Main Category: Diabetes
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The NHS Technology Adoption Centre has launched the How To Why To Guide on Insulin Pump Therapy and believes that this tool can help redress the inequities which currently exist in the treatment of type 1 diabetes. The Guide, which is the result of an intensive two-year project, provides practice guidance to enable the successful implementation of the therapy. The unique tool provides:
- clinical evidence enabling hospitals to better understand insulin pump therapy;
- support to put together a business case which guides the commissioning process;
- a roadmap to pump service implementation and the necessary supporting policies.
Commenting on the Guide, Dr Rowan Hillson MBE, National Clinical Director for Diabetes said: "People with diabetes should have access to the most appropriate insulin therapy for their needs. This includes insulin pumps where they are indicated. I believe that the How To Why To Guide will be a valuable tool to facilitate the wider adoption of insulin pump therapy and I encourage people to use it in their clinical settings."
Three NHS Trusts have been involved in the development of the Guide; each having successfully implemented an insulin pump therapy service.
- Birmingham Children's Hospital NHS Foundation Trust
- Whittington Hospital NHS Trust
- East Lancashire Hospitals NHS Trust
It is estimated that, in the UK, 1 in 200 adults have type 1 diabetes with the current prevalence in children approximately 1 in 700-1000.
In order to avoid complications it is important that those with type 1 diabetes manage their blood glucose levels carefully. An internationally accepted measure of good diabetes control is the glycated haemoglobin (HbA1c). The NICE guidance for diabetes care and the Quality and Outcomes Framework advocate a treatment target of HbA1c < 7.5%. However, the National Diabetes Audit has recently shown that 85% of children with diabetes do not meet this target putting them at substantially greater risk of complications.
The majority of patients control their insulin levels through multiple daily injections (MDI). However, in many cases this leads to poor control of diabetes and can also negatively affect an individual's quality of life.
An alternative to MDI is insulin pump therapy. This portable pump provides precise dosing of insulin with controlled and steady delivery controlling the infusion of insulin in a more flexible manner than conventional insulin injections. NICE recommends the use of insulin pump therapy for some people with type 1 diabetes and estimates that it is likely to benefit 8-15 per cent of adults and up to 50 per cent of children under the age of 12.
However, despite positive NICE guidance insulin pump therapy is poor with considerable inequities in both provision and access being found across the UK with many areas having less than 1 percent take up. The UK also significantly lags behind many other parts of the world where, in some countries, uptake is nearing 40 percent.
In order to overcome these issues NTAC developed the How To Why To Guide on Insulin Pump Therapy. The IPT Guide is one of a series designed to address the issues of poor technology adoption across the NHS.
Source:
NHS Technology Adoption Centre
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