Diabetes Technologies

Martyn Day Excerpts

Wednesday 23rd November 2016 Westminster Hall

[Martyn Day (Linlithgow and East Falkirk) (SNP)]

It is a pleasure to serve under your chairmanship today, Mrs Gillan. I thank the hon. Member for St Ives (Derek Thomas) for bringing forward this interesting debate on diabetes technologies. I thank him for his explanation of the position, and would like to publicly agree with him that we need to accelerate access and that we could do better. I am also grateful to him for informing us of flash glucose monitoring—FGM. It is a new technology that I must admit I am not familiar with, and I would have guessed completely wrong, based on its initials, as to what we were discussing.

There can be little doubt that diabetes is the fastest growing health threat of our time and a critical public health matter. It is estimated that more than one in 16 people across the UK has diabetes—be that diagnosed or undiagnosed—and it is worth remembering that around 80% of diabetes complications are preventable, or can at least be significantly delayed through early detection, good care and access to appropriate self-management tools and resources, of which access to diabetes technologies is a fundamental part. With that challenge of the increasing numbers of people with diabetes, access to the technology to help those living with the disease becomes yet ever more important. We can learn much from the different approaches to this issue throughout these isles, and we have heard examples today that are both good and bad. The right hon. Member for Knowsley (Mr Howarth) informed us of the problems faced by many young people and their experiences at schools. That is a very good example of how we could do better.

Much of the debate centres around the two main technologies: insulin pumps and continuous glucose monitors. It is, unfortunately, fair to say that at present the challenges facing sufferers in Scotland in obtaining them are greater than for those in England and Wales. However, much progress is being made and the Scottish Government are committed to ensuring that people living with diabetes have access to the best possible care.

Since 2010, the Scottish Government have set and met targets to increase insulin pump therapy. In Scotland, we have already made good progress in its provision, and by the end of the current Parliament some 6,000 adults—more than 20% of the type 1 diabetes population across Scotland—will have access to insulin pump therapy; currently, the figure is around 9.5%. In 2010, the diabetes action plan called for NHS boards in Scotland to introduce plans to make insulin pump therapy available for patients who would most benefit from it. That was followed, in 2011, by the target that 25% of under-18s with type 1 diabetes should be on insulin pump therapy; that was met by December 2014, and the figure had reached 31.2% by the end of 2015. Good though this progress is, we must still do better.

This form of insulin delivery has made a big difference to those who have received it; however, it is worth remembering that is not always appropriate for everyone. To be successful, insulin pump therapy requires intensive work by the patient in association with the local diabetes team, and requires self-management and monitoring.

Continuous glucose monitoring devices can be extremely useful in helping sufferers to manage and monitor their glucose levels. The Scottish Intercollegiate Guidelines Network—SIGN—guidance recommends that CGM should not be used routinely for people with diabetes; however, it may be considered for women with type 1 and type 2 diabetes, as it may be beneficial during pregnancy. As a result of that, provision through the NHS in Scotland is limited. Earlier this month, Shona Robison, the Cabinet Secretary responsible for health, wellbeing and sport in Scotland, confirmed that a national approach is being developed, stating:

“Work is currently on-going to develop a national approach for the use of Continuous Glucose Monitoring (CGM) devices in Scotland, as we recognise the speed of development of this technology.”

Best practice on provision of CGMs and insulin pumps will continue to evolve with developments in technology. Innovative new approaches to healthcare may prove key to improving the treatment of conditions such as diabetes. The Scottish Government, in partnership with Scottish Enterprise, has funded a £500,000 competition to develop a new technology to help with the management of type l diabetes. To supplement existing education programmes, competition entrants have been asked to develop a mobile health product, which could be an app, a new interface or a new device, to assist people in dealing with their condition. The competition is a good example of working with partners across private, public and third sector organisations to develop a new and innovative solution. At its launch, Dr Lena Wilson, chief executive of Scottish Enterprise, said:

“The economy grows faster when companies embed innovation in all they do. Scotland operates in an increasingly competitive global market so developing and maintaining competitive advantage is imperative. The work underway with NHS Scotland on solutions to the challenges Type 1 diabetic patients face offers an opportunity for more of our SMEs to embrace innovation.”

Of course, the potential benefits of that are not just with the businesses that take part. Managing diabetes accounts for about 10% of the annual NHS Scotland budget —almost £1 billion a year. When 80% of NHS spending on diabetes goes on treating avoidable complications, potentially significant savings can be made through better self-management and use of technologies—and that is before we consider quality of life for the actual sufferers who benefit.

In conclusion, we can do much to improve diabetes education and care for both type l and type 2 diabetics, and diabetes technologies have a key role to play in that process. The challenge is to find effective ways to overcome barriers to implementation, and to facilitate greater access for those who would benefit. I am thankful for the opportunity to take part in today’s consensual and informative debate.