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We’re making big steps towards an artificial pancreas – but how will it change lives and how can the NHS provide it?

We all need insulin to stay alive. However, people with Type 1 diabetes have a pancreas that doesn’t produce insulin. People with Type 2 diabetes have a pancreas that doesn’t produce enough or the body’s cells can’t use it properly. Diabetes can be a very tough condition to live with. It’s a daily challenge.

So an ‘artificial pancreas’ for people living with people with Type 1 diabetes, and those with Type 2 diabetes who use insulin intensively, has long been a goal. Research-funding organisations such as JDRF and Diabetes UK have backed leading scientists to achieve this goal.

The exciting news is that now, the artificial pancreas isn’t science fiction. It’s not an obscure hope for our research future.

The idea for an artificial pancreas began as a prototype device being tested only in hospital settings. Results showed it could work, and that it was safe, so researchers recruited adult and child patients to test it in their own homes, unsupervised overnight.

The artificial pancreas has now entered advanced trials. Next month, research scientists at the University of Cambridge will oversee their largest home trial yet. It promises to be a huge UK science success story.

The device combines an insulin pump with a continuous glucose monitor and an algorithm. The algorithm works out whether a person’s blood glucose levels are too high, too low or just right, then tells the pump to give the right amount of insulin to keep your levels on track.

The impact of this device on daily lives could be very significant. People with Type 1 diabetes, and some of those living with Type 2 who use insulin, say one of the things they find most difficult about the condition is hypoglycaemia – known as ‘having a hypo’ – which is when blood glucose levels drop to dangerous levels. The artificial pancreas could help protect people from hypos as it promises to help control blood glucose levels much more tightly. It will offer fewer lows, and also fewer highs.

NHS investment makes sense

When blood glucose levels run consistently too high, the risk of long term health complications can increase. So it makes sense for the NHS to embrace diabetes technology and to prepare to embrace the artificial pancreas. Investment in the technology promises long term savings to the NHS budget by keeping people with Type 1 and 2 diabetes healthy and less at risk of needing treatment for complications.

As the reality of the artificial pancreas nears, it’s time to make sure the NHS will be ready to provide it to all those who will benefit from it.

After all, the UK already struggles to provide access to medical technology even when that technology has been around for years. Insulin pumps, as an alternative to multiple daily injections, first emerged as an option for doctors to provide for people with diabetes more than 40 years ago.

But even though it’s proven that pumps can help people achieve tighter blood glucose control, just seven per cent of UK adults with Type 1 diabetes have a pump. This is much lower than in countries such as Germany and Norway, where the figure is over 15 per cent. In the US, use of insulin pumps is even more widespread, with some 40 per cent of people with Type 1 having one.

The pump picture in the UK is slightly better for children, with 19 per cent of under-18s with Type 1 using such a device, but this is still much lower than comparable European countries.

With the NHS facing such challenges in provision of current diabetes technology, the pathway must be cleared for technology of the near future.

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