HCL (Hybrid Closed Loop) News announcement

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Saoirse

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Type 1
www.theguardian.com

NHS to offer 150,000 people with type 1 diabetes an artificial pancreas

Move to make more than half of those living with condition in England and Wales eligible for device hailed as gamechanger
www.theguardian.com www.theguardian.com

This is excellent news. Having a HCL has transformed my life (though it is not an artificial pancreas, and the article does not make clear that treatment decisions still need to be made, still..). Wonderful news that it will be more widely available!🙂
 
Would be a bit disappointing if it's "only" 150,000. The earlier proposed draft would have qualified more like 75%.

Probably doesn't make that much difference in practice, though: the constraint is always going to be how quickly it can be rolled out (it seems many people who're approved for pumps have to wait months for training). And the expectation is that the criteria will be widened as the rollout proceeds.
 
In terms of the timeline, I think the "final" plan has gone out to stakeholders for review, and it'll be made public next week.

I guess the Guardian has been given some advance information from someone.
 
Not happening at all now. Im too old! And not having severe hypos but have a big and almost paralysing fear of them.
 
I am pleased but not excited.

Pleased because it is the right direction.
Not excited because the NHS has to consider the Return on Investment for the cost of HCL. There is little value to the NHS giving this great new tech to adults who invest time and effort into achieving hba1c lower than 58 without HCL.

I can't see me getting it for a few years unless I fund it myself. An improved quality of life (less time and effort and brain power spent worrying about my diabetes) is not worth the cost.
 
gillrogers said:
Not happening at all now. Im too old! And not having severe hypos but have a big and almost paralysing fear of them.
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Does that not mean you run your BG higher so you are more likely to qualify as having a hba1c higher than 58?
 
Yes although i try hard not to. But with so mnany things that can influence my basal and then the complications with my prominent basal drop at lunchtime confusing matters, amongst other thinfs, im struggling. the way im understanding it is that even with that my age will let me down. Im reading it as "we're not going to waste our funds on you at your age"
 
gillrogers said:
it is that even with that my age will let me down. Im reading it as "we're not going to waste our funds on you at your age"
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Where do you get this idea from?
The recommendations quoted above from Partha Kar make no distinction about age "for adults who have an HBA1C above 58".
 
gillrogers said:
Im reading it as "we're not going to waste our funds on you at your age"
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Partha Kar has elsewhere emphasised that age should not be a barrier for technology, so I'd be surprised if there's any age discrimination (beyond the desire to allow children and pregnant women on HCL, which makes sense medically). If your HbA1c is 63 then that would qualify you, but the rollout is going to take years and I'm sure there'll be many patients with even greater need.

I also anticipate that (presuming funding is found) the process will speed up over time as DSNs get better at supporting people and the systems have been improved, so perhaps we'll eventually be surprised by how fast the rollout happened.
 
Yet to be seen whether Coventry find the money to offer this. They've never yet wanted to spend much on us.
 
trophywench said:
Yet to be seen whether Coventry find the money to offer this. They've never yet wanted to spend much on us.
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My hunch is the combination of Partha Kar and all the publicity (which he's probably partly responsible for) will make it hard for areas to resist. As I understand it authorities have to follow TAs by law (unlike guidance), though it's obvious from TA151 that that doesn't always happen.
 
gillrogers said:
Sorry must have been the way i read it and understood it. ‍♀️ Ill read it again. Aha it wasnt this post it was the public release on Abbotts facebook page where they linked to the report.

History | Hybrid closed loop systems for managing blood glucose levels in type 1 diabetes | Guidance | NICE

www.nice.org.uk www.nice.org.uk
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You're right, the final appraisal determination is easy to read as ageist but I think this is just about children (which is worded differently elsewhere):

HCL systems are likely to be more cost effective for children and young people than adults, so they are also recommended for children and young people irrespective of their HbA1c level.​

I'm pretty sure that's just saying people under 18 automatically qualify, not a suggestion that younger adults might benefit more than older adults. (I can believe that's true, but that doesn't seem to be in the planning.)
 
I'll be on the bottom of the list....but prob best to go to those with most to gain first
 
Tdm said:
I'll be on the bottom of the list....but prob best to go to those with most to gain first
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Me too, though I like to think of it as being after the test subjects. There'll surely be things that DSNs and manufacturers learn which I hope will make our experience that much better.
 
Bruce Stephens said:
You're right, the final appraisal determination is easy to read as ageist but I think this is just about children (which is worded differently elsewhere):

HCL systems are likely to be more cost effective for children and young people than adults, so they are also recommended for children and young people irrespective of their HbA1c level.​

I'm pretty sure that's just saying people under 18 automatically qualify, not a suggestion that younger adults might benefit more than older adults. (I can believe that's true, but that doesn't seem to be in the planning.)
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Yes that was it and there doesnt seem to be any other mention for us older ones. In fact im sure there was something about the reasearch showing there was no economical benefits with us older peeps or words to the effect. Im going cross eyed trying to read it again.
 
Bruce Stephens said:
You're right, the final appraisal determination is easy to read as ageist but I think this is just about children (which is worded differently elsewhere):

HCL systems are likely to be more cost effective for children and young people than adults, so they are also recommended for children and young people irrespective of their HbA1c level.​

I'm pretty sure that's just saying people under 18 automatically qualify, not a suggestion that younger adults might benefit more than older adults. (I can believe that's true, but that doesn't seem to be in the planning.)
Click to expand...

Wouldn't begrudge children & young adults being first to benefit from it if honest, wish tech like that was around back when we were all diagnosed.
 
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