Cole-Hamilton challenges government over diabetes treatment lottery

Scottish Liberal Democrat leader Alex Cole-Hamilton MSP has today challenged the Scottish Government over the provision of new technology used to measure blood sugar levels for those with type 1 diabetes, after freedom of information requests revealed dramatically different levels of provision across Scotland.

Continuous glucose monitoring (CGM) gives a continuous display of blood sugar levels that can be seen straight away and used to guide treatment. This makes it easier to manage blood sugar levels and reduce the risks and complications that come with diabetes.

National Institute for Health and Care Excellence (NICE) clinical guidelines for NHS England & Wales have recommended offering CGM devices to all adults with type 1 diabetes and all children with type 1 and 2 diabetes since March 2022.  

2017 guidelines from Healthcare Improvement Scotland do not currently recommend the use of CGM, though this is currently being reviewed with an update due in 2024 (SIGN). However the Scottish Healthcare Technologies Group, which provides advice to NHS Scotland on the use of new and existing health technologies has recommended that CGM should be made available, including recommending that it should be offered to all pregnant women with type 1 diabetes (SHTG 2020). As a result, the Scottish Government have been encouraging heath boards to adopt CGM and made access to these technologies a key priority of their Diabetes Improvement Plan.  

Freedom of information requests submitted by Scottish Liberal Democrats have now revealed a postcode lottery across Scotland:

•  NHS Highland do not appear to provide CGM as of December 2022.
• NHS Shetland and NHS Western Isles appear to only offer CGM to pregnant women.
• NHS Ayrshire & Arran offer CGM in limited circumstances but have confirmed that this will be expanded in 2023.
• NHS Borders, NHS Dumfries & Galloway and NHS Forth Valley provide CGM in limited circumstances.
• NHS Greater Glasgow & Clyde indicated that all adults can access CGM, and children and young people can access CGM in some circumstances.
• NHS Tayside offer CGM to all patients.
• NHS Lothian confirmed that CGM is offered but were unable to provide information on the guidelines they use to determine who this is offered to.
• NHS Grampian, NHS Fife, NHS Lanarkshire and NHS Orkney did not respond.

Commenting, Alex Cole-Hamilton said:

“This looks like a clear-cut case of Scotland being behind the curve, especially outside of the central belt.

“These technologies have obvious benefits in terms of helping people to manage lifelong conditions, but depending on where you are in the country, it’s a lottery as to whether you will be able to benefit.

“I would urge the Health Secretary to push for updated guidance on the use of these techniques and to make sure that patients all across Scotland are able to benefit.

“At this time of immense pressure on our health service, making it easier for people to manage their conditions without the assistance of medical professionals has the potential to deliver huge benefits across the service. Scottish Liberal Democrats are determined to keep the Scottish NHS at the forefront of new technologies to tackle people’s health needs.”