More than 100,000 people with type 1 diabetes in England are to be offered an artificial pancreas, which experts believe could become the ‘holy grail’ of managing the condition.
The innovative device uses an algorithm to determine how much insulin to administer and reads blood sugar levels to keep them stable.
A world-first NHS trial found it was more effective at managing diabetes than current devices and required far less input from patients. The device is planned to be rolled out in the NHS in England after it won approval from the National Institute for Health and Care Excellence (Nice).
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 their diabetes team tells them to. This technology is the best intervention to help them control their diabetes other than a cure.”
In draft guidance published on Tuesday, an independent committee in Nice recommended its use to manage blood glucose levels in people struggling to control type 1 diabetes. The technology allows the patient to go about their daily lives without having to monitor if your blood glucose levels are too high or too low.
Pregnant women are also eligible, because blood glucose levels are more difficult to control during this time. In total, the technology will be offered to around 105,000 people in England.
Charlotte Abbott-Pierce with the innovative device. Photograph: NHS
Managing type 1 diabetes can be challenging, especially in young children, because of variations in required insulin levels and the unpredictability of how much patients eat and exercise. Children are especially at risk of dangerously low (hypoglycemia) and high (hyperglycemia) blood sugar levels, which can damage the body or even lead to death.
The artificial pancreas is worn next to the body. Continuously monitors blood glucose levels and automatically adjusts insulin delivered via a pump.
It also eliminates the need for finger prick tests to check blood sugar levels to prevent hypoglycemia and hyperglycemia attacks.
The draft Nice recommendations require NHS England to agree a cost-effective price for the device on behalf of the relevant health bodies. The average annual cost of the technology is currently £5,744, higher than what Nice considers a cost-effective use of NHS resources.
Although most of the NHS’s estimated £10 billion annual spend on diabetes goes to type 2 diabetes, the devices are expected to help reduce costs by ensuring there is less need for interventions for cases of type 1
“Our committee has reviewed real-world data generated by the NHS and evidence generated by randomized controlled trials showing that there are clear benefits to recommending the use of the technology,” Chapman said. “We look forward to working with NHS England and industry to ensure that a cost-effective price that is fair to taxpayers can be reached.”
Professor Partha Kar, specialist national diabetes adviser at NHS England, said: “This technology has been shown to offer the best control for managing type 1 diabetes and should make things like amputations, blindness and kidney problems are a thing of the past.”
Kar, who has previously described the device as “not far from the holy grail of a fully automated system,” added: “We’ve seen fantastic results from the real-world tests that have been carried out. The quality of life what this technology offers to those who use it is huge.”
Six-year-old Charlotte Abbott-Pierce was one of the first to benefit from the artificial pancreas.
“Before the closed loop hybrid system was installed, my husband and I would get up every two hours every night having to check Charlotte’s blood sugars and most of the time giving insulin, sometimes doing finger pricks or dealing with ketones because of the rapid rise in blood sugar,” her mother, Ange Abbott-Pierce, told the Guardian last year. He said the new system was a “godsend for us as we were at our wit’s end with worry, not being able to catch the highs before they became dangerous”.
This article was amended on 10 January 2023 because, due to an editing change, an earlier version in one case gave the term for excessively high blood sugar levels (hyperglycemia) as hypoglycemia.