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World-first trial helping type 1 diabetes described as huge success

Following a year-long trial of a continuous glucose monitor, type 1 diabetic Hannah Easton's life has drastically improved.

"The trial was amazing, I feel very lucky to be a part of it cause it's not the opportunity that many people get," said Easton.

"It's really just changed everything, it's made my life so much better, quality of life's just been amazing."

Easton's one of 20 at risk type 1 diabetics aged 13 to 25 that took part in an Otago Medical School trial of the artificial pancreas system.

The system works by placing a glucose sensor on the arm that uses an algorithm to deliver insulin through a pump, reducing the need for constant finger pricks.

Paediatric Endocrinologist Ben Wheeler who led the study, says this age group has never been looked at before, and are often excluded from clinical trials.

"This group's particularly interesting - no one's tried to use this sort of equipment on these people before because they're essentially people who've been failing our traditional therapies - so we've taken people who are very unhealthy and then we've used the most advanced automated system we can to see if we can get them healthier," said Wheeler.

The aim is for all diabetics to spend at least 70% of the time between a glucose level of 3.9 and 10 mmol/L.

A normal glucose level for a non-diabetic is around 3.5mmol/L.

Before the trial, participants on average spent only 20% of the time within those measurements - some individuals spent no time at all in a healthy range.

By the end of the study, they were in the target range 67% of the time.

"So that worked out to be about nine and a half hours more time every single day in a healthy glucose," said Wheeler.

"That should dramatically reduce their risk of long term complications and early death.

"Being diagnosed as a child with type 1 diabetes, current data would suggest they might lose somewhere between 12 and 17 years of their lifespan."

The results are attracting international attention.

Some experts say they're unheard of.

When endocrinologist Goran Petrovski heard the results, he simply responded with "wow".

He's Qatar-based, and says the findings here are already changing guidelines for this kind of therapy around the world.

"This study, it will open a huge discussion that this age group can be easily onboarded on the new devices without any problem," he said.

And it's hoped the same will happen here.

While the continuous glucose monitors aren't new, they still aren't funded here, and they cost between $4000 and $5000 every year to run.

Easton says it's been too long since the technology has been around without funding.

"If you look at it from a cost benefit kind of perspective, the benefits outweigh the cost immensely," she said.

"If you cant look after your blood sugar now, you will face problems down the line and from a government funded perspective, that's going to cost a lot more in the end than these are now."

In a statement, Pharmac’s director of operations Lisa Williams said unlike other countries, Pharmac works within a fixed budget, which means that we need to make difficult choices about which items to fund within the available budget.

"There are two CGMs on our Options for Investment list which means we would like to fund them when we have the budget available.

"We are also reviewing our approach to the assessment of diabetes technologies ensuring we are considering all the relevant emerging evidence in relation to enhanced device functionality and applying this consistently across all currently open funding applications."

Otago Medical School is about to run another trial covering all of New Zealand, and is going to extend the age bracket to 7 to 25-year-olds.

"They need to be people who are struggling with their diabetes so they need to be a little less healthy than we would like them to be, but it should give access to this technology to people who otherwise wouldn't normally get access," Wheeler said.

Recruitment for the trial will start soon.

Potential participants should email ben.wheeler@otago.ac.nz to express their interest.

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