Page 0012


Implantables are here. At least, there's a selection of them being

given long-term trials, so they will be coming our way soon. We look

at these, as well as updates on other applications.




continued over


NPUT has been around fornearly

20 years, and was focussed at

first on access to INsulin PUmp

Therapy, which is how it got its

name. As times have changed

so has INPUT -- it's not just about pumps

any more -- many questions now come

their way about how to get funding for

continuous glucose monitoring (CGM),

enough blood testing strips or sensor

augmented pumps.

The chief executive, Lesley Jordan,

says, "Researchers and manufacturers

are working towards a closed loop

solution which involves a pump being

run automatically in response to sensor

readings. It is 12 years since NICE first

appraised insulin pump therapy and we

still don't have anywhere near the number

of pump users that NICE expected.

Clinics and commissioners need to catch

up, otherwise they won't be suitably

experienced in pumps and CGM when

the closed loop becomes available. The

new NICE guidelines NG17 and NG18

are really great news. They basically allow

the NHS to provide CGM, although the

funders are under no obligation to do so,

unlike with insulin pumps."

INPUT, together with Diabetes

UK, JDRF, clinical champions and

NHS England, is currently working to

sort out the details of funding CGM.

Jordan explains, "INPUT does not

support petitions to government about

CGM funding, because it's NICE that

recommends on what drugs, devices

and treatments the NHS should spend

taxpayers' money. NICE only gives

guidance or makes decisions based on

robust evidence in the form of research.

'Popular demand' doesn't make any

difference, and MPs can't tell NICE what

to approve. If we push NICE to examine

CGM before we have a rock-solid body of

evidence, they will dismiss it as clinically

ineffective and too costly, and are unlikely

to reconsider for a further five years."

The long view

Jordan herself has Type 1 diabetes and

was diagnosed at the age of two. Still

a couple of years away from being

awarded her Nabarro medal (for living with

diabetes for 50 years), she did a skydive

in September 2014 to raise funds and is

planning on doing it again in August this

year to mark her 50th birthday.

She says, "My clinic suggested an

insulin pump in 2002; at that time I had to

buy it myself then show the improvement

in my control and apply for funding. I was

lucky to be able to afford it. When the first

NICE guidelines came out a few months

later I got funding as I met the criteria.

It was actually quite easy for me. At the

time I was part of an email support group

and could see that people were having

problems getting pumps."

In 1998, John Davis had started a

local support group for pump users in and

around Bournemouth. He was featured

in an issue of Diabetes UK's Balance

magazine, and his phone number was

given at the end of the article. After

publication he said that the phone did not

stop ringing. There were two Johns - John

Davis and John Neale - and they decided

that John Neale would run the email

support group IP-UK and John Davis

would handle phonecalls and letters, and

this grew into INPUT. John retired from

INPUT in 2011 and was awarded the

MBE in 2012 for his services to people

with diabetes.

Jordan continues, "I contacted John

Davis to ask how I could help people

get access to pumps, he asked me to

help organise a local roadshow, and so

I started as an INPUT volunteer in 2005.


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