The latest type 1 diabetes research

Two new studies reported in the Diabetes and Obesity Review raise important questions about the treatment of type 1 diabetes in this country.

LOSS OF ACCESS TO INSULIN PUMP THERAPY

For people with type 1 diabetes who meet certain criteria, insulin pump therapy has been government funded in this country since 2012. Of those people who get pump funding, some – about 4% each year – later lose access to the funding. A 2020 study has investigated this.

Disturbingly, but in keeping with trends across the health system, the researchers found that loss of access was more common in certain demographics. Youth (those aged 10–29 years) were overrepresented among those who lost funding. So were nonEuropeans, in particular, Māori and Pasifika.

The researchers say that compounding this is the fact that those who are non-European or more socio-economically deprived are less likely to obtain funding for insulin pumps in the first place.

The study concludes that efforts to reduce these disparities are needed – including reviewing current public funding access criteria.

Study: ‘Youth and non-European ethnicity are associated with increased loss of publicly funded insulin access in New Zealand people with type 1 diabetes’. DOI: 10.1111/dme.14450.

‘DOUBLE DIABETES’

As the incidence of type 2 diabetes and pre-diabetes rises around the world, a rise in type 1 is also being seen. Less commonly discussed is the fact that these conditions are also being seen together more often – a dual metabolic condition sometimes called ‘double diabetes’. A UK study to investigate possible interventions has begun.

The researchers found that lifestyle changes and extra hypoglycaemic drugs may help those with type 1 diabetes in the same way that they help those with type 2.

Professor Jeremy Krebs from the University of Otago comments on the study: “Many people with type 1 diabetes struggle with their weight, just as those in the rest of the population do. Managing this is made more difficult by the need to use insulin therapy and the anabolic effects of this interacting with genetic and/or lifestyle factors … [The study] raises the question whether [hypoglycaemic drugs] should also be funded for people with type 1 diabetes in NZ. SGLT-2 inhibitors are not without significant risk of ketoacidosis in type 1 diabetes, and the body of evidence remains small; however, the question needs to be asked.”

Study: ‘The impact of pharmacological and lifestyle interventions on body weight in people with type 1 diabetes: A systematic review and metaanalysis’. DOI: 10.1111/dom.14221.