Type 1 diabetes: pregnancy planning/pregnancy/post-pregnancy

Women with type 1 diabetes who are actively planning pregnancy, pregnant, or immediately post-pregnancy

To be eligible to access fully subsidised continuous glucose monitoring (CGM) and flash glucose monitoring (Flash GM) products through the NDSS:

• the person is expected to benefit clinically from the use of CGM or Flash GM; and
• the person or family/carer has the willingness and capability to use CGM or Flash GM; and
• the person or family/carer has the commitment to actively participate in a diabetes management plan which incorporates CGM or Flash GM.

In addition, the person must meet the criteria in one of the following categories:

Part A – Pregnancy Planning

The woman 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. A health professional authorised to assess and certify eligibility to access CGM or Flash GM products 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 in total) may be authorised.

Part B – Pregnant or Immediately Post Pregnancy

The woman 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.

Eligibility period

Part A: Pregnancy planning

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).

When a woman with type 1 diabetes no longer meets the eligibility criteria for pregnancy planning they should consult their diabetes health professional to discuss eligibility to continue to access subsidised CGM or Flash GM products through the NDSS.

Part B: Pregnant or Immediately Post Pregnancy

From when the pregnancy is confirmed, until 3 months after the expected or actual date of birth of the baby.

In the event of a pregnancy loss, the currently approved period of CGM and Flash GM access will continue unchanged. In this event, the person may reapply for pregnancy planning status at any time.

When a woman with type 1 diabetes no longer meets the eligibility criteria for pregnancy or immediately post-pregnancy they can continue to access fully subsidised products if they have valid concessional status. If they do not have valid concessional status, they will commence paying a co-payment.

At least 1 month prior to the completion of either the ‘pregnancy planning’ or ‘post–pregnancy’ periods, the person will receive a notification from the NDSS, advising them that their access to fully-subsidised products is ending soon and guidance for ongoing access to subsidised products through the NDSS, including if they should consult their authorised health professional in relation to future access.

Find the Continuous and Flash Glucose Monitoring Access form for type 1 diabetes; pregnancy planning, pregnancy or immediately post pregnancy.

Health professionals authorised to certify eligibility

Health professionals authorised to assess eligibility and certify (sign) Continuous and Flash Glucose Monitoring Access forms must be actively involved in the management and care of women with type 1 diabetes during pregnancy planning, pregnancy and immediately post pregnancy. These authorised health professionals are registered or credentialled to practice as a:

• diabetologist/endocrinologist
• nurse practitioner
• credentialled diabetes educator.

General practitioners, physicians and practice nurses are not authorised to certify Continuous and Flash Glucose Monitoring forms for women with type 1 diabetes during pregnancy planning, pregnancy and immediately post pregnancy.

After an initial 12 months eligibility for pregnancy planning—a form is required for an extension of access

Sometimes pregnancy planning may need to continue after the initial 12 months. You should see your diabetes and pregnancy health professionals as soon as possible if active pregnancy planning is continuing.

To learn more about an extension to access to CGM and Flash GM products, please contact the NDSS Helpline on 1800 637 700.