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Hybrid closed-loop system for type 1 diabetes recommended for thousands in England and Wales

NICE (National Institute of Clinical Excellence) has today released draft guidance recommending the use of hybrid closed-loop systems for some people with type 1 diabetes in England and Wales.

These recommendations are a significant step towards making this technology available on the NHS. If this proposal is approved in the consultation process – it would mean over time around 100,000 people with type 1 diabetes could be offered it as an option to help manage their condition.

We welcome these exciting draft proposals, which recommend the technology for people with type 1 diabetes who have an HbA1c of around 64mmol/mol or 8% despite already using an insulin pump, continuous glucose monitoring or Flash glucose monitoring. It is also recommended for women with type 1 diabetes who are pregnant or planning pregnancy.

Transformative tech - hybrid closed-loop systems

Sometimes known as an ‘artificial pancreas’ – hybrid closed-loop systems work by linking insulin pumps and continuous glucose monitors (CGM) with a computer algorithm that can calculate the amount of insulin someone needs based on blood sugar readings. This allows the system to do some of the work for you to help manage blood sugar levels. But you still need to tell the system when and how many carbs you’re eating to receive your mealtime insulin doses.

There’s lots of evidence to show that the technology can help people with type 1 diabetes to improve their blood sugar levels, have less hypos and make self-managing the condition easier.

NICE is responsible for assessing medicines and medical technologies to see if they are beneficial and cost effective for use in the NHS in England and Wales. We’ve been working with NICE and its evaluation of hybrid closed-loop from its early stages. We’ve also supported NHS England in their pilot rollout of the technology, which produced valuable real-world data that fed into NICE’s evaluation.

The draft proposal announced today is a positive step towards making this life-changing technology available for many more people with type 1 diabetes. Next, NICE will collect views about its proposals. We’ll be submitting our response as we continue to work to ensure that everyone who can benefit from a hybrid closed-loop system is able to access one.

You can also submit your views about NICE’s proposals until 31 January.

After this consultation, NICE will review the responses and before making a final decision on who they’ll recommend the technology for. This decision is expected later this year but a date for this has not yet been confirmed. 

Our research made it possible

We've supported research to develop this technology since the beginning. We bought the UK’s first artificial pancreas device in 1977. Our researchers used it to help stabilise blood sugar levels for people with type 1 diabetes during surgery and childbirth.

Since then, we've carried on backing research to improve this technology. We've built evidence of its life-changing impact and we’ve looked for ways to make sure it can benefit as many people as possible.

In 2007, we supported a world-first trial testing the technology outside of a hospital setting for the first time. We then funded research that showed the artificial pancreas could help women with type 1 diabetes better manage their blood glucose levels during pregnancy. And, most importantly, it could help more women to have safer births and healthy babies.

And we funded one of the first trials of the artificial pancreas with people with type 2 diabetes. The results, in 2018, showed that the device could transform the care some people with type 2 diabetes receive while in hospital.

Nikki Joule, Policy Manager at Diabetes UK, said:

“Hybrid closed-loop technology has the potential to transform the lives of people with type 1 diabetes, improving both clinical outcomes and their quality of life. NICE’s draft guidance is a promising step towards ensuring people living with type 1 diabetes in England and Wales have access to the technologies they can benefit from most, helping them to manage their diabetes, avoid complications and live well with the condition.

“Type 1 diabetes can take a huge mental toll, with people manually calculating how much insulin they need regularly throughout the day. By automating these calculations, hybrid closed-loop technology can greatly alleviate the emotional burden of diabetes. We look forward to it being rolled out on the NHS and will work towards ensuring that everyone who could benefit from this life-changing technology has access to it.”

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