and reduce the risk of diabetes complications
High blood glucose can lead to diabetes complications such as nerve damage in the feet, vision loss, and cardiovascular issues like heart attacks and strokes.11 CGM enables you to make more informed decisions about glucose management throughout the day, helping to reduce hyperglycaemia, or high glucose levels, and increase the time spent in your target glucose range.6,7 Spending more time in range (TIR) is associated with a lower HbA1C, which is correlated with a reduced risk of diabetes complications.12,13 A lower rate of diabetes complications means a significant reduction in treatment costs for the NHS.
3. CGM empowers self-management and can simplify doctor visits
CGM allows people to get a better view of what causes highs and lows so they can improve the self-care decisions they make every day. Additionally, Dexcom CGM Systems integrate with Dexcom Clarity, an app that allows individuals to see glucose trends over days, weeks, and months, and share that data with their healthcare professional (HCP).* Using the notifications in Dexcom Clarity to inform self-management is associated with an increase in TIR.14 With a comprehensive view of glucose patterns over time, HCPs can create more personalised treatment plans that lead to better outcomes—potentially reducing the frequency of doctors’ appointments.
4. CGM can support overall well-being and enhance quality-of-life
Many people who live with diabetes experience diabetes distress, which is the term for the mental health challenges that come up due to feeling overwhelmed by the responsibility of dealing with the condition. CGM can help you feel more confident and in control of diabetes, which helps reduce diabetes distress. It can also give you a little extra peace of mind around low glucose, known as hypoglycaemia, and make glucose monitoring at night a bit easier so you can get the rest you need.15-18 These benefits can play a role in helping people living with diabetes look after their emotional and mental well-being, which means they may be less likely to need mental health services covered by the NHS.
Can I get Dexcom CGM on the NHS?
The National Institute for Health and Care Excellence (NICE) guidelines recommend CGM for children, young people and adults living with T1D as well as adults with insulin-treated type 2 diabetes.19-21 For the first time, new guidance from NICE recommends the use of continuous glucose monitoring (CGM) or intermittently scanned glucose monitoring (isCGM) devices for some children living with type 2 diabetes who are currently using finger prick testing and insulin therapy.22 NICE also recommends CGM for managing diabetes during pregnancy.23
You can get Dexcom ONE+ on prescription from the NHS at your local pharmacy or hospital clinic if you meet the criteria set by your healthcare provider
Endnotes
* An internet connection is required to send data to Dexcom Clarity.
1 Stedman M, et al. Cost of hospital treatment of type 1 diabetes (T1DM) and type 2 diabetes (T2DM) compared to the non-diabetes population: a detailed economic evaluation. BMJ Open. 2020;10(5):e033231.
2 NHS Diabetes Prevention Programme (NHS DPP). NHS England. Accessed July 2023. https://www.england.nhs.uk/diabetes/diabetes-prevention/
3 O'Donnell MT, et al. Delivering value-based healthcare for people with diabetes in a national publicly funded health service: Lessons from Ireland and Wales. J Diabetes Investig. 2023;14(8):925-929.
4 Diabetes UK. Diabetes is Serious: Recovering diabetes care: preventing the mounting crisis. 2022:10. https://diabetes-resources-production.s3.eu-west-1.amazonaws.com/resources-s3/public/2022-04/Diabetes%20is%20Serious%20Report%20Digital_0.pdf.
5 NHS Prevention Programme cuts chances of Type 2 diabetes for thousands. NHS England. Updated March 2022. Accessed September 2023. https://www.england.nhs.uk/2022/03/nhs-prevention-programme-cuts-chances-of-type-2-diabetes-for-thousands/.
6 Beck RW, et al. Effect of continuous glucose monitoring on glycemic control in adults with type 1 diabetes using insulin injections: The DIAMOND T1 RCT DIAMOND randomized clinical trial. JAMA. 2017;317(4):371-378.
7 Welsh JB, et al. Comparisons Of Fifth-, Sixth-, And Seventh-Generation Continuous Glucose Monitoring Systems. J Diabetes Sci Technol. 2022:19322968221099879.
8 Acciaroli G, et al. Mitigation of Rebound Hyperglycemia With Real-Time Continuous Glucose Monitoring Data and Predictive Alerts. J Diabetes Sci Technol. 2022;16(3):677-682.
9 Puhr S, et al. Real-World Hypoglycemia Avoidance With a Predictive Low Glucose Alert Does Not Depend on Frequent Screen Views. J Diabetes Sci Technol. 2020;14(1):83-86.
10 Heinemann L, et al. Real-time continuous glucose monitoring in adults with type 1 diabetes and impaired hypoglycaemia awareness or severe hypoglycaemia treated with multiple daily insulin injections (HypoDE): a multicentre, randomised controlled trial. Lancet. 2018;391(10128):1367-1377.
11 Complications of diabetes. Diabetes UK. Accessed July 2023. https://www.diabetes.org.uk/guide-to-diabetes/complications.
12 Vigersky RA, et al. The Relationship of Hemoglobin A1C to Time-in-Range in Patients with Diabetes. Diabetes Technology & Therapeutics. 2019;21(2):81-85.
13 Diabetes Control and Complications Trial (DCCT): results of feasibility study. The DCCT Research Group. Diabetes Care. 1987;10(1):1-19.
14 Akturk HK, et al. Real-World Evidence and Glycemic Improvement Using Dexcom G6 Features. Diabetes Technol Ther. 2021;23(1):21-26.
15 Polonsky WH, Fortmann AL. Impact of Real-Time CGM Data Sharing on Quality of Life in the Caregivers of Adults and Children With Type 1 Diabetes. J Diabetes Sci Technol. 2022;16(1):97-105.
16 Polonsky WH, et al. The impact of continuous glucose monitoring on markers of quality of life in adults with type 1 diabetes: Further findings from the DIAMOND randomized clinical trial. Diabetes Care. 2017;40(6):736-741.
17 Gilbert TR, et al. Change in hemoglobin A1c and quality of life with real-time continuous glucose monitoring use by people with insulin-treated diabetes in the Landmark study. Diabetes Technol Ther. 2021;23(S1):S35-S39.
18 Visser MM, et al. Effect of switching from intermittently scanned to real-time continuous glucose monitoring in adults with type 1 diabetes: 24-month results from the randomised ALERTT1 trial. Lancet Diabetes Endocrinol. 2023;11:96–108.
19 Diabetes (type 1 and type 2) in children and young people: diagnosis and management: Recommendations. NICE guideline [NG18]. Updated May 2023. Accessed July 2023. https://www.nice.org.uk/guidance/ng18/chapter/Recommendations
20 Type 1 diabetes in adults: diagnosis and management: Recommendations. NICE guideline [NG17]. Updated August 2022. Accessed July 2023. https://www.nice.org.uk/guidance/ng17/chapter/Recommendations
21 Type 2 diabetes in adults: management: Recommendations. NICE guideline [NG28]. Updated June 2022. Accessed July 2023. https://www.nice.org.uk/guidance/ng28/chapter/Recommendations
22 Hundreds of children with type 2 diabetes to be offered choice of two life changing technologies. NICE. Updated May 2023. Accessed July 2023. https://www.nice.org.uk/news/article/hundreds-of-children-with-type-2-diabetes-to-be-offered-choice-of-two-life-changing-technologies
23 Diabetes in pregnancy: management from preconception to the postnatal period: Recommendations. NICE guideline [NG3]. Updated December 2020. Accessed July 2023. https://www.nice.org.uk/guidance/ng3/chapter/Recommendations
1 Stedman M, et al. Cost of hospital treatment of type 1 diabetes (T1DM) and type 2 diabetes (T2DM) compared to the non-diabetes population: a detailed economic evaluation. BMJ Open. 2020;10(5):e033231.
2 NHS Diabetes Prevention Programme (NHS DPP). NHS England. Accessed July 2023. https://www.england.nhs.uk/diabetes/diabetes-prevention/
3 O'Donnell MT, et al. Delivering value-based healthcare for people with diabetes in a national publicly funded health service: Lessons from Ireland and Wales. J Diabetes Investig. 2023;14(8):925-929.
4 Diabetes UK. Diabetes is Serious: Recovering diabetes care: preventing the mounting crisis. 2022:10. https://diabetes-resources-production.s3.eu-west-1.amazonaws.com/resources-s3/public/2022-04/Diabetes%20is%20Serious%20Report%20Digital_0.pdf.
5 NHS Prevention Programme cuts chances of Type 2 diabetes for thousands. NHS England. Updated March 2022. Accessed September 2023. https://www.england.nhs.uk/2022/03/nhs-prevention-programme-cuts-chances-of-type-2-diabetes-for-thousands/.
6 Beck RW, et al. Effect of continuous glucose monitoring on glycemic control in adults with type 1 diabetes using insulin injections: The DIAMOND T1 RCT DIAMOND randomized clinical trial. JAMA. 2017;317(4):371-378.
7 Welsh JB, et al. Comparisons Of Fifth-, Sixth-, And Seventh-Generation Continuous Glucose Monitoring Systems. J Diabetes Sci Technol. 2022:19322968221099879.
8 Acciaroli G, et al. Mitigation of Rebound Hyperglycemia With Real-Time Continuous Glucose Monitoring Data and Predictive Alerts. J Diabetes Sci Technol. 2022;16(3):677-682.
9 Puhr S, et al. Real-World Hypoglycemia Avoidance With a Predictive Low Glucose Alert Does Not Depend on Frequent Screen Views. J Diabetes Sci Technol. 2020;14(1):83-86.
10 Heinemann L, et al. Real-time continuous glucose monitoring in adults with type 1 diabetes and impaired hypoglycaemia awareness or severe hypoglycaemia treated with multiple daily insulin injections (HypoDE): a multicentre, randomised controlled trial. Lancet. 2018;391(10128):1367-1377.
11 Complications of diabetes. Diabetes UK. Accessed July 2023. https://www.diabetes.org.uk/guide-to-diabetes/complications.
12 Vigersky RA, et al. The Relationship of Hemoglobin A1C to Time-in-Range in Patients with Diabetes. Diabetes Technology & Therapeutics. 2019;21(2):81-85.
13 Diabetes Control and Complications Trial (DCCT): results of feasibility study. The DCCT Research Group. Diabetes Care. 1987;10(1):1-19.
14 Akturk HK, et al. Real-World Evidence and Glycemic Improvement Using Dexcom G6 Features. Diabetes Technol Ther. 2021;23(1):21-26.
15 Polonsky WH, Fortmann AL. Impact of Real-Time CGM Data Sharing on Quality of Life in the Caregivers of Adults and Children With Type 1 Diabetes. J Diabetes Sci Technol. 2022;16(1):97-105.
16 Polonsky WH, et al. The impact of continuous glucose monitoring on markers of quality of life in adults with type 1 diabetes: Further findings from the DIAMOND randomized clinical trial. Diabetes Care. 2017;40(6):736-741.
17 Gilbert TR, et al. Change in hemoglobin A1c and quality of life with real-time continuous glucose monitoring use by people with insulin-treated diabetes in the Landmark study. Diabetes Technol Ther. 2021;23(S1):S35-S39.
18 Visser MM, et al. Effect of switching from intermittently scanned to real-time continuous glucose monitoring in adults with type 1 diabetes: 24-month results from the randomised ALERTT1 trial. Lancet Diabetes Endocrinol. 2023;11:96–108.
19 Diabetes (type 1 and type 2) in children and young people: diagnosis and management: Recommendations. NICE guideline [NG18]. Updated May 2023. Accessed July 2023. https://www.nice.org.uk/guidance/ng18/chapter/Recommendations
20 Type 1 diabetes in adults: diagnosis and management: Recommendations. NICE guideline [NG17]. Updated August 2022. Accessed July 2023. https://www.nice.org.uk/guidance/ng17/chapter/Recommendations
21 Type 2 diabetes in adults: management: Recommendations. NICE guideline [NG28]. Updated June 2022. Accessed July 2023. https://www.nice.org.uk/guidance/ng28/chapter/Recommendations
22 Hundreds of children with type 2 diabetes to be offered choice of two life changing technologies. NICE. Updated May 2023. Accessed July 2023. https://www.nice.org.uk/news/article/hundreds-of-children-with-type-2-diabetes-to-be-offered-choice-of-two-life-changing-technologies
23 Diabetes in pregnancy: management from preconception to the postnatal period: Recommendations. NICE guideline [NG3]. Updated December 2020. Accessed July 2023. https://www.nice.org.uk/guidance/ng3/chapter/Recommendations
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