Freestyle Libre 2 Plus Sensor — Point32Health

Initial criteria

• Patient has insulin dependent type 1 or type 2 diabetes mellitus or gestational diabetes AND
• Patient age ≥ 2 years AND
• Patient is insulin dependent with either insulin pump therapy OR 3 or more injections per day OR a long-acting basal insulin AND
• For patients with type 2 diabetes mellitus, patient has inadequately controlled blood glucose as evidenced by one of the following: recurrent unexplained severe hypoglycemia (blood glucose < 50 mg/dl) OR poorly controlled diabetes endangering fetal health OR HbA1c > 7% on a test taken in the past four months