DANII MEADS-BARLOW FOUNDATION
ABN:157880147
DANII
Foundation
DIABETES -INNOVATION -MANAGEMENT
Briefing Paper: Implementing Continuous Glucose Moni toring to save lives and reduce unnecessary management of diabetes in Australia .
Meeting with insert name of politician and date
Background: The DANII Foundation was established in 2012 in honour of Daniella Meads - Barlow who died in her sleep as a result of nocturnal hypoglycemia aged 17. Daniella was a type one diabet ic and a beautiful and talented young woman with a full life ahead of her. In 3 years since the foundation has g rown from strength to strength. We have attracted thousands of followers and supporters and alongside o ur national support and advocacy role hold a gala fundraising ball in June every year. It is the Foundation's clear purpose to ensure there is not another unnecessary d eath as a result of substandard monitoring practices.
Issues: Type one diabetes is not a lifestyle choice. You can’t get it from eating too much sugar. It is an autoimmune disorder, caused when the body’s own immune system attacks the pancreas, rendering it permanently unable to produce insulin.
Most are young children. It is a life sentence of endless needles, finger pricks and carb counting. Management of type one is intense, round the clock and vitally important. Blood sugar that is too low will cause disorientation, loss of consciousness, coma and, if unrecognised or untreated - death. Low blood sugar levels whilst sleeping are particularly dangerous and can also be fatal. Blood sugar that is too high has an immediate threat of DKA (blood that is too acidic) which is also life threatening. It is a fin e line and a balancing act that diabetics walk every day to try to maintain normal blood sugar levels. There is no cure. 80% of those diagnosed have no family history.
Current Management of type one diabetes:
To better manage their diabetes, type one patient s need comprehensive information about the way their body's blood glucose levels trend. The current recommendation (supported and funded by the Australian healthcare system) is for type one diabetics to check their blood sugar levels by conducting approximately 10 finger pricks a day (upon waking, before every snack or meal, before bed and at 2am). Whilst this was recognised as best practice, thankfully technology has advanced. The 10 small snapshots, that does not allow the identification of blood sugar level trends has been enhanced with Continuous Glucose monitoring (CGM).
Continuous Glucose Monitoring:
Continuous Glucose monitoring (CGM) is not only clinically superior to current funded practices it is also far more cost effective. The cost of a CGM monitor and related consumables is $4474.00. Considering the current cost of managing a type One diabetic costs over 3 times as much at $16000.00 it is essential that government fast-track the adoption of CGM technology; first to improve the lives of those with type one diabetes and secondly to reduce precious health funding and divert it to those in need.
CGM is conducted by the wearing of a sensor (such as a Dexcom) that checks the blood sugar level every 5 minutes, 24 hours a day. It allows for trend identification, prevention of high and low blood sugar events, and is the best way to prevent hospitalisation for common illnesses, as it allows for better management and
/•••2
control at home.
Better day to day management is the best prevention for long term complications. It also allows type one diabetics (and their families) to sleep at night, knowing they will be alerted by their CGM if their blood sugar is dangerously low, a critical factor in saving the lives of those living with type one diabetes.
In addition to the financial and health implications just described, a diagnosis of type 1 diabetes also has a profound emotional impact on the entire family. Parents of children with type one diabetes face grief, fear and desperation in coming to terms with the diagnosis of a chronic medical condition that has the real possibility of shortening your child's lifespan by decades.
CGM technology provides type one diabetics and their family's peace of mind. The ability to know with a glance at the Dexcom that your child is not going dangerously low or high and that they will wake up in the morning obviously has benefits that are not quantifiable.
Evidence to support CGM:
Insulin pump therapy has the ability to reduce the risk of long - term complications by reducing the number of hypoglycemic events versus multiple daily injections iii
• 84% Hypoglycemic eventsiii
• 60% Nerve damage (neuropathy)
• 63% Eye Damage (retinopathy)
• 54% Kidney Damage
• 41% Cardiovascular Damage
Recommendations:
1. The Government make an immediate decision to trial for up to 5000 CGM glucose sensors for high risk children and adults with type one diabetes*.
2. On conclusion of the Government’s National Diabetes Strategy Consultation and after a successful evaluation of the trial; the Government commit to subsidising CGM glucose sensors through the National Diabetes Services Scheme (NDSS).
*The DANII foundation would be happy to work in partnership with the government to implement evidence based technology, improve the quality of life of those living with type one diabetes and reduce the overall costs to government of managing this disease.
DANII Foundation
insert month 2015
i Diabetes Control and Complications Trial (DCCT) Research Group. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. NEJM. 1993; 329(14):977-986.
ii Section 7 clinical study. Data on File. Bayer Healthcare, LLC
iii Bode BW, Steed RD, Davidson PC. Reduction in severe hypoglycemia with long-term continuous subcutaneous insulin infusion in Type 1 diabetes. Diabetes Care 1996;19:324-327