Research into diabetes care set to benefit patients in Birmingham and beyond
The diabetes team at Birmingham Children’s Hospital have developed an efficient and easy way to get children and parents trained in the use of technology that automatically regulates insulin, which they are now sharing across the NHS.
The team responded to the challenge of onboarding children and young people with type 1 diabetes onto hybrid closed-loop systems, which check the child’s glucose levels and administer insulin accordingly, by innovating a hybrid model of diabetes education.
This approach blended digital and face-to-face learning, allowing many children and parents to do the learning virtually, and allowing the team to spend time face-to-face with those that may need extra help. They found this improved glucose management and equitable access across diverse patient demographics.
Jon Pemberton, Paediatric Diabetes Specialist Dietitian, said: "In 2022, we recognised that the new hybrid closed-loop systems were transforming the lives of the young people with type 1 diabetes we support. However, we were frustrated by our limited capacity to onboard only 35 children per year, which meant it would take eight years for all our children to benefit. In response, we developed a virtual hybrid program that allowed those who could self-educate virtually to do so, freeing up more time to support those with educational and language challenges promptly.
“We were thrilled to increase our onboarding rate fivefold, enrolling nearly 100 children in six months compared to only 18 previously in that timeframe previously.
“Most importantly, our results show that the virtual hybrid model ensured equitable onboarding, addressing health inequalities and meeting the NHSE Core20Plus5 initiative. This achievement was truly a team effort, with everyone from the administration team, library team providing articles, to consultants playing their part. Families have told us that the hybrid closed-loop systems have changed their lives forever."
Emily Allen, from Birmingham, mother of James who is one of the patients helped by the team, said: “Prior to starting on the Automated Insulin Delivery system, James was on pen injections and could need up to eight injections a day. Despite all our best efforts, James would often find that he would yo-yo between lows and highs. James struggled with bad moods at times due to his fluctuating blood sugars and, quite frankly, he would often look dreadful, with pale skin and dark circles under his eyes.
“James started on the machine three days after his seventh birthday, and he is a different boy. He is more relaxed, happier and less angry with life. It’s given us back the carefree James that we had prior to diagnosis 18 months ago.
“The team made learning about the new technology incredibly easy. James and I undertook some introductory online learning at home before a morning session at the hospital with three other young people with type 1 diabetes. By the end of that session James was wearing an insulin pump for the first time. I felt confident in using it and supporting James with the required insulin delivery and, as ever, the team are on the end of the phone whenever I have any queries, which was particularly helpful during the first week or so.”
Now results have been published, and the team have hosted local and national training events to assist other hospitals and health centres in meeting the challenge set by NICE Technology Appraisal 943, which aims to have all children and young people with type 1 diabetes on a hybrid closed-loop system over the next few years. Alongside these events, the digital learning system has been made available to other healthcare providers so that they don’t need to produce their own.