Artificial pancreases for type 1 diabetes: Better access is “watershed moment”—but delivery is key

“People say it’s the closest thing to living without diabetes. They just feel so relieved at having to think about their condition much less. It’s absolutely amazing.”

Consultant diabetologist Emma Wilmot has seen major advances in the management of type 1 diabetes over the past 20 years, including the advent of insulin pumps and continuous glucose monitoring (CGM) sensors that attach to the skin. Hybrid closed loop systems—also known as “artificial pancreas” systems—combine both these elements to create an automated system of basal (long acting) insulin delivery that is being hailed as the most significant advancement in type 1 diabetes care since the discovery of insulin over 100 years ago.

Now, in its final guidance for England and Wales, published on 19 December 2023,12 the National Institute for Health and Care Excellence (NICE) has recommended that all children with type 1 diabetes and adults who meet certain criteria should be offered hybrid closed loop technology over the next five years, an estimated 150 000 people.

“There’s nothing better than people coming into a clinic and telling you that something has been life changing,” says Wilmot, who is head of the diabetes technology network of the Association of British Clinical Diabetologists (the ABCD, which is funded by membership fees and sponsorship, including from the drug industry3). “We saw that a lot with the early introduction of continuous glucose monitoring. But this takes it to a different level.”