If you live in England, Wales, or Scotland, see the latest guidelines on whether you — or someone you’re supporting— should be eligible for a flash glucose monitor (Freestyle Libre), continuous glucose monitor (CGM) or insulin pump to help manage diabetes.
If you live in Northern Ireland, you may need to check with your healthcare team, as some national guidelines will apply there and others will not.
These are guidelines only, it’s worth saying. Diabetes healthcare teams may have a local policy which they have to use in line with national guidelines as a minimum.
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. If you are using a flash glucose monitor and may now be eligible for a CGM, you may have to keep using the old one for a set time before being moved over.
In November 2023, NICE recommended that over the next five years hundreds of thousands of people living with type 1 diabetes should be offered hybrid closed-loop systems. Read the full update here.
Children and young people under 18 with type 1 diabetes
CGM and flash glucose monitor (Freestyle Libre)
If your child is under 18 and you’re in England or Wales, they should be offered a continuous glucose monitor (CGM) say NICE guidelines.
If your child is under 18 and you live in Scotland, national guidelines say they should be offered a flash glucose monitor (Freestyle Libre). National guidelines do not recommend CGM, but it may still be worth asking your child’s healthcare team if you think it could benefit them, as it is sometimes prescribed on the NHS.
If your child is under 18 and you’re in Northern Ireland, you’ll need to check the guidance with their healthcare team.
Insulin pump
If your child is under 12, and you live in England or Wales, a pump may be recommended if multiple daily insulin injections aren’t practical or appropriate, say NICE guidelines.
If your child is over 12 and you’re in England or Wales, they should be offered a pump if they meet one of the following, say NICE guidelines:
- They can’t get to their target HbA1c without severe hypos
- Their HbA1c remains high despite carefully trying to manage their diabetes.
For children in Scotland, national guidelines say the same criteria for insulin pumps above should apply. Guidelines also say that people who require very small doses of insulin (often babies or very young children) should be considered for insulin pump access.
For children in Northern Ireland, check the rules on insulin pumps for your child with your healthcare team
Adults with type 1 diabetes
CGM and flash glucose monitor (Freestyle Libre)
If you’re 18 and over, live in England or Wales and have type 1 diabetes, you should be able to choose between a CGM or flash glucose monitor (Freestyle Libre) say NICE guidelines. You should be offered CGM if you are pregnant and have type 1 diabetes.
If you’re in Scotland, national guidelines recommend that you should be offered a flash glucose monitor (Freestyle Libre) if you have type 1 diabetes. National guidelines do not currently recommend CGM, except during pregnancy.
We’re working to expand this eligibility criteria in the next update to the guidelines planned for 2024. And it’s still worth asking your healthcare team about CGM if you think it could benefit you, as it is sometimes prescribed on the NHS.
Insulin pump
If you’re 18 or over and have type 1 diabetes and live in England or Wales, you should be offered an insulin pump if one of the following applies say NICE guidelines:
- You can’t get to your target HbA1c without severe hypos
- Your HbA1c remains high despite carefully trying to manage your diabetes.
If you live in Scotland and have type 1 diabetes, national guidelines recommend the criteria listed above should also be used to determine if you can access a pump.
If you live in Northern Ireland, check the guidance with your healthcare team.
Adult with type 2 diabetes
CGM and flash glucose monitor (Freestyle Libre)
If you have type 2 diabetes, live in England or Wales and use insulin two or more times a day, you should be offered a flash glucose monitor (Freestyle Libre) to help you check your blood sugar levels if any of the below apply, say NICE guidelines.
- You have recurrent or severe hypoglycaemia
- 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 should otherwise be advised to do a finger prick test at least eight times a day.
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 a flash glucose monitor.
If you have a learning disability and use insulin, you should be offered a flash glucose monitor (Freestyle Libre) say NICE guidelines for England and Wales. The guidelines also say that CGM can be considered as an alternative to flash glucose monitoring to all those eligible if it is available for the same or lower cost.
In Scotland, national guidelines recommend that people who manage their diabetes (including type 2 diabetes) with multiple daily injections or insulin pump therapy should have access to flash glucose monitoring. CGM is not currently recommended, except during pregnancy.
Children and young people under 18 years old with type 2 diabetes
CGM and flash glucose monitor (Freestyle Libre)
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 glucose 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.
Flash should also be prescribed 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 and flash 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. A CGM should be offered rather than a flash glucose monitor as evidence shows CGM can be particularly beneficial during pregnancy, and flash should only be considered if you can’t use CGM or have a clear preference for it.
If you’re pregnant and have type 2 diabetes or gestational diabetes you may be offered CGM if you have severe hypos. This is regardless of your hypo awareness, or if you have unstable blood sugar, say NICE guidelines for England and Wales.
If you live in Scotland you should be considered for CGM if you’re pregnant and have type 1 or type 2 diabetes. 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.
Adults with other types of diabetes
There is very limited NICE guidance on tech access for other types of diabetes such as LADA 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. Your healthcare team are likely to apply the guidance for type 1 or type 2 diabetes based on the type of treatment you’re receiving for your blood sugar levels.
We would suggest that if you manage your diabetes with two or more insulin injections, you should be given access to a flash glucose monitor (Freestyle Libre) or CGM.
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 flash glucose monitor, CGM or insulin pump 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.
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 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 control?
- 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?
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 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.
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 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 really 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.
Our Diabetes Tech Can’t Wait campaign is calling for everyone living with diabetes to have fair and equal access to the diabetes tech they’re eligible for. Find out more.
