Portugal’s SNS Adds Free AI SmartGuide Glucose Monitor for Type 1 Adults

Portugal’s public health service has just unlocked broader access to state-funded technology that promises fewer finger-pricks and better overnight safety for thousands of adults living with type 1 diabetes. By approving the Accu-Chek SmartGuide, the Serviço Nacional de Saúde (SNS) places a second continuous glucose monitor beside the long-standing FreeStyle Libre 2 Plus, while guaranteeing full reimbursement for every sensor.

A fresh choice at the pharmacy counter

Until now, Portuguese patients who qualified for public support had a single item on the shelf. That changes with the arrival of Roche’s real-time interstitial sensor, backed by an Infarmed ruling issued on 13 November. Regulators stress that wider competition will improve supply and keep pressure on prices, yet the immediate headline for users is simpler: a new device with predictive alerts can now be picked up at zero out-of-pocket cost.

Under the skin, on the screen

Each 14-day SmartGuide is inserted just below the skin and transmits a glucose value every five minutes. Artificial-intelligence algorithms estimate where those readings will be in thirty minutes, two hours and overnight, allowing users—and clinicians—to intervene before blood-sugar swings hit. The Portuguese endocrine community has highlighted that early warnings of nocturnal hypoglycaemia are particularly valuable in reducing hospital admissions and easing the so-called “fear of the night” that many families describe.

Who qualifies and how much the state pays

Infarmed tied the subsidy to adults, eighteen or older, who manage their condition with multiple daily injections or a non-integrated insulin pump. Prescriptions must be filed electronically by specialists in endocrinology, internal medicine, paediatrics or family medicine. The underpinning legal framework—Portaria No. 18/2025/1 and Portaria No. 170/2025/1—sets reimbursement at 100 % of the retail price, an upgrade from the 85 % ceiling that had applied to earlier devices. The decision aligns with the 2025 State Budget, which earmarks extra funds for hybrid insulin-delivery systems.

How it stacks up against Libre 2 Plus

Both monitors enable round-the-clock tracking and can replace most finger-stick tests; however, several distinctions emerge. The Libre offers a 15-day lifespan and well-tested high- or low-glucose alarms, while the SmartGuide banks on machine-learning forecasts of upcoming trends. Roche cites an accuracy rate above 90 %, a figure clinicians view as comparable to Abbott’s flagship. Portuguese hospital centres are, for now, waiting on head-to-head data, but early feedback suggests that having two reimbursed options will allow prescribing teams to match features to individual lifestyles rather than shoe-horning everyone into one platform.

National impact and the numbers behind it

Roughly 35 000 to 40 000 adult residents live with type 1 diabetes in Portugal, though only a subset uses the injection or pump regimens required by the new rule. Health-ministry economists refused to release a detailed budget forecast, yet independent analysts note that continuous monitoring tends to trim costs elsewhere—fewer emergency visits, fewer days off work, and lower long-term complication rates. The SNS investment, therefore, is framed less as additional spending and more as a strategic shift toward preventive digital care.

What happens now

Pharmacies expect to receive the first SmartGuide starter kits before the end of the year. Clinicians are updating prescription software, and diabetes associations are planning coaching sessions to walk newcomers through sensor insertion, app setup and alarm fine-tuning. For many families, the greatest relief may be psychological: the knowledge that their national health service is committed to keeping pace with technology, and that better overnight peace of mind no longer hinges on personal income.