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NICE gives initial backing to HbA1c monitoring device

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An integrated automatic glucose monitoring system for patients with type 1 diabetes has been recommended in draft guidance issued by the National Institute for Health and Care Excellence.

NICE has today published draft diagnostics guidance recommending the MiniMed Paradigm Veo System (Medtronic) for monitoring blood glucose levels in some people with type 1 diabetes.

“The system could also offer benefits to the NHS through cost and resource savings by reducing the number of hospital admissions”

Carole Longson

The draft guidance recommends the system as an option for people who experience frequent episodes of hypoglycaemia, despite optimal management with insulin pump therapy.

NICE noted that it was thought that around 30% of people with type 1diabetes have problematic hypoglycaemia, which can affect many aspects of daily life and result in significant anxiety.

The MiniMed Paradigm Veo system consists of a glucose sensor placed under the skin that continuously measures glucose levels, an insulin pump which delivers insulin continuously, and a transmitter that sends glucose level readings wirelessly from the sensor to the pump.

The system alerts the user if glucose levels become too high or low, if levels are rapidly changing, or if the system predicts levels will be too high or too low in the near future.

The automated low glucose suspend function of the system operates independently of user action and stops insulin delivery for two hours if the user fails to respond to the alert.

Professor Carole Longson, director of the NICE Health Technology Evaluation Centre, said: “Using the MiniMed Paradigm Veo System may help people with type 1 diabetes improve their glucose control and consequently may reduce the number of diabetes-related complications and improve their quality of life.

“The ability of the MiniMed Paradigm Veo system to automatically suspend insulin delivery when it predicts the person’s glucose levels will become too low could help in reducing the incidence of hypoglycaemia that happens during sleep and its associated anxiety,” she said.

National Institute for Health and Care Excellence

MiniMed Paradigm Veo system

She added: “The system could also offer benefits to the NHS through cost and resource savings by reducing the number of hospital admissions and consultations associated with diabetes-related complications.”

Another integrated automatic glucose monitoring system, but that does not have the low glucose suspect function, was also considered as part of evaluation by NICE.

However, the draft guidance did not recommend the Vibe and G4 PLATINUM CGM system because of insufficient evidence to demonstrate its clinical effectiveness in practice.

The draft diagnostics guidance on integrated sensor-augmented pump therapy systems for managing blood glucose levels is available on the NICE website.

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