Women with type 1 diabetes who are actively planning pregnancy, pregnant, or immediately post-pregnancy
To be eligible to access subsidised products through the NDSS:
- the person is expected to benefit clinically from the use of CGM; and
- the person or family/carer has the willingness and capability to use CGM; and
- the person or family/carer has the commitment to actively participate in a diabetes management plan which incorporates CGM.
In addition, the person must meet the criteria in one of the following categories:
Category A - Pre-pregnancy
The person with type 1 diabetes is considered as actively planning pregnancy and should be having regular engagement with pre-conception care services such as an endocrinologist, diabetologist and/or specialist physician, ideally at least every 6-8 weeks and more frequently if there is sub-optimal glycaemic control. An authorised health professional may certify eligibility for an initial 6-month period on the basis of the person seeking active pre-pregnancy care and committing to regular engagement with the pre-conception care service provider.
If at the end of the initial 6-month period the pre-conception care is continuing, an authorised health professional may certify eligibility for a further 6-month period. A maximum of two, 6-month access periods (up to a maximum period of 12 months) may be authorised.
There may be exceptional circumstances for an extension of this timeframe that will be considered on a case-by-case basis, noting these will be:
- considered by an appropriately constituted expert panel established by Diabetes Australia that will provide a recommendation to the Department of Health; and
- the Department of Health will be the deciding body for all of these cases.
Any extension to the pre-pregnancy period will be considered on a case-by-case basis and require documented evidence of exceptional circumstances – such as that the person has been referred to fertility services for assessment.
Category B – Pregnant/Post-Pregnancy
The person with type 1 diabetes has a confirmed pregnancy and is regularly engaging with a health professional such as an endocrinologist, diabetologist and/or specialist physician. An authorised health professional may certify eligibility that will continue until 3 months after the expected date of birth of the baby.
Category A: Pre-pregnancy
Up to 12 months (initial period of 6 months with a subsequent period of an additional 6 months on confirmation that pre-pregnancy care is continuing)
Category B: Pregnancy/Post-pregnancy
From when the pregnancy is confirmed, until 3 months after the expected date of birth of the baby
In the event of a pregnancy loss, the currently approved period of CGM access will continue unchanged. In this event, the person may reapply for pre-pregnancy status at any time.
At least 1 month prior to the completion of either the ‘pre-pregnancy’ or ‘post–pregnancy’ periods, the person will receive a notification via SMS or email, advising them that their access period is ending soon and that they should consult their authorised health professional in relation to future access, or transitioning to alternative arrangements for finger prick blood glucose checks.
For more information read the CGM FAQs.
Find the CGM eligibility assessment form for Type 1 diabetes; Pregnancy Planning, Pregnancy or Immediately Post Pregnancy here.