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Utilisation, access and recommendations regarding technologies for people living with type 1 diabetes: consensus statement of the ADS/ADEA/APEG/ADIPS Working Group

Anthony J Pease, Sofianos Andrikopoulos, Mary B Abraham, Maria E Craig, Brett Fenton, Jane Overland, Sarah Price, David Simmons and Glynis P Ross
Med J Aust 2021; 215 (10): . || doi: 10.5694/mja2.51118
Published online: 21 June 2021

Abstract

Introduction: Type 1 diabetes presents significant challenges for optimal management. Despite intensive glycaemic control being the standard of care for several decades, glycaemic targets are infrequently achieved and the burden of complications remains high. Therefore, the advancement of diabetes management technologies has a major role in reducing the clinical and economic impact of the disease on people living with type 1 diabetes and on health care systems. However, a national framework is needed to ensure equitable and sustainable implementation of these technologies as part of holistic care.

Main recommendations: This consensus statement considers technologies for insulin delivery, glucose sensing and insulin dose advice that are commercially available in Australia. While international position statements have provided recommendations for technology implementation, the ADS/ADEA/APEG/ADIPS Working Group believes that focus needs to shift from strict trial‐based glycaemic criteria towards engagement and individualised management goals that consider the broad spectrum of benefits offered by technologies.

Changes in management as result of this statement: This Australian consensus statement from peak national bodies for the management of diabetes across the lifespan outlines a national framework for the optimal implementation of technologies for people with type 1 diabetes. The Working Group highlights issues regarding equity of access to technologies and services, scope of clinical practice, credentialling and accreditation requirements, regulatory issues with “do‐it‐yourself” technology, national benchmarking, safety reporting, and ongoing patient advocacy.

  • Anthony J Pease1,2
  • Sofianos Andrikopoulos3
  • Mary B Abraham4,5
  • Maria E Craig6,7
  • Brett Fenton8
  • Jane Overland9,10
  • Sarah Price11,12
  • David Simmons13
  • Glynis P Ross9,10

  • 1 Monash University, Melbourne, VIC
  • 2 Monash Health, Melbourne, VIC
  • 3 Australian Diabetes Society, Sydney, NSW
  • 4 Perth Children’s Hospital, Perth, WA
  • 5 Children’s Diabetes Centre, Telethon Kids Institute, Perth, WA
  • 6 Children’s Hospital at Westmead, Sydney, NSW
  • 7 University of New South Wales, Sydney, NSW
  • 8 Central Coast Local Health District, Gosford, NSW
  • 9 University of Sydney, Sydney, NSW
  • 10 Sydney Local Health District, Royal Prince Alfred Hospital, Sydney, NSW
  • 11 Melbourne Health, Melbourne, VIC
  • 12 University of Melbourne, Melbourne, VIC
  • 13 Western Sydney University, Sydney, NSW



Acknowledgements: 

Anthony Pease received honoraria from the Australian Diabetes Society, for his role in developing the consensus statement.

Competing interests:

Sofianos Andrikopoulos reports past participation in advisory boards and/or receiving honoraria outside the submitted work from GlaxoSmithKline, Novartis, AstraZeneca and Bristol‐Myers Squibb Australia, Eli Lilly Australia, Janssen Cilag, Merck Sharp and Dohme (Australia), Sanofi Aventis, Novo Nordisk and Servier Laboratories. Mary Abraham reports receiving honoraria outside the submitted work from Eli Lilly and Medtronic. Jane Overland reports receiving consultancy fees from Abbott, Medtronic and Roche outside the submitted work. Glynis Ross reports receiving honoraria outside the submitted work from Roche.

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