Dr Thalange's Talk on Insulin Pumps

Dr Thalange's Talk on Insulin Pumps

Talking to the group on Thursday 28th August Consultant Paediatrician Dr. Nandu Thalange focused on the benefits of the insulin pumps that are now becoming more widely used for the greatly improved and continuous control of blood sugar especially for those diabetics who for many reasons have difficulty keeping their blood sugars within the target range.

First developed in the 1960s insulin pumps have advanced technically whilst reducing in size such that they are now readily worn and used by patients. The inevitable problem for the NHS is their seeming high cost, however, and encouragingly, studies in Australia have shown that when all lifetime costs are calculated they show significant overall savings because when under good treatment both children and adults will live longer and experience fewer complications.

Further, good early control shows long-term (even 25 years later) reductions of complications such as retinopathy, nephropathy, neuropathy and microalbuminaria. And the savings to the NHS are obvious considering that only 10% of the NHS budget for diabetes goes towards all therapies whereas the long-term, mainly hospital, costs for dealing with complications takes 82% of the NHS’s £18 billion budget for diabetes. Sadly too for diabetics hospital outcomes are always poorer.

There are now some 380 children and young people (under 19) suffering with diabetes in Norfolk, mostly with Type 1 but there are now some Type 2s and others who fit neither category. It was only as recently as 2001 that the first patient in Norfolk received a pump and, as is now understood, insulin works better at certain times of the day with the normal body level of insulin following an m-shaped curve. This cannot be matched by injections (even with the complex and demanding basal bolus therapy and multiple daily injections) – but the pump can.

When you think of the serious problems for children of carb counting, very frequent testing and injecting (7-10 times daily) it is not surprising to find that dangerous hypos are four times less likely when using a pump, whilst the long-term life benefits are potentially immense.

Dr. Thalange showed he has a wealth of facts and figures on research at his fingertips and it is to be hoped that his great understanding of diabetes will help make pumps more widely available for diabetics, especially children.