People struggling to manage their type 1 diabetes could benefit from a new technology helping to control glucose levels with little human input. 

The National Institute for Health and Care Excellence (NICE) has recommended the use of new hybrid closed loop systems for managing blood glucose levels in type 1 diabetes – technology that has been lauded as a step towards an artificial pancreas. 

Around 278,000 people in England and Wales are living with type 1 diabetes, and around 33,000 people in Scotland were recorded to have type 1 diabetes in 2019.

For people with type 1 diabetes, their blood glucose level becomes too high as their pancreas produces little to no insulin, leaving them no way to regulate their own blood sugar levels. 

Left unmanaged, type 1 diabetes puts people at risk of long-term complications of hyperglycemia, including blindness, amputations, or kidney problems. 

According to interim director of Medical Technology at NICE, Mark Chapman, for people struggling to manage their type 1 diabetes, the new technology “is the best intervention to help them control their diabetes, barring a cure.”

NHS trials have provided enough positive data to allow NICE to consider a wider use of the technology, which allows people with type 1 diabetes to go about their day-to-day life without having to constantly monitor their blood glucose levels. 

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

The hybrid closed loop system utilises a continuous glucose monitor sensor which calculates the amount of insulin required by the body, which it transmits to a body worn insulin pump. The tool allows glucose levels to be monitored and controlled completely automatically without human intervention. 

Currently, the standard care for type 1 diabetes involves regularly measuring blood glucose levels by using finger-prick blood testing or by using a continuous glucose monitor, with the levels managed by multiple daily insulin injections or an insulin pump. 

Health Minister Helen Whately said: “People living with type 1 diabetes face the constant stress of needing to monitor their blood glucose levels – sometimes multiple times a day – 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.”

NICE recommended the new tech for people who are unable to control their condition despite using other methods if their long-term average blood glucose levels are indicating they are at risk of long-term complications. An HcA1c reading of 8% or more would be an indication of this. 

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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. 

In total, around 105,000 people in England and Wales could be offered the technology. 

In its draft recommendations, NICE also required NHS England to agree to a cost-effective price for the systems on behalf of relevant health bodies. 

“At a time when the number of people with diabetes is rising, we have to focus on what matters most to people who use NHS services by balancing recommending the best care with value for money,” Chapman said. 

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