New figures show that 4.3 million people are now living with a diagnosis of diabetes in the UK, according to Diabetes UK.
Registration figures for 2021-22 are up by 148,951 from 2020-21, and more than 2.4 million people are at high risk of developing type 2 diabetes in the UK. Diabetes UK warns the total could hit 200,000 18-39-year-olds by 2027 out of around five million patients in total.
Now, hundreds of children with type 2 diabetes who currently manage their condition with the ‘burdensome’, ‘tiring’, and ‘stressful’ task of finger prick testing several times a day could be offered a choice between two ‘life changing’ technologies to virtually automate the process, National Institute for Health and Care Excellence (NICE) has said.
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For the first time new guidance from NICE, the independent body which provides treatment guidelines to the NHS, has recommended the use of real-time continuous glucose monitoring (rtCGM) or intermittently scanned glucose monitoring (isCGM) devices for some children living with type 2 diabetes who are currently using finger prick testing and insulin therapy.
The NICE committee was told that children being offered the technology would be subjected to the ‘burdensome’, ‘tiring’, and ‘stressful’ task of finger prick testing several times a day, and instead technology could automate this process. The devices have already been recommended for children with type 1 diabetes.
The technologies give a continuous stream of real-time information on a smartphone allowing better/quicker management of the condition. A sensor is attached discreetly to the body to monitor current and previous glucose levels. It also shows a prediction of where the glucose levels are headed meaning they can inject themselves with insulin to stabilise their levels if necessary.
If a patient or their family has a preference for which technology they wish to use, they could opt for an intermittently scanned glucose monitoring (isCGM) device – also known as flash monitoring – as an alternative to real-time devices, picking the technology that will work best for them. Research has found both real-time and flash devices help a person in maintaining optimal blood sugar control, says NICE.
The recommendation comes following changes to NICE’s guideline on the diagnosis and management of type 1 and type 2 diabetes in children and young people published today (Thursday, May 11). Dr Judith Richardson, programme director in the Clinical Directorate at NICE, said: “Type 2 diabetes in children is the most aggressive form of the disease and recommending new technology is a clear step towards giving children on insulin therapy the ability to manage their own condition in a less invasive way, and to live happier and healthier lives.
“We’re focused on bringing the best care to people fast, while at the same time ensuring value for money for the taxpayer. This technology can take away the burdensome task of several finger prick tests a day, which can be tiring, stressful and have a negative psychological impact on the child.
“Improvements made in managing a child’s diabetes at an early stage can reduce the health impact of the condition later in their lives, and the potential impact on the health service.”
Professor Partha Kar OBE, national specialty advisor for diabetes at NHS England, added: "Some of the children and young people often have the most complex needs with a high proportion of them having either a learning disability, special educational need or mental health issue.
"Asking these children to carry out finger prick testing when non-invasive sensors are progressing to become standard care in diabetes is not right, so I am pleased these evidence-based recommendations have been made to offer this life-changing technology to them."
Diabetes is a serious condition in which the level of glucose in your body is too high. There are two types of diabetes, with the main difference being that type 1 diabetes is a genetic condition, while type 2 largely results from lifestyle choices.
Type 2 diabetes is caused by problems with a chemical in the body called insulin, says the NHS. It's often linked to being overweight or inactive - and it's a lifelong condition that can affect everyday life, including needing regular check-ups, medication and diet changes.
Rates of type 2 diabetes in the under-40s are now increasing faster than in the over-40s, with cases up by 23 per cent in the last five years. A type 2 diagnosis at a younger age can lead to more complications, including kidney and heart disease, according to the national diabetes group, Diabetes UK.
There are lots of risk factors for type 2 diabetes, which can be complicated, explains the charity. Age, ethnic background, family history and history of other medical conditions can all play a role in increasing your risk of type 2 diabetes, as well as living with obesity or overweight.
Nikki Joule, policy manager at Diabetes UK, said: “We are pleased to see the new NICE guidelines recommending that continuous glucose monitoring devices are made available for some children with type 2 diabetes.
“Diabetes is a relentless condition, requiring constant, careful management, which can be really challenging for children and young people. It’s important that these devices are now rapidly offered to affected families to help them manage their child’s condition well. That will require healthcare systems to swiftly make plans to equitably roll out these devices to children who are eligible.”
The guideline committee has also recommended the technology is offered to children and young people with type 2 diabetes, if they:
- have a need, condition or disability (including a mental health need, learning disability or cognitive impairment) that means they cannot monitor their blood glucose by finger prick testing
- would otherwise be advised to self-measure at least 8 times a day
- have recurrent or severe low blood sugar levels
- have impaired blood sugar awareness.
Those eligible should speak to their diabetes team to access real-time or flash monitors on prescription.
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