NICE Guidelines And Funding For Insulin Pump Therapy

Who Can Benefit from CSII Therapy?

For adults and adolescents aged 12 years and older with Type 1 diabetes, CSII therapy is recommended under the following circumstances:

Disabling Hypoglycaemia with Multiple Daily Injections (MDIs)
When attempts to achieve target HbA1c levels with MDIs result in recurrent and unpredictable hypoglycaemia, causing persistent anxiety and a significant adverse impact on quality of life, CSII therapy becomes a viable option.

High HbA1c Levels Despite MDI Therapy
If HbA1c levels persist at 8.5% or above despite careful management with MDIs, including the possible use of long-acting insulin analogues, CSII therapy is advised.

For children under 12 years of age with Type 1 diabetes, CSII therapy may be considered when MDI therapy is deemed impractical or inappropriate. However, it’s important to note that children on insulin pumps should typically undergo a trial of MDI therapy between the ages of 12 and 18 years.

Monitoring And Sustained Improvement

Following the initiation of CSII therapy in adults and adolescents aged 12 years and older, its continuation should be based on demonstrable improvements in glycaemic control. This can be evidenced by a reduction in HbA1c levels or a sustained decrease in the rate of hypoglycaemic episodes.

The responsible physician, in consultation with the individual receiving treatment or their caregiver, sets appropriate targets for these improvements. This collaborative approach ensures that the treatment plan is tailored to the unique needs and goals of each individual.