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Understanding Diabetes 2019

Technology that can help prevent hypos and how to access it

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Karen Baxter

Country Director, Dexcom UK, Ireland, and Belgium

Karen Baxter, Country Director at Dexcom UK, Ireland, and Belgium talks about the incredible advances in diabetes technology she has seen in the last decade, with real time glucose monitoring revolutionising management for those patients who experience frequent, severe hypoglycaemic episodes.

When I started working in the diabetes space thirteen years ago, the standard method of glucose measuring for people with Type 1 diabetes was with a blood glucose meter. I’ve seen this industry evolve in myriad ways but the most exciting thing has been seeing patients – who were relentlessly pricking their fingers to draw blood and test their glucose – transition to wearing a continuous glucose monitoring system (CGM) and being able to glance at their glucose numbers on their compatible smartphone or smartwatch.*

Giving patients choice is at the heart of what we do here. My hope is that every person with diabetes (PWD) has a choice of diabetes technology and can access it without barriers; whether they’re using our device or another.

How to choose the appropriate technology

In order to find the best solutions for patients, we must collaborate with diabetes charities, leading clinicians within the diabetes space, and our colleagues in the industry. One such project is the Type 1 Diabetes Tech Pathway which is a fabulous step towards making healthcare professionals within the NHS feel empowered to guide their Type 1 patients to the appropriate technology to meet their needs.[1] However, of the three arms of technology available – continuous subcutaneous insulin infusion (CSII – insulin pumps), flash glucose monitoring (scanning), and real-time continuous glucose monitoring (RT-CGM) – it is only RT-CGM that lacks mandated funding. This is despite growing evidence of its efficacy in improving outcomes; particularly for those PWDs who have impaired hypoglycaemic awareness and/or are experiencing severe hypoglycaemia, which requires third-party assistance. I want this to change.

Reducing hypos with RT-CGM

Clinical trials, such as HYPO DE, demonstrate that using RT-CGM reduces hypoglycaemic episodes by an incredible 72% in a cohort of patients vulnerable to severe hypos.[2] Furthermore, using predictive low alert features with a CGM device has been shown to reduce the amount of time the patient spends in hypoglycaemia. This is backed-up by real-world data that shows that this kind of alert is allowing people to meet the globally agreed upon target for Time in Range relating to hypos.[3]

Preventing hypos through technology

I feel strongly that we need to better serve this group of PWD who are experiencing these kinds of serious issues with hypoglycaemia – as many as 80,000 in the UK and Ireland alone.[4]

Recent years have shown a massive improvement in access to technology for PWD, but there is a risk that this group of vulnerable patients could be left behind. It is this group who are most likely to require an ambulance call out and hospital admission for a hypoglycaemic event at a cost to the NHS of approximately £1800.[5]

A focus on prevention through investing in technology will have life changing benefits through helping to prevent these severe hypoglycaemic events.

How to access this technology

If you are struggling to gain access to this technology, there is help available from our charity partner, JDRF-INPUT who can support and guide you through the process of accessing CGM technology.

*If your readings do not match your symptoms, please confirm your readings with a fingerstick. For a list of compatible devices, visit Smart watches require a compatible smart device. | [1] P. 534 |[2] Heinemann L, et al. Benefits of continuous glucose monitoring use in adults with type 1 diabetes and impaired hypoglycaemia awareness and/or severe hypoglycaemia treated with multiple daily insulin injections: Results of the multi-centre, randomised controlled HypoDE study. Lancet. In press | [3] Puhr, Sarah et. al. Real-World Hypoglycemia Avoidance with a Continuous Glucose Monitoring System’s Predictive Low Glucose Alert. Diabetes Technology and Therapeutics. In press | [4] Geddes J, et. al. Prevalence of impaired awareness of hypoglycaemia in adults with Type 1 diabetes. Diabetic Medicine, 2008 Apr;25(4):501-4. | [5] Chaugule S, et. al. An Economic Evaluation of Continuous Glucose Monitoring for People with Type 1 Diabetes and Impaired Awareness of Hypoglycaemia within North West London Clinical Commissioning Groups in England. European Endocrinology, 2017;13(2):81–85

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