Diabetes Treatments

Karin Smyth Excerpts

Tuesday 29th October 2024 Westminster Hall

[The Minister for Secondary Care (Karin Smyth)]

It is a pleasure to serve under your chairmanship, Mrs Harris. I welcome the hon. Member for South Northamptonshire (Sarah Bool) to this place, as I have not had a chance to do that. I thank her for securing the debate and sharing her own personal experience. She spoke powerfully about her fear, disbelief and sadness at her own diagnosis.

More than 4.9 million people in the UK have diabetes and 2 million people are now at risk of type 2 diabetes. The impact on the health and wellbeing of the nation and on the lives of people with diabetes and their families cannot be overstated. The hon. Lady has put a superb case this morning. A central mission of this Government is to build a health service and care system fit for the future. As part of that, tackling preventable ill health such as type 2 diabetes is crucial. At the same time, we want to ensure that people with types 1 and 2 diabetes receive the best possible care so that they can live healthier lives wherever they live in the United Kingdom.

As the hon. Member for South Northamptonshire mentioned, a central factor to people with diabetes living well is ensuring that they have access to annual diabetes reviews that cover the eight processes recommended by NICE. Annual diabetic reviews are associated with reduced emergency admissions, amputations, retinopathy and mortality. However, in 2019 only 42% of people with type 1 diabetes received all eight health checks, and that figure dropped significantly during the covid-19 pandemic. The NHS has worked hard to recover these services, and the proportion of people with type 1 and type 2 diabetes receiving all eight care processes reached 43.3% and 62.3% respectively in 2023-24. Although that is an improvement, in order to drive faster uptake the NHS will invest £14.5 million over the next two years to support up to 140,000 people aged between 18 and 39 to receive additional tailored health checks from healthcare staff. That will include support to help break down any stigma associated with the disease and support people with diabetes management through blood sugar-level control, weight management and cardiovascular risk minimisation.

I want to draw attention to what the hon. Lady said about stigma, because it is important. My best friend from university was diagnosed in her early 20s, which was some time ago—she will not thank me for mentioning that. I have family and constituents who have type 1, and I have learnt a lot from them about how important it is to look after oneself and get the care that one needs. I also commend Baroness May and Sir George Howarth. They were a formidable duo in Parliament, raising awareness of what is possible. They were both great servants of their respective parties, and I know they will continue that work.

Technology also plays a critical role in helping people with diabetes to live healthier lives, and I am pleased to hear of the personal impact a hybrid closed loop system has had on the hon. Member’s life. As many will be aware, NICE has made recommendations on offering real-time continuous glucose monitoring and hybrid closed loop technology to adults and children with type 1 and type 2 diabetes. The NHS is making progress, with over 65% of people with type 1 diabetes using glucose monitoring to help manage their condition, and I expect to see similar rapid progress for people with type 2 diabetes.

Following NICE’s final guidance in December 2023 on HCL systems, NHS England has developed a five-year national strategy with guidance for NHS providers on a phased uptake for delivering this life-changing technology to eligible diabetes patients. I am sure the hon. Member and others will be watching that roll-out closely. It started this April with an initial focus on children, young people, pregnant women or those planning to become pregnant, and adults already using pumps who want to transition to a HCL system. The longer implementation period is because of a need to build essential workforce competencies in specialist adult services. To ensure that patients are safe, NHS trusts should only provide HCLs if they have access to specialist, trained clinical staff experienced in providing insulin pumps and continuous glucose monitors for type 1 diabetes. I know that waiting to access this technology is causing many people distress, and I assure the hon. Member that NHS progress in delivering these technologies is a matter of importance to this Government.

I also thank the hon. Member for raising the important issue of type 1 and disordered eating. NHS England has provided funding for eight integrated care boards to support the development and establishment of type 1 disordered eating services in every NHS region. NHS England is drawing on learning from the existing services, other emerging evidence and the findings of a recent parliamentary inquiry to ensure that all areas of the country are supported to improve care for those identified as having type 1 disordered eating.

On type 2 diabetes, the hon. Member expressed concerns about access to GLP-1 medications, such as Ozempic. Following intensive work with industry, the broad supply position for GLP-1 medications in the United Kingdom has improved. However, global supply issues remain for specific medicines, including Ozempic. We continue to work closely with manufacturers and others in the supply chain to help ensure the continued supply of GLP-1 receptor agnostics for UK patients, and to resolve the remaining supply issues as quickly as possible, for example by asking suppliers to expedite deliveries.

I now turn to prevention and to the support available for people to put their type 2 diabetes into remission, which, as the hon. Lady outlined, is possible. In fact, I canvassed somebody last weekend who was very proud of their ability to do that. It is great work. Lord Darzi’s report on the NHS, which was published last month, noted the worrying increase in the prevalence of people with type 2 diabetes and the necessity of prevention.

The prevention of diseases, including diabetes, is a priority for this Government. The Healthier You NHS diabetes prevention programme supports people at risk of developing type 2 diabetes to make lifestyle changes, either through face-to -ace group programmes or digital services. The programme reduces the risk of type 2 diabetes by 40%. The programme has also been working to raise awareness among the diabetes healthcare professional community about the growing numbers of children and young adults with type 2 diabetes, and we have heard about that today.

Healthcare professionals need to understand the more aggressive nature of early onset type 2 diabetes, compared with older onset type 2 diabetes, to support earlier diagnosis. Further, given the inequalities in who develops type 2 diabetes and the poorer outcomes for those of south Asian and black ethnicity, which were also mentioned by the hon. Member, the NHS has established a focused engagement campaign, using social media and more traditional approaches to raise awareness and boost the uptake from those groups.

Living with type 2 diabetes is not inevitable if early action is taken to live a healthier life. As the hon. Member said, the NHS type 2 diabetes path to remission programme is a joint initiative between NHS England and Diabetes UK. It provides a low calorie diet and support to people who have been recently diagnosed with type 2 diabetes who are living with obesity or are overweight. This year, the programme has been expanded to make it available across all England, enabling more people to benefit and to recover from type 2 diabetes.

The hon. Member asked specifically about the ELSA study, which I understand is recruiting 20,000 children in the UK, to better understand the potential benefits of screening for type 1 diabetes. I understand that the University of Bristol, in my home city, is also undertaking a similar study, looking at the risk of type 1 diabetes in adults. The Government look forward to seeing the outcome of both of those studies, to help inform future policy making.

By moving from sickness to prevention, the Government want to shorten the amount of time people spend in ill health and prevent illnesses before they happen. That is one of the goals of reforming the NHS, which is part of the Government’s 10-year plan. I know that the hon. Lady will contribute to the debate in the rest of this Parliament.

Question put and agreed to.