Published on 17 November 2023

Draft guidance from the National Institute for Health and Care Excellence supports use of system for managing blood glucose levels.

Hybrid closed loop management system is expected to be available via the NHS – following a recommendation from NICE.

The hybrid closed loop system, also referred to as an artificial pancreas, can help people living with type 1 diabetes to improve management of their blood glucose levels.

Following the consultation on the case for extending the statutory 3-month period for funding of hybrid closed loop systems for managing blood glucose levels in type 1 diabetes, the NICE draft guidance is anticipated to be published next month (December 2023), that could mean the system will soon be offered to around 150,000 people living with the condition in England.

Hybrid closed loop (HCL) systems work by linking an insulin pump and continuous glucose monitor (CGM) with a computer algorithm that can calculate the amount of insulin someone needs based on their blood glucose readings, helping people manage diabetes with minimal user interaction. 

Those eligible to be offered HCL as part of the recommendation will include people living with type 1 diabetes who are under the age of 18 or those who are over 18 with either an HbA1c of 7.5% or who are experiencing disabling hypoglycaemia (low blood glucose levels), the technology appraisal also impacts women who are pregnant or planning a pregnancy, and people already using an insulin pump.

HCL manufacturers Dexcom have recently published the results of a new study around the perceptions of HCL among patients with type 1 diabetes and healthcare providers involved in their care.

A person holding an insulin pump.

The research found that 79% people struggle with time in range, but 45% do not know what a HCL is or understand how the system could benefit them.  

According to HCL users participating in the study there were numerous benefits to HCL, including improvements in quality of life (52%), time in range (46%), productivity at work (44%), sleep (42%) and reduced stress related to diabetes (40%).

All HCL users surveyed said it was important to them that they had a choice of insulin pump, with more than half indicating it was very important (55%), and the rest noting it was somewhat important (45%).

Healthcare providers were also in agreement at the potential of HCL to change lives for people living with type 1 diabetes for the better (99%), while 98% said they would want all people with the condition to have access to HCL.

Partha Kar, National Specialty Advisor, Diabetes with NHS England, said: “It's a cause for celebration that hybrid closed loop systems are now a possibility for around 150,000 people with type 1 diabetes. This guidance would not have been possible without the support of our industry partners investing in new innovations and advancing technology for diabetes management. Today we are one step closer to providing access to life changing technology for more people with diabetes.”

Karen Baxter, Vice President for UK Ireland Benelux Spain and France for Dexcom, said: “It is clear from our research that so many more people could benefit from HCL. Every single person (100%) surveyed with type 1 diabetes said that being on an HCL system has reduced the burden of managing their diabetes and 98% of healthcare practitioners say they would want all people with type 1 diabetes to have access to HCL. The newly announced technology appraisal from NICE is a great advancement in access to diabetes technology.

“As such, to support healthcare professionals with their understanding of the benefits of HCL systems for patients with diabetes, Dexcom has worked with the clinical experts at the Diabetes Technology Network (DTN) to launch a series of education modules encompassing everything they need to know about the technology, we are excited to play a key role in widening access to HCL as a result.”

Jeremy Irvine, actor and HCL user, said: “I can honestly say using the Dexcom G6 continuous glucose monitoring device to power my HCL system has changed my life. I can’t imagine going back to finger pricks and blood glucose monitoring, and I certainly couldn’t do the intense filming I’ve been doing without my HCL system.”

Read draft NICE guidance Hybrid closed loop systems for managing blood glucose levels in type 1 diabetes

Read the NICE final appraisal document on Hybrid closed loop systems for managing blood glucose levels in type 1 diabetes

Read more about type 1 diabetes

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