A summary of the 'Hybrid closed-loop systems for managing blood glucose levels in type 1 diabetes' published by NICE

For those of you with an interest in type 1 diabetes, on 10th?of January 2023 , The National Institute for Health and Care Excellence (NICE) produced guidance on using Hybrid closed-loop systems for managing blood glucose levels for those with type1 diabetes.

In this article, I cover

? The number of people currently living with type 1 diabetes?in England

? An introduction to what a hybrid closed loop (HCL) system is?

? What this technology will mean for people living with type 1 diabetes?

? Considerations around health inequalities and access?

?The cost-effectiveness of the technology

My interest:

?? My youngest daughter has Type 1 diabetes?

??I want to help improve education, resources and support to young people living with type 1 diabetes?

??I work in primary care

How can you view the guidance?

The guidance which is open for public consultation can be found here;

https://www.nice.org.uk/guidance/indevelopment/gid-ta10845/documents

Some of the language went over my head, considering I have an MBA and I have experience supporting my child to manage the condition for 5 years, but here are the headlines.

This is an opportunity to review the guidance and comment on the findings.

The consultation closes on 31st January 2023.

Introduction

It is estimated that approximately 400,000 people in the UK are living with type 1 diabetes, including around 29,000 children.?

In type 1 diabetes, a person’s blood glucose level becomes too high (hyperglycaemia) because there is no, or very little, production of insulin by the pancreas.

If blood glucose levels become too low, this leads to hypoglycaemia (also known as a hypo). The symptoms can be; confusion, tiredness, feeling irritable,?sweating, dizziness, hunger, feeling shaky or trembling, a fast or pounding heartbeat (palpitations), becoming tearful, anxious or moody.

What is a hybrid closed loop system (HCL)?

Hybrid closed loop systems automatically deliver insulin using a calculation based on continuous glucose measurements, and these systems do not need as much input from the person.

What does this mean for the patient?and their families or carers?

As a parent of a child with type 1 diabetes, the mental burden is high for everyone involved.

Children are less able to recognise the symptoms of highs and lows, which can affect learning at school and can regularly cause sleepless nights even with the use of continuous glucose systems like Dexcom or Libre.

Health inequalities and access?

The consultation highlighted health inequality issues related to family background, socioeconomic status and how access to technology can be a postcode lottery.?

Clinical experts said that the automation offered by HCL systems could help reduce some of the inequalities for people who find it difficult to maintain healthy blood glucose levels because of a language barrier, a lower level of education or a learning disability.

The committee also highlighted that the number of trained staff could also be a barrier to faster implementation to accommodate the increased number of patients using the technology.

How much will this cost?

The cost is to be determined, but the estimated annual cost could be around ￡20k per person. However, the committee concluded that at the current average price, HCL systems are unlikely to be cost-effective, but it recognised the potential benefits to people.?

What does it mean for people like my 10 year daughter Tahlia?

Hybrid closed-loop systems HAVE been recommended as an option for managing blood glucose levels in type 1 diabetes for people who are having difficulty managing their condition.

We are on the list to receive HCL, and we are excited!?

Hopefully, Tahlia can get this before going to secondary school.?

The thought of her on the bus and at risk of her having a hypo and falling asleep without an adult around is terrifying.?

With HCL providing an added layer of support, this is one step closer to her being able to live a bit more independently.?

Don't forget to have your say and read the full guidance document here: https://www.nice.org.uk/guidance/indevelopment/gid-ta10845/consultation/html-content