NHS rollout of artificial pancreas narrows inequality in diabetes care

The rollout of a “life-changing” artificial pancreas on the NHS for people with type 1 diabetes has helped to narrow ethnic and socioeconomic inequality within access to treatment, according to figures.

Officially known as a hybrid closed-loop system, an artificial pancreas comprises three interconnected parts: a sensor worn on the body called a continuous glucose monitor; an algorithmeither built into the pump or on a separate device such as a phone that calculates the precise dose of insulin needed; and an insulin pumpthat delivers the dose into the bloodstream.

For patients, the device removes much of the mental burden of managing blood sugar levels, especially around mealtimes and during the night. According to previous clinical trials, the device is more effective at managing diabetes than current diabetes technology, such as using continuous glucose monitors alone.

Previous rollouts of diabetes technology have had stark disparities in uptake regarding ethnicity and deprivation. Studies have shown that people from minority ethnic backgrounds in England are less likely to have access to continuous glucose monitors, while people from deprived backgrounds have been unable to have full use of this tech.

However, the first two years of the artificial pancreas rollout has been seen to reverse this trend, with only a 3% difference in uptake between people from the most and least deprived backgrounds, as well as those from minority ethnic backgrounds compared with white counterparts.

Naiha Shafiq, 27, from London, was fitted with an artificial pancreas three years ago. She said the device had been “life-changing” because she was previously in and out of hospital with diabetic ketoacidosis, a life-threatening complication, as a result of struggling to administer her insulin injections.

“There was a time I would be in hospital every three to five days,” Shafiq said. “When I fell pregnant, I knew something had to change for me for the sake of my son. That’s when the team introduced me to the pump. I was very hesitant at first but once I got started, I loved it.”

For Shafiq, administering her insulin was previously made more difficult due to her religious beliefs. “As a Muslim woman who wears hijab it was extremely difficult for me to be on injections as I would always look for somewhere private to inject most times, and if there was nowhere private to inject I would miss injections because I wasn’t comfortable. The pump makes life now so much easier.”