Preston Stanley was hospitalised with type 1 diabetes at the age of three. Photo: Supplied
- Children with most poorly controlled type 1 diabetes benefit the most from automated insulin delivery
- Extra nine hours a day in "normal" blood sugar range set to cut complications and add years to their lives
- Pharmac to fund insulin pumps and continuous glucose monitors for all type 1 diabetics from 1 October
- Researcher says extending coverage to type 2 diabetics could save lives and reduce multi-million dollar burden on health system.
Children and young people with poorly controlled type 1 diabetes have the "most to gain" from automated insulin delivery, world-first New Zealand research shows.
The study - which has just been published in The New England Journal of Medicine Evidence - involved 80 seven- to 25-year-olds who were struggling to control their diabetes, with half getting an insulin pump with a continuous glucose monitor.
Professor Ben Wheeler from Otago University, who led the co-pilot trial, said that group spent an "extraordinary" nine hours more a day in the normal blood sugar range, compared with those receiving usual diabetes care.
"There's no other randomised controlled trial in this sort of technology world-wide that's shown that kind of improvement. And at nine hours, it's completely life-changing."
Those children and young people were not only "feeling much better and safer", but long-term they would be less likely to develop complications and suffer early deaths, he said.
"People who develop type 1 diabetes at an early age can have their lives cut short by between 10 and 18 years."
Type 1 diabetes is an auto-immune disease that requires constant monitoring of blood sugar levels, and regular insulin injections.
Traditional treatment involves pricking fingers multiple times per day, manual injections, and strictly controlling diet and exercise.
Automated insulin pumps act as "an artificial pancreas", analysing blood sugar through a continuous glucose monitor and delivering insulin as required through an automatic pump.
Wheeler said many patients with poorly-controlled diabetes had traditionally missed out on the expensive technologies.
"Our findings show we must now challenge historical norms and policies by prioritising the initiation of automated insulin delivery among these individuals, who may not have traditionally been viewed as ideal candidates, ensuring that they can fully benefit from this transformative, burden-reducing technology.
"Those with the worst-managed diabetes have the most to gain. We need to get these devices into the hands of Māori, Pacific, people of low socioeconomic status, children and youth as a priority - this is vital world-wide, and especially important for equity," he said.
Free access for type 1 diabetics from next week
Pharmac will fund continuous glucose monitors for all type 1 diabetes patients from 1 October.
Wheeler noted Australia was currently considering making them available to type 2 diabetics too. There are close to 300,000 type 2 diabetics in New Zealand.
"I think as the evidence comes in, that this technology helps all types of diabetes in many cases, I think we'll see that funding come here too. But we're a long way away from that in New Zealand."
Karen Reed wears her continuous glucose monitor on her left arm. Photo: Supplied
Families welcome "landmark decision" to fund continuous glucose monitors
Preston Stanley's parents used to need a flashlight to check his glucose levels in the middle of the night, sneaking into his room to prick his fingers.
Now they can just use their phones.
The 15-year-old Auckland boy was diagnosed with type 1 diabetes at the age of three.
"When I entered primary school, and teachers were injecting me with insulin, I realised how serious it could get if I don't take care of my glucose levels," he said.
Getting a continuous glucose monitor and pump (FreeStyle Libre 2) was "a game changer" for the representative basketball player.
He said Pharmac's decision to fund the monitors would be a huge financial help to his family.
"This will have a massive impact on all the other families who have had to give this up for their kids."
Karen Reed said she "burst into tears" when she heard the monitors would be funded.
Now 54, she was diagnosed with type 1 diabetes at 10 and has lost feeling in her fingertips due to finger pricking 10-15 times per day, for over 35 years.
She said she had been feeling "selfish" spending so much money on herself to pay for the pump and monitor.
"I had to constantly ask myself, 'do I need this now? How necessary is this? Can I live without this?' But after one week I knew I could never go back."