Recommendation ID
NG17/5
Question

Technologies for preventing and treating impaired awareness of hypoglycaemia in adults with type 1 diabetes:- For adults with type 1 diabetes, what are the optimum technologies (such as insulin pump therapy and/or continuous glucose monitoring, partially or fully automated insulin delivery, and behavioural, psychological and educational interventions) and how are they best used, in terms of clinical and cost effectiveness, for preventing and treating impaired awareness of hypoglycaemia?

Any explanatory notes
(if applicable)

Why this is important:- Impaired awareness of hypoglycaemia renders adults with type 1 diabetes susceptible to sudden unexpected deteriorations of conscious level and irrational behaviour, and increases their risk of severe hypoglycaemia 6-fold. Impaired awareness of hypoglycaemia and severe hypoglycaemia creates barriers to many aspects of daily living, and can cause enormous stress for family and friends. Severe hypoglycaemia can also cause fear of hypoglycaemia great enough to prevent a person achieving the glucose targets that are associated with minimal risk of complications. Impaired awareness of hypoglycaemia results from overexposure to hypoglycaemia in daily life, and awareness can be much improved by avoidance of hypoglycaemia. Developing technologies in glucose monitoring and insulin delivery have not been rigorously tested in adults with type 1 diabetes and impaired awareness of hypoglycaemia. Research is needed formally to document the extent to which existing technologies can help the adult with type 1 diabetes and impaired awareness of hypoglycaemia to avoid hypoglycaemic episodes and regain awareness for occasional episodes. Research is also needed to develop new technologies. Research is also needed into how to engage adults with type 1 diabetes and impaired awareness of hypoglycaemia with treatment strategies designed to improve awareness.


Source guidance details

Comes from guidance
Type 1 diabetes in adults: diagnosis and management
Number
NG17
Date issued
August 2015

Other details

Is this a recommendation for the use of a technology only in the context of research? No  
Is it a recommendation that suggests collection of data or the establishment of a register?   No