The National Institute of Health and Care Excellence, or NICE, has released its final draft guidance, setting the stage for a significant change in diabetes management in England and Wales. NICE has recommended that over the next five years, hundreds of thousands of people living with type 1 diabetes will be eligible for a new device known as the hybrid closed-loop system.
What is a Hybrid Closed-Loop System?
Often referred to as an ‘artificial pancreas’, this device connects an insulin pump to a continuous glucose monitor (CGM) using a computer algorithm. It automatically adjusts insulin delivery based on blood sugar readings, reducing the need for finger prick tests and insulin injections. This system still requires user interaction for meals and exercise.
Who Will Get Access?
The system is recommended for:
- Adults with type 1 diabetes who have an HbA1c level of 58 mmol/mol (7.5%) or higher
- Those experiencing disabling hypoglycaemia despite current management techniques
- All children and young people under 18 years old with type 1 diabetes
- People with type 1 diabetes who are pregnant or planning pregnancy
Support and Education
According to the guidance, users and their caregivers should receive appropriate training. A structured education programme is also advised to help manage insulin dosing effectively.
Response from Diabetes UK
Colette Marshall, Chief Executive of Diabetes UK, expressed her satisfaction with the expanded access: “This new technology could greatly improve health and day-to-day life for many. We welcome the expanded recommendations which include all children and young people.”
The Rollout Plan
The NHS will prioritise those under 18 and women planning pregnancy in the initial phase of the five-year rollout plan. The plan aims to provide fair access and consider local needs. The NHS England oversight group, which Diabetes UK will join, will regularly monitor the implementation process.
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Training and Funding Needs
The plan acknowledges the need for additional staff and specialist training. Diabetes UK has emphasised the importance of securing funding to ensure the technology is available to those who need it, without increasing health inequalities.
More than 150,000 individuals with type 1 diabetes are expected to benefit from this system in England and Wales. The implementation of this technology marks a step forward in diabetes care, promising to make daily management easier and reduce the risk of complications.
Reactions from Healthcare Leaders
Professor Jonathan Benger, Chief Medical Officer at NICE, commented on the decision: “This technology will improve the health and wellbeing of patients and could save the NHS money in the long term.”
Dr Partha Kar, National Specialty Adviser for Diabetes, also shared his enthusiasm: “This is amazing news for people living with type 1 diabetes. It’s as close to a fully automated system as we have, and it will allow patients to live their lives without constant worry about glucose levels or medication.”
The NHS is set to commence a groundbreaking step in diabetes care, with the phased introduction of the hybrid closed-loop system. This reflects a commitment to enhancing the lives of those with type 1 diabetes through advanced medical devices and ensuring equitable access across the country.
