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NEWS
Unlocked
Mylife YpsoPump insulin pump is now available as a Digital Essentials Pack via
the NHS Supply Chain. The pack contains a Mylife YpsoPump insulin pump, a
four-year subscription to Mylife CamAPS - an algorithmic app which sits on
an Android phone. Because that is the case - and not everyone has an Android
phone or can afford to buy one in order to use the app - the pack includes new,
unlocked, unmanaged Android A15 phone. This pack has come about because
access to healthcare should not be defined by personal circumstances. This is
another step in the collaborative work between suppliers of diabetes technology
and NHS England. It is aimed at breaking down barriers by allowing people who
do not have an Android phone to use this Hybrid Closed Loop (HCL) system from
YpsoMed which features the CamAPS app.
Ypsomed.com/en
How tight a grip?
Moving on from the old HbA1c
measure of diabetes control, Time
in Range (TIR) took shape as a much
more user-friendly way for people
living with diabetes to see how they
were doing (and the HCPs and others
involved in their care). The concept
came out of way that CGM results
could be seen as graphs, with 'above
range', 'in range' and 'below range'.
Adding a bit of specificity to this, it
was deemed appropriate to look at
time - hence the Time Below Range
(TBR), Time in Range (TIR) and Time
Above Range (TAR).
In the main, TIR took off. People
'got it', it's a range that can be seen
hourly, daily and weekly. It was an
evolution welcomed by people with
diabetes and HCPs. In general, using
CGM or hybrid closed loop (HCL), the
aim was to be around 70% TIR over a
30-day period.
But is it enough? With the advent
of modern diabetes technology, can
control be even greater? Should
there be a standard for Time in Tight
Range (TITR)?
There is currently a proposal
to go in that direction. However,
who is asking people with diabetes
themselves if they want it? Doubtless,
some will. But is anyone thinking
beyond the numbers, of the impact
that level of control takes, and
its potential to trip people into
diabetes burnout, or a diabetes
eating disorder?
Prof David Kerr, a consultant at
Bournemouth Hospitals, now based
at Stamford University in the US,
and UK-based psychologist Prof
Katherine Barnard-Kelly, aren't for
or against - but they do want to
know what we think - those of us
who live with the condition and the
targets that are set for us that we are
expected to live by.
Says Barnard-Kelly, "I think
everyone is definitely up for
achieving optimal glycaemia and
quality of life for people with T1D.
There is some compelling evidence
that time in tighter range may be
beneficial, however there is also
evidence that there may be an
additional burden for folks from a
psychosocial perspective, and further
work is required to better understand
this. We know that people living with
diabetes are dealing with it day in
day out, not just on an hourly basis,
but constantly. They know that 'bad'
control can lead to unwanted health
outcomes - they are trying their best.
We just want to know if they want
this, if it would be helpful to them -
or harmful. We're just asking a few
questions to give us some insights as
to what people living with diabetes
think, before the proposal goes
any further."
CALL TO ACTION: Calling individuals with Type 1 diabetes. We need
your help. Please take our anonymous survey about your views on a
new metric for assessing diabetes outcomes called Time In Tight Range
(TITR). It will take no more than ten minutes to complete. To take the
survey, CLICK HERE.
Results will be shared once the data is collated.