A more integrated and comprehensive approach to insulin pump therapy and related new technology is needed so more Australian families affected by type 1 diabetes can benefit from treatment advances, according to a new report.

Diabetes Australia CEO Professor Greg Johnson said that while there are 118,000 Australians with type 1 diabetes, only 12 per cent (14,990 people) have access to insulin pump therapy due to cost, access and limited availability.

“Australia is lagging behind the US which has about twice the level of access to insulin pump therapy for people with type 1 diabetes,” Prof Johnson said.

Insulin pump therapy can be life-changing and together with new technologies such as continuous glucose monitors, potentially life-saving for people with type 1 diabetes.

An insulin pump is a small battery-operated electronic device about the size of a mobile phone and is worn 24 hours a day. The rapid acting insulin is delivered via an infusion set which is inserted under the skin, delivering insulin continuously.

Research has shown that insulin pump therapy can reduce the frequency of severe hypoglycaemia as well as improve the quality of life of pump users. Using a pump may improve blood glucose control.

The latest Australian data suggests around one in five adults with type 1 diabetes may experience hypoglycaemia unawareness and be more at risk of dangerous low blood glucose levels.

Insulin pumps, continuous glucose monitoring and newer closed loop systems can potentially help prevent hypoglycaemia.

“Access to diabetes technology such as insulin pumps should be available for Australians of all ages living with type 1 diabetes based on high or urgent clinical needs and also for women preparing for and during pregnancy,” Prof Johnson said.

The advantages for women in pregnancy include achieving optimal blood glucose levels which are important for the healthy development of the baby with less frequent hypoglycaemia for the expectant mother, and more convenience and flexibility during labour.

Renza Scibilia promotes the positive aspect of using an insulin pump, “I began using an insulin pump 13 years ago when my husband and I decided we were ready to start a family. I knew that pump therapy would give me the best chance of having a healthy baby. I had a terrific pregnancy and a very healthy baby. Today, using a pump and continuous glucose monitor is all about choice and freedom,” she said.

The largest funding source of insulin pumps comes through private health insurance which accounts for about 12,000 insulin pump users in Australia.

The Commonwealth Government funded Insulin Pump Program established in 2008 has provided access to the technology for 611 children and adolescents under the age of 18 years.

“Private health insurance at least allows access for people who can afford it but private health funds don’t fund or support the cost of ongoing consumables or accessing self-management education. Also replacement of pumps after warranty periods is often problematic,” Prof Johnson said.

Diabetes is a serious and complex condition and good management is paramount to living a healthy and productive life.

The Australian Centre for Behavioural Research in Diabetes Director, Professor Jane Speight said, “For many people, insulin pump therapy is a more flexible and convenient option than multiple daily injections. The freedom, spontaneity and independence it offers make a huge difference to quality of life, and can reduce the distress caused by the daily burden of diabetes self-care.”

Alicia Jenkins, an endocrinologist and a Professor of Diabetes and Vascular Medicine at the NHMRC Clinical Trials Centre, University of Sydney, added, “Technological advances such as insulin pumps and glucose sensors, a better understanding of related human factors, and enlightened health care policy can and should improve the quantity and quality of life for Australians with type 1 diabetes.”

*In summary, the Diabetes Australia report recommends:
*

• Establishing a comprehensive and coordinated national approach to the provision of insulin pump therapy and related support, to increase access to this life changing technology for all Australians with type 1 diabetes, and integrating federal and state governments and private health insurance funding.
• Enhancing the current Government funded insulin pump program by extending access to people age over 18 years including women preparing for and during pregnancy.
• Developing a funding pathway (including government and private health funds) for proven technology including continuous glucose monitors.