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Hybrid closed loop technology set to be made available in England and Wales

The announcement is the biggest treatment breakthrough for type 1 diabetes since the discovery of insulin.
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Mary-Liz McGrath 7 November 2023

Nina Willer, who used hybrid closed loop technology through pregnancy, and her child.

Hybrid closed loop technology, also known as the artificial pancreas, is set to be made more widely available on the NHS in England and Wales, transforming the lives of many people living with type 1 diabetes. It comes as the National Institute for Health and Care Excellence (NICE) releases new recommendations for the use of hybrid closed loop, following years of research and advocacy work by JDRF.

A proven treatment

Hybrid closed loop (HCL) is a proven treatment at the frontier of health technology, which takes a continuous glucose monitor (CGM) and introduces an advanced algorithm to automate the delivery of insulin through a pump. It becomes more effective over time delivering personalised medicine and transforming the lives of those who use it.

Living with type 1 diabetes is relentless and requires intense management 24 hours a day. Hundreds of individual treatment decisions must be made around the clock as extreme blood glucose highs and lows can be fatal. By automating what is currently a manual process, HCL can lift the relentless burden and risk of burnout.

Not only does HCL make day-to-day life easier, it also enables people with type 1 diabetes to live healthier lives without fear, by reducing the risks of complications including heart failure, loss of limbs, kidney failure and sight loss.

Research funded by our supporters

This high-tech treatment was developed thanks to JDRF supporters, who enabled the charity to invest £115 million in rigorous international research and clinical trials over almost 20 years. JDRF was also instrumental in campaigning and advocacy work to make this technology available on the NHS in Scotland, Wales and England.

Who will be eligible?

NICE has agreed with NHS England that all children and young people, women who are pregnant or planning a pregnancy, and those people who already have an insulin pump will be first to be offered a hybrid closed loop system as part of a five-year roll-out plan.

The technology will also be issued to adults with an average HbA1c reading of 7.5% or more. NICE guidelines recommend people should aim for an HbA1c level of 6.5% or lower. Adults who experience hypoglycaemia, defined as an abnormally low level of glucose the blood, despite best possible management will also be offered the technology.

“The world is watching”

Karen Addington, CEO of JDRF UK, said: “Today’s announcement makes Great Britain the first country in the world to make hybrid closed loop widely available, as England and Wales follow the lead of Scotland, who approved the use of HCL earlier in 2022. We know the world is watching right now and we hope that today’s announcement spurs other countries to follow.

“JDRF funded the international research into HCL for almost 20 years, developing the robust clinical evidence required for regulatory approval. We have campaigned for this treatment to be made available for people with type 1 diabetes for the last five years. We are delighted with the recommendations from NICE today and expect them to lead the world in access to treatment. More work needs to be done in gaining access across the devolved nations, in particular Northern Ireland and we will not rest until everyone has fair access wherever they live.”

“People with type 1 diabetes can get on with their lives”

Professor Partha Kar, NHS national speciality advisor for diabetes, said: “This is amazing news for people living with type 1 diabetes and this announcement can be made possible thanks to the hard work of the NHS, once again trialling and testing the best and latest innovations for the benefit of our patients.

“This tech might sound sci-fi like but it will have a dramatic impact on the quality of peoples’ lives, not to mention outcomes – it is as close to the holy grail of a fully automated system as science can provide at the moment, where people with type 1 diabetes can get on with their lives without worrying about glucose levels or medication”.

“From day one it was amazing”

Yasmin Hopkins took part in trials of HCL. She said: “From day one it was amazing. Before the closed loop system, I would experience a lot of highs, which I’d then overcorrect, go low and eat a lot of sugar. All of that has been eradicated. This technology gives me the freedom to get on with my life and live without fear of what might happen in a few hours, days or years.”

What comes next?

Today’s recommendations are subject to an appeal process and are expected to become law later this year.

More work needs to be done in gaining access in Northern Ireland to this treatment. However, today’s news will create the momentum and evidence to help secure parity across the four nations.

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