Hybrid closed loop system eligibility criteria

[sebg]

So the NHS eligibility criteria for people that wish to be accepted for a closed loop system on prescription, says that if the
•HbA1c is 58 mmol 7.4% or more
•Children and young people living with T1D
•women, trans men and non-binary people living with type 1 diabetes who are pregnant or planning to become pregnant
I'm not sure what to think about the last one here, I can understand if you are pregnant or planning to become pregnant, especially if you are planning on becoming pregnant to me it makes sense to be prepared and get used to the closed loop system before you get pregnant but TRANS MEN and NON-BINARY can somebody please help me with whatever it is I'm missing here because I don't see why these groups take preference over someone that is doing their best to stay in control

 

[Fairygodmother]

Where did you copy those criteria from?

 

[Fairygodmother]

Ah, found it, NHS site.
It’s applicable if a woman who’s non-binary, or living as a trans, is pregnant or planning to become pregnant. Seems absolutely reasonable to me; they, and their babies, would be facing the same Type One problems as ‘straight’ women.

 

[sebg]

Ah, found it, NHS site.
It’s applicable if a woman who’s non-binary, or living as a trans, is pregnant or planning to become pregnant. Seems absolutely reasonable to me; they, and their babies, would be facing the same Type One problems as ‘straight’ women.

I copied and pasted the bullet points straight from the NHS website

 

[Antje77]

can somebody please help me with whatever it is I'm missing here because I don't see why these groups take preference over someone that is doing their best to stay in control

Excuse me?
What does being trans or non binary have to do with trying to stay in control?
Those guidelines simply say that anyone who can biologically get pregnant and wants to get pregnant is eligible.

Would you rather have pregnant people who aren't female to be excluded from using this system? Why?

 

[sebg]

Excuse me?
What does being trans or non binary have to do with trying to stay in control?
Those guidelines simply say that anyone who can biologically get pregnant and wants to get pregnant is eligible.

Would you rather have pregnant people who aren't female to be excluded from using this system? Why?

It's not about the people that are included, I'm not sure why you're asking about people who can get pregnant, my post is clearly about the people that are not mentioned in the eligibility criteria the fact is diabetes does not discriminate and the NHS hasn't included a large group of people affected.

 

[Nicola M]

Your post did not suggest you’re talking about people that were not included as per the section below;

I'm not sure what to think about the last one here, I can understand if you are pregnant or planning to become pregnant, especially if you are planning on becoming pregnant to me it makes sense to be prepared and get used to the closed loop system before you get pregnant but TRANS MEN and NON-BINARY can somebody please help me with whatever it is I'm missing here because I don't see why these groups take preference over someone that is doing their best to stay in control

But in regards to your other point, the NHS cannot afford to give closed loop systems to absolutely every person with diabetes and whilst I do agree with people that that isn’t fair they have to make the list smaller somehow. I think for now the criteria is relatively fair until they can open their options more, I would have fallen into the first category (and did) before it was even a thing. Pregnant people and children are for obvious reasons but I don’t think they can justify giving someone a closed loop if they have a good HbA1c even if it does take a lot of extra work for that person to get that HbA1c especially if they already have a pump and cgm (just not closed loop).

 

[CheeseSeaker]

Thought it also covered existing pump users:

NICE has agreed with NHS England that all children and young people
women who are pregnant or planning a pregnancy
and those people who already have an insulin pump will be first to be offered a hybrid closed loop system as part of a five-year roll-out plan.

From JDRF - https://jdrf.org.uk/news/hybrid-clo...et-to-be-made-available-in-england-and-wales/

 

[Antje77]

I'm not sure what to think about the last one here, I can understand if you are pregnant or planning to become pregnant, especially if you are planning on becoming pregnant to me it makes sense to be prepared and get used to the closed loop system before you get pregnant but TRANS MEN and NON-BINARY

I'm not sure why you're asking about people who can get pregnant

Transmen and non binary people can and do get pregnant.
Those guidelines simply say that anyone who want to become/is pregnant is eligible, including those with a non female gender.

Yes, I wish it was available for everyone who wishes to use it, but this is not the case yet. I'm all for letting pregnant people and children go first until everyone is eligible.

 

[Pipp]

Just a general mod reminder to all contributing to thread to please consider the rules A1, A2, and A5. As some posts are close to being in breach of these.

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[AndBreathe]

If these guidelines are an attempt to be fair to everyone, would it not be fairer to allow all those who would like to use a pump that opportunity, rather than building in yet another apparent layer of entitlement lottery to the process?

Being a T2, I have no skin in this game, but to be honest, none of it seems very equal to me.

< Puts on flak jacket, colander and adopts the crash position. >

 

[Antje77]

If these guidelines are an attempt to be fair to everyone, would it not be fairer to allow all those who would like to use a pump that opportunity

Of course it would!
But as of yet, the funding isn't there to provide for all who want it, so choices have to be made. (The situation with pumps and hybrid closed loop systems is similar in my country and he UK.)

Until the funding is there, it makes sense to me to treat the most vulnerable (children and pregnant diabetics), and the ones whose health will likely improve most (those with high hba1c's) first.

 

[becca59]

If everyone was eligible it would be a mad free for all and there would still be disappointed people. It’s a bit like Libre, wait and it will happen eventually. If we don’t fit the criteria we must be doing ok. So that is a positive in my opinion. Right at the front of the queue should be children which they are. That makes me happy.

 

[tim2000s]

To be honest, the criteria are straightforward.

There is a lot of evidence that supports children and young people, plus those who are either pregnant or want to get pregnant, having fewer long term issues if they have better glucose levels earlier. Over the life of the patient, this results in lower costs.

Those on pumps are an easy win (and should, in reality, already meet the Hba1C level criteria, as they were in place to get a pump. They also jack up the numbers with only an incremental cost (remember CGM is already available to all with Type1).

As for everyone else, well it's unfortunate, but they have to draw a line somewhere.

 

[CheeseSeaker]

As for everyone else, well it's unfortunate, but they have to draw a line somewhere.

100% agree - the frustration for people is (basically) "I want it now"

If someone shows you a huge improvement to the way we live - we all want the chance to grab it and not wait 5 or more years before we can live it.

As everything (when it comes to pounds shilling and pence) we need to wait patiently for funding to become available and the rollout to happen, or for those of us fortunate enough, self fund.