NICE recommends new ‘artificial pancreas’ technology for type 1 diabetes patients

NICE has recommended the use of hybrid closed loop systems for patients who are struggling to manage their type 1 diabetes, according to new draft guidance.

The ‘artificial pancreas’ technology could help over 105,000 patients control their condition with little human input via a continuous glucose monitor sensor attached to the body.

This system transmits data to a body worn insulin pump. This uses the data to run a mathematical calculation to work out how much insulin needs to be delivered into the body to keep blood glucose levels within a healthy range.

The number of people living with type 1 diabetes is expected to double by 2040 to between 13.5 and 17.5 million people, according to a recent Lancet modelling study. Of the 8.4 million individuals living with type 1 diabetes in 2021, 18% were under 20 years old, 64% were between 20-59 years, and 19% were over 60 years.

NICE has recommended people who are unable to control their condition despite using an insulin pump, or real-time or intermittently scanned continuous glucose monitoring, are offered the technology if their long-term average blood glucose levels are indicating they are at risk of long-term complications. That is, an average HbA1c reading of 8.0% or more when the NICE guideline recommends people should aim for a HbA1c level of 6.5% or lower to minimise the risk of long-term complications from diabetes.

People with type 1 diabetes who are pregnant or planning a pregnancy are also eligible, because blood glucose levels are harder to manage during this time.

The draft recommendations also require NHS England to agree a cost-effective price for the systems on behalf of relevant health bodies. At present an average annual cost for the technology is £5,744, which is higher than what NICE considers a cost-effective use of NHS resources.

Balancing recommending the best care with value for money

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 asked of them by their diabetes team. This technology is the best intervention to help them control their diabetes, barring a cure.

“At a time when the number of people with diabetes is rising, we have to focus on what matters most to people who use NHS services by balancing recommending the best care with value for money.

“Our committee has reviewed the real-world data generated by the NHS and evidence generated by randomised controlled trials which show there are clear benefits of recommending the technology’s use. We look forward to working with NHS England and industry to ensure a cost-effective price can be reached which is fair to taxpayers.”

A consultation has begun on the draft recommendations and consultees can have their say via nice.org.uk until Tuesday 31 January 2023.