Losing access to these technologies at such a stressful time of life could be harmful, say experts.
As soon as they hit age 21, many patients with type 1 diabetes are left without vital medical technologies, and being forced to manage their condition for the first time in their lives without these tools can be harmful, warned a diabetes expert.
Losing access could force young adults to be on the hook for hundreds of dollars a month to pay for insulin delivery, glucose sensing and insulin dose advice tools if they did not have either a concession card or high enough level of private health insurance.
These devices are subsidised by the government for all eligible children and young adults with type 1 diabetes until they turn 21. Afterwards only select groups may get them subsidised.
“We’ve heard a lot of stories of people turning 21 years of age and losing access, and how that really stresses them out because sometimes it’s the only means that they’ve used to measure blood glucose or manage their type 1 diabetes,” diabetes expert Associate Professor Sof Andrikopoulos told The Medical Republic.
And being is such a position during such a tumultuous life stage could be harmful, warned the head of the Islet Biology and Metabolism Research Group at the University of Melbourne.
“For some of these young adults, they only know how to manage their diabetes with continuous glucose monitoring (CGM) or flash glucose monitoring (FGM). That’s the only thing that they’ve used for the past two or three years – they’ve got nothing else.
“They don’t know how to do finger-pricking; they’ll have to learn new skills at a time when life is evolving for them. They may be at school or just out of school, [or changing] relationships,” he said. “We want to make things easier for them – we don’t want to add stress to people’s lives.”
Now, Professor Andrikopoulos and his colleagues are calling on the government to subsidise these tools for any adult with type 1 diabetes who wants them.
Those under-21s who use a CGM can reduce their HbA1c by about 1% on average, said Professor Andrikopoulos. This is an uplifting figure for a group in which it is typically challenging to control blood glucose, he added.
Around 130,000 Australians live with type 1 diabetes, but only one-fifth have access to an insulin pump, according to recent figures.
“Furthermore, it was reported that 80% of pump users in Australia obtained their device via private health insurance and about twice as many pump users were living in areas of high socio-economic status compared with low socio-economic status areas,” according to the paper.
Out-of-pocket, these devices cost around $7000-$8500.
Meanwhile, one in four adults used CGM. An Australian analysis supported the cost-effectiveness of adults using a hybrid closed-loop system compared with multiple daily injections with capillary glucose testing.
Professor Andrikopoulos said that the cost of subsidising these devices for all adults who want them would be less than the cost to the healthcare system of people with poorly managed diabetes.
“We know that not all people with type 1 diabetes will take up the technology, but they should have the option to choose the best way to manage their diabetes, whether that is finger pricking the traditional way and multiple daily injections, or whether that’s a continuous glucose monitor and a sophisticated insulin pump, which can sense the glucose monitor and switch itself off,” he said.
