Partha Kar predicts closed loops will become standard care in the next 5 years

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This would be great, I don’t want to sound objectively negative but the NHS is under enough strain, how would they manage this?
 
I really hope that’s the case. the movement towards it in the past 2-3 years has been huge.

I’d also really like to see access to continuous monitoring for T2s made much more widely available. Particularly those who want to use the data to improve their balance between BG, menu, and any meds they are taking. We can see on the forum how useful and motivating many T2s find that level of information. A blanket denial is just not fair at all. :(
 
I tend to agree with @Lily123.
The Closed Loop pump seems to be assumed to be the easy option but I understand it still requires a fair amount of effort to set up and understand what is going on so the user can manage when it fails or goes awry.
You only have to read the copious pages of people complaining about the Libre. Some are finding it doesn't suit them but many assume it should be 100% accurate all the time and do not understand the limitations (partially because HCPs are not explaining them ... because they don't have time to understand themselves).

I would love a closed loop system but I know I will still have to carb count and still have to be wary of DKA and do not expect it to be able to manage my exercise and ...
 
I just wish we could have the same tech access for t2 on insulin. Honestly I am happy for you T1s if this happens, but us t2/rarer types taking MDI insulin with low insulin production but not t1, really need to get the same tech access, it’s difficult being in permanent ‘honeymoon’ stage.
 
Partha has done amazing work for those living with T1. I think it is a shame his interest in the other 90% of those living with diabetes doesn't have a heart beat.

Bearing in mind the complexity of T2, being that bucket zone for diagnosis of anyone in adulthood, and even moreso if they carry a few spare pounds, I am utterly certain there are many T2s (and "T2"s) out there who would benefit enormously from even basic tech, long available to T1s.

To reiterate, I have the utmost respect for those living with T1, and those living with insulin dependent diabetes whose burden of self care is much greater than my own. I don't grudge those the tech, specialist care and so on that they receive. I just wish the 2 tiers of our NHS care (and, yes it is 2-tier) were not so far apart. That is near criminal.
 
@Lily123 - yes love, we all know that little fact.

BUT ! a lot of us also know by now that unless we live in hope, we're all going to be miserable old buggers, so we'll carry on living in hope, thanks.

None of us on here knows the finer details or has any input into the management or funding (other than via our taxes generally) of anything national government are in charge of, hence when General Election time arrives that's when we can try and make a difference by taking an interest and finding out more about the candidates for our Ward, then voting for the people who we think can both handle the job properly, and make a difference themselves - rather than having to vote for the 'least bad' candidate cos they all appear useless. (The same applies to Local Government too)
 
Personally, I would not want a closed loop. I can manage fine with MDI and Libre and I think a lot of other people could too with the right support and education and I agree with @Lucyr and @AndBreathe that I would prefer to see more funding go into tech availability for Type 2s as a levelling up exercise. Not saying that some Type 1s would not benefit from closed loop but I thik it should be in exceptional circumstances rather than the norm and I feel that there is currently a big injustice in diabetes investment that needs addressing first.

I am incredibly grateful for the tech I have. Libre/other CGM is wonderful once you understand it's limitations and how to use it effectively and I accept that some people get on better with one system than another, so now having a choice is good but to me that makes the need for pumps and closed loops much less beneficial for most Type 1s. I think Type 2s on MDI should routinely be offered intensive education and CGM (if they want it) first not have to fight for it and often be disappointed. We are all diabetic and whilst I appreciate what @Partha Kar has done for us Type 1s I would like to see him championing those who are treated as the underdog a bit more and supporting them. ie Type 2s, even if it is at our expense. He has achieved a lot for us Type 1s. We should be grateful, not always wanting more. Just my view!
 
nonethewiser said:
Hope his prediction comes true, he's a good egg is Partha.
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He is a good egg for T1s. My view of him, in his role of National Specialist Advisor in Diabetes to the NHS, is one of great disappointment. His apparent view of what is good enough for whom is staggeringly blinkered.

In these days when T2 diabetes costs the NHS outrageous sums, it is bewildering why, on diagnosis, the attitude to those with T2 is go away and work it out. We'll see you when you get worse.

What proportion of those living with T1 are on mixed insulins? Not overly many (outside the elderly population) I would wager, and what proportion os insulin dependent T2s are afforded the "luxury" of MDI?

At every level, it stinks, and he is the figurehead.
 
Partha Kar is the JOINT clinical lead, along with Prof Gerry Rayman, who seems to have been concentrating on safety in hospitals for people with Diabetes. I wonder what this other guy is currently doing, we never hear about him. Maybe they need to appoint a third joint head, to concentrate on Type 2 tech.
gettingitrightfirsttime.co.uk

Diabetes Workstream - Getting It Right First Time - GIRFT

Diabetes The GIRFT diabetes workstream is focused on helping people with diabetes and their clinicians to better manage the condition and reduce avoidable harms. The 2020 national report focuses on improving services for people with type 1 diabetes, and improving inpatient care and foot care for...
gettingitrightfirsttime.co.uk gettingitrightfirsttime.co.uk
 
Imagine the impact on T2 costs it would have if every diabetic at diagnosis was asked whether theyd be interested in testing bgs to help them change diet. Then if they said yes were issues with 1-2 pots of test strips, a workbook or online course that walked them through testing before and after a meal, eg breakfast for the first week, lunch the second, dinner the third, around exercise the fourth.

With 50 test strips there could be an invaluable amount of knowledge learnt. You could reissue the test strips and workbook/online course when they needed a refresher if a1c was high later on etc.
 
Robin said:
Partha Kar is the JOINT clinical lead, along with Prof Gerry Rayman, who seems to have been concentrating on safety in hospitals for people with Diabetes. I wonder what this other guy is currently doing, we never hear about him. Maybe they need to appoint a third joint head, to concentrate on Type 2 tech.
gettingitrightfirsttime.co.uk

Diabetes Workstream - Getting It Right First Time - GIRFT

Diabetes The GIRFT diabetes workstream is focused on helping people with diabetes and their clinicians to better manage the condition and reduce avoidable harms. The 2020 national report focuses on improving services for people with type 1 diabetes, and improving inpatient care and foot care for...
gettingitrightfirsttime.co.uk gettingitrightfirsttime.co.uk
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A joint third, forth or whatever would be good, just concentrating on T2 would be good, again, bearing in mind the burden we are told it is having on the population and resources.

Yes, I wholly agree, T2s, where appropriate, should be offered tech, but many T2s are offered nothing, even in terms of education or checks.
 
Lucyr said:
Imagine the impact on T2 costs it would have if every diabetic at diagnosis was asked whether theyd be interested in testing bgs to help them change diet. Then if they said yes were issues with 1-2 pots of test strips, a workbook or online course that walked them through testing before and after a meal, eg breakfast for the first week, lunch the second, dinner the third, around exercise the fourth.

With 50 test strips there could be an invaluable amount of knowledge learnt. You could reissue the test strips and workbook/online course when they needed a refresher if a1c was high later on etc.
Click to expand...
On my diagnosis, when I raised testing (my father had been a steroid induced diabetic, so I understood the value), I was instructed not to, because I wouldn't understand it. That instruction was without knowing me, my background or education to assess if I might be able to get my grey matter around it all.

It's a root and branch thing for me. Not tinkering around the edges.
 
AndBreathe said:
He is a good egg for T1s. My view of him, in his role of National Specialist Advisor in Diabetes to the NHS, is one of great disappointment. His apparent view of what is good enough for whom is staggeringly blinkered.

In these days when T2 diabetes costs the NHS outrageous sums, it is bewildering why, on diagnosis, the attitude to those with T2 is go away and work it out. We'll see you when you get worse.

What proportion of those living with T1 are on mixed insulins? Not overly many (outside the elderly population) I would wager, and what proportion os insulin dependent T2s are afforded the "luxury" of MDI?

At every level, it stinks, and he is the figurehead.
Click to expand...

Take your grievance up with Prof Kar if you feel so strongly about it, this thread & discussion is about closed loops for type1s which he predicts will be widely used to manage condition in 5 years time.
 
AndBreathe said:
A joint third, forth or whatever would be good, just concentrating on T2 would be good, again, bearing in mind the burden we are told it is having on the population and resources.
Click to expand...
I think he'd probably argue that he cares also about T2, and that other people involved do too. I know he's written a few times about how other consultants advised him not to worry so much about T1 since T2 is much more prevalent and important, and T2 is where the most impact can be had.

My guess is his undeniable success is partly a coincidence: Libre came along at a low enough cost and worked well enough that he (and others) could eventually get it recommended for everyone with T1 (and a smaller proportion with T2). Which then (likely) provoked Dexcom to produce a similarly priced product. Similarly now is surely the right time to be advocating for closed loops.

(Not that he's simply lucky, obviously. I can imagine other people in the role might have concentrated on other things and/or have been much less successful.)
 
nonethewiser said:
Take your grievance up with Prof Kar if you feel so strongly about it, this thread & discussion is about closed loops for type1s which he predicts will be widely used to manage condition in 5 years time.
Click to expand...

Some time ago, I asked Professor Kar, politely, on Twitter if he could signpost me to any of his work for T2s. He advised that I unfollow him.

I didn't unfollow him, but no longer see his content, unless as retweets or such like, so I am assuming he blocked me.
 
Hello. I’m puzzled by this prophesy.
So, I should (or should I.) expect in 5 years time to be offered the chance of using a closed loop system as part of standard care for type 1s. I can see this as a natural progression for existing pump users with standing experience.
But I’ve never been considered for a pump & I can’t see that happening in the next five years.

So it begs the question. Who is this tweet actually aimed at?
 
AndBreathe said:
A joint third, forth or whatever would be good, just concentrating on T2 would be good, again, bearing in mind the burden we are told it is having on the population and resources.

Yes, I wholly agree, T2s, where appropriate, should be offered tech, but many T2s are offered nothing, even in terms of education or checks.
Click to expand...
As an aside, regarding the tweet image used. “The mad titan” Thanos (was his name.) also succeeded in a plan to dispatch half the universe by snapping his fingers in a fancy glove with some “mystical stones.”
In effect. “Blocking” a lot of people.
 
He's simply making a statement about what he thinks to anyone who is on Twitter and follows him, can read. I presume but don't know for a fact, that the people who follow him, all have an interest in the treatment of diabetes.

OTOH the great and good people who were jointly delivering diabetes in 1972 (and after) were all assuring me they thought there would be a cure for T1 found within 10 years. I didn't place a bet on it myself and hope nobody else did!

We're just having a bit of a chat about it, is all.
 
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