Type I diabetes is a common autoimmune condition managed by the injection of insulin to regulate blood glucose. At present, there is no cure for Type 1, so regular injections of varying doses are given by the individual, based upon readings taken from a finger prick test. It can be very ‘hit or miss’ with some individuals managing better control of their diabetes than others. Poor control can lead to more serious health consequences later in health, and higher associated costs for the NHS.
In recent years, doctors have been able to make a case for some patients, often children, to be provided with a ‘closed loop’ insulin management system. The patient wears an insulin pump on the body that wirelessly connects to a glucose sensor that is inserted into the skin, and a smartphone. The system can then constantly measure blood glucose and automatically dispense insulin into the body through a cannula, thereby maintaining a more physiological state for the body, and preventing some of the hypoglycaemic and hyperglycaemia episodes that can be dangerous. This is the closest thing to having an artificial pancreas and has been demonstrated as transformative for users, who are more able to maintain their day-to-day health and lead an otherwise normal life.
The National Institute of Health and Care Excellence (NICE) has recommended the use of these closed loop insulin management systems for selected patients in draft guidance published today, based on evidence from studies undertaken in the NHS. The NICE guideline recommends the technology for patients who have an average HbA1c reading of 8.0% or more, when the target to achieve long term health complications is 6.5% or lower.
The average annual cost of a closed loop system is around £5,500 per person. The draft NICE recommendations requires NHS England to strike a balance to make provision of the technology more cost-effective. A consultation has begun on the draft recommendations with consultees invited to have their say via www.nice.org.uk until Tuesday 31st January 2023.
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