We must end the postcode lottery for diabetes treatment
Continuous glucose monitoring (Credit: Dragoljub Bankovic / Alamy Stock Photo)
3 min read
Since my shock diagnosis of type 1 diabetes three and a half years ago, one of the most transformational elements of the management of my condition has been access to hybrid close loop technology (HCL).
The average diabetic has to make an extra 180 decisions per day to keep their blood sugar within the normal range, which takes a toll on our mental health. The HCL cuts down on the number of additional decisions we have to make, reduces peaks and troughs in our blood-sugar level, and ultimately reduces our risk of diabetic complications.
Type 1 diabetes is an autoimmune condition where your immune system attacks your pancreas and kills off the production of insulin, the hormone which controls the amount of glucose (sugar) in your blood. There is nothing a patient has done to cause or trigger type 1 diabetes; they are simply unlucky.
Without insulin, you become incredibly ill as your blood sugar soars and, over a prolonged period, it has the potential to prove ultimately fatal. You are issued with insulin pens when first diagnosed to regulate your blood-sugar levels; you use finger-prick tests to monitor your blood-sugar levels and you have a small sensor that sits under your skin to provide automatic glucose readings – a continuous glucose monitor (CGM). Keeping on top of the condition is a lot of work.
The revolutionary HCL combines two pieces of technology: a CGM and an insulin pump that talk to each other via Bluetooth. It essentially acts as an artificial pancreas. The CGM determines your blood-sugar level; the insulin pump releases the required amount of insulin. It even announces when it is finished with a helpful beep!
Blood sugar is never a fixed number – it fluctuates throughout the day depending on what you eat, if you exercise, and even how hot or cold it is outside. One of the main benefits of HCL is that it helps keep your blood-sugar levels more stable, keeping you within your target range.
Despite all the benefits of HCL, the biggest challenge is gaining access to its technologies. We have to end the postcode lottery – diabetics must have equitable access to this crucial technology wherever they live in the UK. There must be an increased awareness of HCL, particularly among lower socio-economic groups and more funding for the increased roll-out of it.
The NHS should provide comprehensive training for healthcare practitioners on HCL technology. Part of this training should focus on the mental health implications for using this technology – diabetics can reject HCL as it acts as a very visible physical reminder of your condition. Additionally, establishing a national diabetes registry would support technology adoption and track health outcomes.
As a society we must remove the stigma around diabetes. Wearing an HCL can help diabetics to better manage their condition. However, there are still barriers to overcome: in access across the UK and mental health for those living with the condition. I might beep every now and again, but the HCL has been a lifesaver as a late-onset type 1 diabetic.
Sarah Bool, Conservative MP for South Northamptonshire
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