Hba1C and T1 Tech. It matters.

I’ve written a lot about the tech that I use, and part of that is the NHS’s online GP service. Recently while digging into this, I was able to find the details of all my Hba1Cs going back for more than 10 years, and what an interesting find that was. I also discovered my diagnosis date, more of which another time. 

Let’s start by looking at the Hba1C data. It’s fair to say that I wasn’t the most reliable at getting my bloods done for a lot of my adult life, so the data is perhaps a little sparser than I’d have liked, and serves as a good reminder to everyone that you should get it done regularly.

What we can see from this data is that for 14 years (give or take a few gaps) using MDI with Lantus & Novorapid, I generally had a result that came in below the UK’s target level of 58 mmol/mol (7.5%). I’d suggest that’s through luck rather than judgement, but it’s an interesting result none the less.

The orange line is the date at which I got Libre, and the first Hba1C result after that is approximately six weeks later. There’s’ a very clear drop there, and I’d attribute it to the Libre. Every six months, or year, after that you can see that the level has dropped a little bit more, but stabilised around 5.8% (39mmol/mol).

Why do I care? All the points that I’m showing here that are below the NICE target of 6.5% are all values achieved with the use of T1 Tech, and all of it is self-funded. All the points prior are done using fingerprick testing and MDI.

It shows a stark difference. 

Why is that important? Because as I’ve talked about before, the lower the value of the Hba1C, the lower the risk of complications, and complications are what take up the largest proportion of the budget when allocating costs for the care of people with type 1 diabetes.

And this is why we need to support the fight for flash. Whatever you might think of the tech, the reality of living with Type 1 Diabetes is that there is no magic bullet and certainly at this point, no cure. New insulins don’t magic away the vagaries of the condition or help you to administer them effectively or safely. As I can see looking back at my data, and Dr Fraser Gibb has shown with the Edinburgh Centre for Endocrinology and Diabetes patients, adding tech into the mix and using it properly gets results:

 

T1 Tech matters. A lot. 

 

 

Add into that what can be achieved with systems like Loop, OpenAPS and AndroidAPS and the picture seems even more convincing:

 

Flash glucose monitoring and the forthcoming progress in T1 Technology is a test for healthcare systems globally, encouraging them to recognise that to reduce the impact and cost of living with T1D, there are technologies out there that make a huge difference, both in clinical outcomes and massively in quality of life. While I’m not denegrating the need for education and the fact that education makes the biggest difference, if DAFNE was offered alongside Libre, or any other CGM device, the education could achieve so much more.

Within the UK’s NHS, it has to be used as the battering ram to open the door for what comes next, as technology is as good as, or better than a drug, which might nominally be prescribed by a GP or allowed by a CCG with much greater ease.

So if you live in an area (as most of us do) where Libre is nigh on impossible to get your hands on for whatever reason, let’s remind the CCG panels that we pay for their wages and we’d like to live longer and more productive lives. That we’re not happy with them wasting money rewriting England and Wales wide guidance to fit their own ends. And that the technologies available now, and coming in the very near future need to be in the hands of those who need them when they become available, and not lost in the far distant future.

Hba1C and T1 Tech. Tightly linked. It matters.