Reduce sugar: diabetics are not given medical products due to a regulatory gap
Glucose monitoring sensors are not issued to patients due to a gap in regulations. The need for constant monitoring of sugar levels is contained in clinical guidelines and standards for the treatment of diabetes, but such devices are not on the list of prescription medical devices for providing social services, which was the reason for the refusal to issue them. This is reported by the All-Russian Organization of Parents of Disabled Children in its letter to the Ministry of Health and deputies of the State Duma. Izvestia investigated what the problem was for diabetic patients.
Review the list
The All-Russian Organization of Parents of Disabled Children (VORDI) drew the attention of deputies and the Russian Ministry of Health to a contradiction in regulations: clinical guidelines for the treatment of diabetes prescribe the need to use glucose monitoring systems, a device that continuously monitors its level. However, there is no such device in the list of medical devices dispensed by prescription when providing a set of social services.
In mid-November 2025, Izvestia reported that in at least eight Russian regions, patients complain about the inability to get sensors for continuous glucose monitoring for free.
"Due to their absence from the list of medical devices dispensed as part of a set of social services, doctors do not prescribe them to patients, which is why a critical situation has developed," the ministry told Izvestia.
The list was last reviewed in 2018. The rules for its formation are regulated by a Government decree dated September 22, 2014.
— The absence of medical devices for research in the list of medical devices necessary for the treatment of the disease, provided for by the standard of treatment and clinical recommendations, leads to massive refusals to prescribe them and issue preferential prescriptions for medical devices, — Deputy Natalia Kostenko confirms in her appeal to the Ministry of Health (Izvestia has it).
The current situation leads to a violation of patients' rights to receive medical services and to carry out treatment of a serious socially significant disease in full. Thus, the financial burden falls on patients and their families, which is unbearable for many and forces them to seek judicial protection, the deputy noted.
Adding glucose monitoring systems to the list will have a long-term positive effect, will save thousands of lives and prevent the disability of tens of thousands of Russians, Natalia Kostenko is sure.
— Russia is a welfare state whose policy is aimed at creating conditions that ensure a decent life and free human development. This fundamental norm, enshrined in the Constitution, obliges the state to support people with disabilities and those suffering from socially significant diseases, including diabetes mellitus," the parliamentarian emphasizes.
VORDI and other public organizations have repeatedly sent proposals to the Ministry of Health to include medical devices for patients with diabetes in the list in order to bring it in line with clinical recommendations and treatment standards.
On December 16, 2025, immediately after sending Izvestia's request and a letter from the patient organization to the Russian Ministry of Health, a message was posted on the agency's website stating that in 2024 applications for the inclusion of glucose monitoring systems in the list were rejected, since its formation "is carried out taking into account the amount of budget allocations provided in the federal budget for financial support for the provision of state social assistance".
"The inclusion of the systems in the list will lead to additional costs," says the rationale for the decision of the commission of the Ministry of Health.
The ministry confirmed receipt of the requests to Izvestia and noted that the standard of medical care provides for the provision of medical services, but not providing the patient with a medical device. The ministry also recalled that standards of medical care are developed on the basis of clinical recommendations.
"In accordance with the clinical recommendations, "Type 1 diabetes mellitus in adults" and "Type 1 diabetes mellitus in children", the continuous glucose monitoring system is used as an addition to traditional self—monitoring and does not completely replace it," the Ministry of Health emphasized.
What the patients said
In Moscow, a young man with severe diabetes mellitus was denied continuous glucose monitoring systems due to their absence from the list of prescription medical devices for providing a range of social services. This response was received by his mother Anna from the health department of the capital (Izvestia has it).
The agency recalled that currently, at the expense of the federal budget, the provision of medical devices for monitoring glucose levels is provided for children under 18 years of age and for pregnant women. Provision for adults is carried out at the expense of the subject's budget at its discretion.
The Moscow Department of Health also noted that according to clinical guidelines, diabetics are recommended to use glucose meters for self-monitoring of blood glucose levels, and continuous blood glucose monitoring systems are provided as an alternative method of measuring blood sugar levels, but not the only one.
After that, in November, Anna, on behalf of her son, appealed to Oleg Mamaev, head of the investigative department for the Northwestern District of Moscow, with a request to bring to justice members of the medical commission of the City Polyclinic No. 115 at the DMZ due to the refusal to issue continuous glucose monitoring systems to the young man.
On December 9, 2025, the Investigative Committee sent a reply: "The decision in 2025 was made taking into account the course of the disease."
In addition, the UK noted, with reference to clinical recommendations, that "now continuous real-time glucose monitoring is used as an addition to traditional self-monitoring of glycemia and it does not completely replace it," and added that the list of prescription medical devices for providing a set of social services does not include the system. The UK also recalled that a glucose meter and test strips can be used for self-monitoring.
"There was no confirmation of episodes of severe hypoglycemia,— the UK's response states.
Patients in the Perm Region and the Samara Region were also denied glucose monitoring systems due to their absence from the list of medical devices provided as part of a set of social services. As Izvestia wrote, residents of the Ulyanovsk, Omsk, Orel, Murmansk, Bryansk and Chelyabinsk regions, as well as Bashkiria, faced a similar problem.
— Now tens of thousands of adult patients with diabetes mellitus are forced to buy glucose monitoring systems at their own expense, — emphasized in VORDI. — For many, this is an unbearable burden, leading to poor health and early disability.
Why do we need glucose monitoring systems?
Diabetes mellitus is one of the most common non—communicable diseases in the world. To reduce the risk of its development and progression, regular self-monitoring of blood glucose should be carried out, said the Associate professor of the Department of Clinical Laboratory Diagnostics at the Faculty of Advanced Medical Sciences named after M.F. Vladimir Natalia Balashova.
"Based on the indications of glycemia, vital decisions are made on the dosage of insulin, physical education and sports, and correction of glycemic levels," the expert added.
The modern method of glucose control, which is included in the standards and clinical recommendations for the treatment of diabetes in children and adults, is continuous glucose monitoring, confirmed by endocrinologist and nutritionist Alexey Kalinchev.
— Monitoring systems allow real-time measurement of blood glucose levels with a frequency of 288 measurements per day. This increases the possibility of predicting adverse episodes of severe hypoglycemia (a condition in which blood sugar levels fall below the physiological norm. — Ed.) or prolonged hyperglycemia (a symptom indicating elevated blood glucose levels. — Ed.) and take the necessary measures in a timely manner," explained Alexey Kalinchev.
Traditional self-monitoring of blood sugar levels with any number of measurements using a glucose meter does not allow you to get an idea of the dynamics and its fluctuations throughout the day, which means that it is less likely to stop conditions that can lead to death, the expert added.
— It is especially important to use continuous glucose monitoring systems at night, when many patients do not feel symptoms of low glucose levels and are at maximum risk of developing severe hypoglycemia. In this case, the use of these systems can save lives," emphasized Alexey Kalinchev.
In addition to the harmonization of regulations, it is necessary to resolve the issue of accessibility of glucose monitoring systems by including it in the federal project to combat diabetes, says Nikolai Prokhorenko, an expert in the field of public health. According to him, an increase in the number of patients in the federal project will lead to lower prices for glucose monitoring systems and will not require additional allocation of an amount beyond the state's capacity.
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