From NICE UK Jan 23, 2023

National Institute for Health and Care Excellence NICE

If type 1 diabetes is not well controlled, people are at risk of long-term complications of hyperglycaemia, including blindness, amputations, or kidney problems.

The hybrid closed loop system comprises of a continuous glucose monitor sensor attached to the body. This transmits data to a body worn insulin pump. 

  • This uses the data to run a mathematical calculation to work out how much insulin needs to be delivered into the body to keep blood glucose levels within a healthy range.

NICE has recommended people 

  • who are unable to control their condition despite using an insulin pump, or real-time or intermittently scanned continuous glucose monitoring, are offered the technology if their long-term average blood glucose levels are indicating they are at risk of long-term complications. 
  • That is, an average HbA1c reading of 64 mmol/mol or more when the NICE guideline recommends people should aim for a HbA1c level of 48 mmol/mol or lower to minimise the risk of long-term complications from diabetes.
  • People with type 1 diabetes who are pregnant or planning a pregnancy are also eligible, because blood glucose levels are harder to manage during this time.

Mark Chapman, interim director of Medical Technology at NICE, said

  • “Some people living with type 1 diabetes struggle to manage their condition, even though they are doing everything asked of them by their diabetes team. 
  • This technology is the best intervention to help them control their diabetes, barring a cure.
  • “Our committee has reviewed the real-world data generated by the NHS and evidence generated by randomised controlled trials which show there are clear benefits of recommending the technology’s use. 

Professor Partha Kar OBE, national specialty advisor for diabetes at NHS England, said

  • “This technology has been proven to give the best control for managing type 1 diabetes and should make things like amputations, blindness, and kidney problems possibly a thing of the past.
  • “We have seen fantastic results from the real-world trials which have taken place and thank you to NICE for their review of the evidence and subsequent conclusions. The quality of life this technology gives to those using it is huge.

Health Minister Helen Whately said: 

  • “People living with type 1 diabetes face the constant stress of needing to monitor just to stay healthy and avoid complications. This new technology could ease the burden on patients and allow them to manage their condition more easily.
  • “We are determined to harness the latest innovative technology to improve outcomes for patients, reduce serious complications and ultimately ease pressure on the NHS.”



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