I’m a big believer in Automated Insulin Delivery systems. This is what “closed loops” have evolved into. They’ve made a huge difference to my life with T1D, but I’m conscious that many people are shut out from being able to access them. Sometimes they don’t even know what they’re missing.
In NZ the government is introducing pumps, CGM and AID for everyone with T1D. The UK has already started rolling this out. In Australia we’re getting left behind.
Call to action
There’s a campaign to try to address this inequity. Do note that we are entering a federal election cycle, so now is a good time to make noise.
As part of this, please consider adding your signature to this petition.
Also follow up with talking to your local Member of Parliament. Just like we have done in the past with each phase of expanding CGM access. The petition is just one part of this effort.
Why you should support this
Those of us with T1D who have private health insurance in place and have already been able to access insulin pumps might feel that this doesn’t affect us. But I urge everyone to consider this on multiple levels:
- Less than a quarter of Australians with T1D are using insulin pumps. Often because the current funding model means they can’t afford it (but yes sometimes by choice).
- This is not just about you as a current pump user.
It will affect your future access to the tech, but it’s also about supporting the other 3/4 of the Aussies with T1D! - Not everyone with T1D “has to” use pumps and AID.
But everyone deserves the opportunity. - This flows on from getting CGM access for T1D. That was previously a roadblock for AID (which relies on CGM). Pumps are the other component.
We do want to keep expanding CGM access for more people (as it’s not just T1D who can benefit from that) but not everything can happen at once and we should not hold back on this issue. More on this below.
David’s example
My own advanced AID system helps me maintain excellent health. My doctors keep commenting that my HbA1c and CGM data are better than theirs, and they don’t have diabetes! Now being in my 5th decade of living with T1D, I know that the AID system has made the difference for me.
My own “control” wasn’t great for years. By the time I started using my current AID system CGM had helped me improve things, but I was still having to do a lot of work, and diabetes took up lots of time in my life. Because it had to in order to get good results.
Now I don’t even have to count carbs or manually bolus. And my clinical data is even better than it was! I get to spend time on the rest of life. And I have confidence that my future health prospects are now better than they ever were.
I know this is literally life-changing compared to the way I had to try to manage. Everyone deserves access to this.
Not every AID system is the same as mine (which is research software) but I know that even the older more-primitive ones offer huge advantages over manual pumping and MDI (injections).
What about other forms of diabetes?
These AID systems were developed for T1D (where they can track all the insulin going into the system without having to cope with the body’s variable insulin generation). So right now they mainly apply to T1D.
Research is ongoing around the world as to the use of these systems (or rather modified forms of them) to improve the health of people with T2D.
Some examples have been looking at the benefits for all hospital inpatients with diabetes, avoiding many of the dangers of going into hospital and having your diabetes mis-managed.
This is all still at the research stage, but it offers exciting possibilities.
Expanding CGM and pump access to people with other forms of diabetes than just T1D will be important for the future. Having wider access to AID for the T1D population will be a beach-head for that.
Please support this current effort, as part of improving everyone’s lives.
Type 1 diabetes
I have been diabetic for 50 years I would like to have any other person when I tried the Omnipod was the first time I felt like every one else I think my children suffered having a normal life
AID for everyone who wants it. Latest omnipod system yes please
You mention the uptake among T1D being at 25%, presumably because even a subsidised pump is too expensive.
You also talk about potential eligibility for Type 2s who can’t access the subsidy for pumps.
There is a third category (“other” or insulin dependent Type 3c in my case) who also don’t have eligibility to access the subsidised equipment.
Yes the costs of pumping are significant. Yes the monthly consumables are subsidised for PwT1D through NDSS (and concession status does get you a little off the cost) but the pumps themselves are not subsidised. Reworking the system would open up lots of possibilities.
There are needs for lots of people. I do suspect that in the future CGM subsidy for some non-T1D folk will come before pump subsidy for them. But my crystal ball is hazy. It would be nice if we could do everything at once.
Isn’t there a risk that we just normalise asking for technology that is already three years old at every election cycle and then when it does get delivered it is three years later and we end up with six year old technology with only a fews years to run before the patent runs out? Meanwhile the technology is updating every year or two. Instead should we, as a community, try to influence the conversation such that if a T1d technology or insulin is approved by a US, UK or EU regulator then it is also automatically approved in Australia??? It doesn’t have to be exactly that – but something in that direction.
This is not about getting something approved by the TGA. This is about getting the government to fund appropriate device categories for people to use.
I’m sure new devices will continue to appear in those categories, hopefully without having to change whatever funding model is set up.