The UK has “lagged behind” other countries in terms of providing diabetes technologies according to an op-ed by The Lancet Diabetes &Endocrinology.

The article discusses pioneering new treatment approaches and how the diabetes landscape has changed in recent years.

The Lancet authors mention how there is a “substantial geographical variation in access to diabetes technologies” within the NHS.

However it also refers to Diabetes UK’s consensus guideline, published earlier this year to “rationalise and improve access to available technologies”.

In recent years there has been criticism over access to the pioneering FreeStyle Libre because it largely depends on where people live, with diabetes organisations campaign to put an end to the so-called ‘postcode lottery’.

Earlier this year the NHS revealed how from April 2019 it planned to make the FreeStyle Libre available for one in five people with type 1 diabetes.

The document said: “Hopefully the recommendations in the new consensus guidelines will help to ensure that more people who stand to benefit will have access to these devices. The guideline is intended both for local policy makers to ensure an integrated approach to availability and for clinicians to use as a guide for joint decision making with patients.”

Diabetes treatment progress was also celebrated in the article, mentioning how integration with consumer electronics and cloud-based data systems are helping people manage their condition better.

The article said: “These developments make this a time of unique promise for people with type 1 diabetes, as well as parents of paediatric patients, with novel technologies offering the potential opportunity to ease the burden of self-management and to improve glycaemic control, reduce hypoglycaemia, and improve quality of life. However, important challenges remain.”

Cyber security issues were addressed, relating warnings issued by the US Food and Drug Administration (FDA) that some Medtronic MiniMed insulin pumps were being recalled because of cybersecurity vulnerabilities. This meant they could be hacked, allowing someone to change the settings wirelessly. The FDA noted that there had not been any reports of patient harm.

While not reported in the op-ed, is aware that engineers with type 1 diabetes have used this ‘vulnerability’ for positive means in order to turn insulin pumps into a form of artificial pancreas.

An organisation working to help people to achieve these modifications is the Open Artificial Pancreas System project (#OpenAPS).

On one hand, these modifications could be risky depending on the skill and experience of the engineer; on the other hand, a significant number of people with type 1 diabetes have reported significant benefits to their diabetes control in using the methods outlined by the OpenAps project.

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