By Sue Marshall, editor, Desang Diabetes Magazine
As I said in the editorial of the latest issue of the magazine, which went out last week,when I set the magazine up, the point was to share information and talk about diabetes ‘kit’. Back then (about a decade ago), few people wore, or had even heard about insulin pumps and everyone was blood testing, with all the rigmarole that entailed. Now, it’s great to be reporting that we are all well on the way to a better future with smaller, cleverer devices that can help ease the burden while also giving insights.
On Friday 1 April (oh the irony, this is NOT an April’s Fools), changes to NICE guidelines on access to diabetes technology were published. The changes are quite astonishing, but are nothing less than what they should be. No longer will people will not have to ‘build their business case’ for going on diabetes technology, they will be offered it directly if they have T1D. Many may stick to the knitting and stay with whatever they currently use, others who may have been told ‘no’ to going on a pump or sensor in the past, should get a different answer when they ask again.
There is a lot to be said about what you yourself bring to the party – diabetes is a strict teacher, and much of our control is based on lessons learned on our life’s journey. Our interaction with food and exercise is more complex than those not living with the condition, and we have to be organised – oh so organised! All of this will hold us in good stead when taking up diabetes tech.
There are some sticking points with diabetes tech as it develops, particularly the fact that some manufacturers systems are ‘lock ins’ that do not ‘talk’ to other devices. However, that is now being addressed, a bitter pill to swallow for the more old-fashioned businesses that set out to have end-to-end solutions where only their equipment could be used with their own other equipment. The movement #wearenotwaiting also started in the US by parents of children with diabetes who were themselves software engineers and who knew they could make better solutions than were currently available, and far faster than waiting for big industry to get around to it with their much slower R&D programmes.
So, we are where we are, and we are in a far better place when it comes to choice. Please see further information and additional commentary below.
To See the updated guidelines, CLICK HERE.
Abbott has commented on NICE’s updated guidelines on glucose monitoring for people with diabetes in the UK. Abbott provides a portfolio of glucose sensing solutions with the FreeStyle Libre system that includes the only Flash Glucose Monitoring systems (FreeStyle Libre and FreeStyle Libre 2 systems), as well as a real-time CGM (FreeStyle Libre 3 system). As the most widely used sensor-based glucose monitoring system in the world, the FreeStyle Libre portfolio has so far changed the lives of nearly 4 million people in over 50 countries around the world.
Neil Harris, General Manager of Abbott’s Diabetes Care Business in the UK and Ireland commented on the NICE guidelines, saying, “The updated NICE guidelines are a significant advance, especially for people with Type 2 diabetes who rely on insulin, the majority of whom have not had access to such technology on the NHS until now. We welcome the acknowledgement that Flash Glucose Monitoring can empower more informed health decisions, improving outcomes and quality of life as a result. Combined with the expansion of CGM access for those with Type 1, the guidelines support choice to allow the right product, based on individual need, and bring us closer to a future where finger-prick testing is a thing of the past for all people who use insulin.”
The charity (Juvenile Diabetes and Research Foundation, which focuses on finding a cure for Type 1 diabetes, ran the headline Everyone with Type 1 diabetes will be offered flash or CGM technology free on the NHS in England and Wales: new NICE guidelines published. It said, ‘JDRF is delighted that the National Institute for Health and Care Excellence (NICE) is recommending that glucose monitoring devices can now be chosen based first and foremost on a person’s preferences and needs and how well the devices available will meet those needs, such as predictive alerts, uploading to the cloud, pump or smart pen integration and sharing with parents or carers.’ Read its full coverage here: www.jdrf.org.uk/news
A medical reportage website, Medscape’s coverage included its story, ‘Transformational’ Shift in Diabetes Care. It stated that, ‘Real-time continuous glucose monitoring (rtCGM) will be offered to all adults and children living with Type 1 diabetes, following updated recommendations from the National Institute for Health and Care Excellence (NICE). In addition, ‘flash monitoring’ with intermittently scanned glucose monitoring devices, previously only available for certain patients, has been expanded to anyone with Type 1 diabetes and to adults with tTpe 2 diabetes on insulin therapy.
“Patients will now have a choice in picking the technology that is right for them, in discussion with their diabetes team,” NICE said. It estimated that over 250,000 type 1 patients would benefit, and that the need for finger prick testing would be reduced by up to 50%.
Chris Askew OBE, chief executive at Diabetes UK, hailed the news as “celebrating a clear step towards ensuring many more people living with all types of diabetes will have access to the appropriate technology that can help them live happier and healthier lives”.
Professor Partha Kar along with many others within the NHS have made consistent, scientific arguments backed up by statistics to show the benefits of diabetes for many, if not most, users. However, in another article, Medscape addressed the fact that ‘Access to Technology ‘Huge Issue’ in Diabetes Treatment.’ The fact is that these changes announced by NICE will not be enough by themselves to guarantee that all who need it have access to the technology, argues Partha Kar, MD, national specialty advisor in Diabetes for NHS England and a consultant in Diabetes Medicine at Portsmouth Hospitals NHS Trust. “For those of you who don’t know the data, let’s make it very simple,” he said speaking ahead of the announcement at the opening Plenary session of the Diabetes UK Professional Conference 2022 on March 28. “To put it as starkly as possible, we do know CGM is incredibly important for children living with type 1 diabetes, [yet] a black child has got half the chance of a white child” to receive the technology. That, under no circumstances, is acceptable in the NHS, which is supposed to be free to all. Whether it’s structural problems, whether it’s individual problems, I just want that gap to be closed.”