ELMMB logo
Facebook logo Twitter logo
6.1.6 Diagnostic and monitoring devices for diabetes mellitus

6.1.6 Diagnostic and monitoring devices for diabetes mellitus

Blood Glucose Monitoring
A patient information leaflet on self-testing can be found here
Blood glucose monitoring using a meter gives a direct measure of the glucose concentration at the time of the test and can detect 
hypoglycaemia as well as hyperglycaemia. Patients should be properly trained in the use of blood glucose monitoring systems 
and be empowered to take appropriate action on the results obtained. Inadequate understanding of the normal fluctuations in 
blood glucose can lead to confusion and inappropriate action.
A range of meters have been evaluated and approved locally for adults with Type 2 diabetes. These meters are: 
        >        TEE 2 +
         >        Contour® Next Link
         >        Contour®  plus
         >        CareSens N Voice
To see the agreed list of approved meters and associated  functions click here 
For Type 2 diabetics that are diet controlled or on metformin alone then routine testing of blood glucose is NOT indicated. 
CLICK here to download the Guide to Blood Glucose Monitoring Patient Information Leaflet.
TEE2 + , CareSens N, Contour® Next, Contour Plus are the formulary test strips of choice in the following patient groups:
         >       Type  1 or 2 diabetics on insulin alone
         >       Type 1 or 2 diabetics on insulin + oral therapy
         >       Gestational Diabetes
         >       Those under the care of a secondary care/intermediate care specialist e.g. renal patients with low haematocrit levels     
GREEN      TEE2+
GREEN      CareSens N   
GREEN      Contour® Next , [for Type 1 & 2 Insulin patients who are recommend by a specialist to use the CONTOUR®DIABETES app]
GREEN      Contour®  Plus
Gestational Diabetes only
AMBER      WaveSense JAZZ blood glucose testing strips 
GREEN      Universal fit insulin pen needles   
                   >       Insupen
                   >       GlucoRx carepoint
                   >       GlucoRx finepoint
                   >       Omnican Fine*
                   >       BD viva™ pen needles
 *Note - Omnican needles do not have an inner cap. This is simply to promote single use of the needles and prevent patients re-capping the
 needle to use again.  The Omnican needle can be safely disposed of by screwing the plastic case back on to the needle and screwing it off the 
 insulin pen.
Accu-Check® Expert 
Accu-Check® Expert has been approved for use by paediatric patients only as it allows  greater flexibility with respect to the
incremental dosing that is often required for these patients. The choice of meter should be governed by individual need and
suitability following a discussion with a clinician. For all paediatric patients the meter and initial supply of consumables  
will be made by the specialist service.
In all instances of blood glucose monitoring a testing regimen should be agreed with the patient and must include the frequency
of testing. This should be recorded in the patient's written management plan.
FreeStyle Libre® Glucose Monitoring System  
The Policy for the Provision of Continuous Glucose Monitoring and Flash Glucose Monitoring has been updated based on National
national guidance to CCGs issued by NHS England on unifying the patient access criteria for Flash Glucose Monitoring.
FreeStyle Libre is now Amber traffic light for individuals meet the criteria set out in the policy
[Policy criteria for Freestyle Libre®] 
Specialists are responsible for initiation, training and reviews at 3 and 6 months.
GPs can continue to prescribe FreeStyle Libre to individuals that fit the policy criteria after an initial supply via the specialist.
AMBER        FreeStyle Libre® sensor
Ketone Testing 
Ketone testing is occasionally required for some patients for example pregnant women, patients with recent/frequent DKA, those
under 17 years of age.  All Type 1 diabetic patients should be offered the option to test for Ketones as part of Dose Adjustment For
Normal Eating Type 1 education programme. (DAFNE).
Patients required to self-test for ketones should be identified by the diabetes specialist service and they are responsible for making 
the initial supply of consumables and providing a meter. The service should provide the patient with structured,  meaningful 
education on the use of the device including what action to take depending on the readings obtained.  It may be necessary for primary care to repeat prescribe such strips.
The use must be carefully monitored and it is not expected that this will exceed more than one pack per year, with the exception of insulin pump patients.

In East Lancashire the Ketone testing strip of choice is Glucomen® Areo 2K Test strip which is compatible with the Glucomen® areo 2K meter (Areo 2K  brings glucose and ketone testing together in one meter).                               
GREEN          Glucomen® Areo2K
The FreeStyle Optium β Ketone test strip is another option and is compatible with either a FreeStyle Optium Neo or FreeStyle Optium meter. 
Please note that these machines are reserved for Ketone testing only. If patients are also required to self-monitor their blood glucose then the choice of meter will be the Glucomen® areo2K                              

GREEN           FreeStyle Optium β  Ketone
EU directive 2010 – to prevent sharps injury 
This directive required organisations to put  measures in place to improve safety in advance of the legislation which came into
force 11 May 2013. Such measures include assessing the risk or occurrence of sharps injuries to health care workers, reviewing
procedures and changing to safety engineered devices where practicable to do so.
Existing insulin pen needles remain exposed after insulin administration. Insulin syringes also have exposed needles after use. To
prevent sharps injury the following devices should be prescribed if the patient is having their insulin administered by a 
community nurse or other healthcare professional:
Safety Pen Needles
GREEN          GlucoRx  Safety Pen Needles - 1st line option 
GREEN         BD AutoShield™ Duo Safety Engineered / 5mm / 30G /  
                     (Pip Code 360-5615 / FTR1083)

All material in this section is aimed at health care professionals, but is information currently held in the public domain, members of the
 public seeking advice on medicine-related matters are advised to speak with their GP, pharmacist, nurse or contact NHS111 Service
  Email: info.elmmb@nhs.net
Copyright© 2016 -2020 East Lancashire Medicines Management Board  
All rights reserved.  Disclaimer/Terms and conditions