Debate contribution: Diabetes Care

Debate contribution by Ms Cheryl Brownlee on 28 April 2025.

MLA

Ms Cheryl Brownlee

Party at the time

Democratic Unionist Party

Date

28 April 2025

Type

Debate contribution

Business

Private Members' Business

Heading

Diabetes Care

Assembly identifier

Official Report component 4914134

Read the official Assembly record

Text

I beg to move

Thank you, Mr Deputy Speaker. Diabetes is a chronic illness, the complexity of which is often misunderstood. For a person living with diabetes, managing the condition is not something that is left until a check-up or a hospital appointment. It is every moment of every day and involves a constant cycle of monitoring, adjusting, planning and reacting. One of the best depictions that I have ever seen of what it is like is a simple video of a person going about their day, walking, working and parenting, all the while trying to keep a blue balloon in the air, constantly adjusting, constantly being aware and never quite being able to rest. Sometimes the balloon drops and sometimes it soars away, but the focus is always there, and it is exhausting. That is why we are here debating this important motion to drive forward quality standards in diabetes care in Northern Ireland. First, the Assembly must recognise what the data clearly tells us, which is that diabetes is on the rise. Almost 115,000 people here live with diabetes, and that number continues to grow year-on-year. Type 2 diabetes accounts for most of those cases, but, among children, 98% of those diagnosed have type 1 diabetes, which is an autoimmune condition that cannot be prevented. Without urgent action, the health and well-being, and the very future, of thousands of our citizens is at risk. One of the most critical elements for improving the life of those living with diabetes is technology. Technological advances, particularly continuous glucose monitoring (CGM) and hybrid closed-loop (HCL) systems, have transformed what is possible. Hybrid closed-loop systems are often referred to as an artificial pancreas, as they integrate insulin pumps and glucose monitors to adjust insulin delivery automatically throughout the day and night. Rather than multiple daily injections, constant finger-pricking and complex calculations, individuals simply input the carbs that they consume, and the system does the work for them. However, that is not a luxury. It dramatically improves blood glucose control, reduces hypos, improves sleep quality, reduces hospital admissions and gives people back their freedom. It matters especially for children and vulnerable adults — those who may not be able to recognise the signs of dangerously low blood sugar in the time to act. Whilst Northern Ireland has made significant strides in providing continuous glucose monitoring systems, challenges still persist. The Dexcom G6 is a real-time system with customisable alerts, but it is currently not listed on the Northern Ireland drug tariff. As a result, it cannot be prescribed in primary care and funding is not routinely available. That situation has led many families to self-fund those devices despite their critical role in enabling hybrid closed-loop systems and providing peace of mind, especially for parents of young children who may not be able to recognise the signs and symptoms of blood sugar levels during the night. I also want to touch on the challenges of transitioning to adult services. Recently, I worked with the family of a young man with complex learning difficulties who was successfully managed with a hybrid closed-loop system during his paediatric care. However, on transitioning to adult services, the support for that technology was withdrawn. He was expected to revert to multiple daily injections and calculations, which he clearly could not manage. Only after significant advocacy was the decision reversed. That case underscores the need for clear, compassionate transitional pathways that consider the unique needs of individuals with additional challenges. The National Institute for Health and Care Excellence has formally endorsed the use of hybrid technology through its technology appraisal guidance TA943, yet, today, while some children and adults here in Northern Ireland are clearly benefiting from that incredible technology, access is not equal and depends far too often on where you live. It is the cruel reality of that postcode lottery. That is despite clear commitments that were set out in our own diabetes strategic framework, dating back to 2016, which prioritised access to technology and better outcomes. Alongside that, data is critical to drive improvements. The National Diabetes Audit that is undertaken in England, Scotland and Wales collects vital information, tracking outcomes, highlighting service gaps and identifying inequalities. In those regions, the audit has shaped better services and continues to drive stronger outcomes. In Northern Ireland, we are still not fully participating in the National Diabetes Audit despite the commitments that were made nearly a decade ago. Infrastructure challenges, including delayed systems, mean that we do not have a full picture of how our diabetes services are actually performing. Without robust data, how can we know whether our care is right? Without clear measurement, how can we improve? Without understanding, how can we allocate our limited budgets wisely? We note, with deep concern, that Northern Ireland has not yet been able to benefit from the insights of that audit. That, of course, must change. We call on the Minister of Health to ensure that regional participation in the audit is prioritised, supported and delivered as was committed to in the strategic framework. Of course, none of that will come without challenges. We recognise the immense financial pressures facing the Department of Health. Implementing the hybrid closed-loop system will require not only devices but training, infrastructure and service design. However, the cost of inaction in complications, hospital admissions and early deaths is, sadly, far higher. I will finish with some of the positives when we get it right. I know from my experience that the care of the diabetes team in the Northern Trust is nothing short of exceptional. Its compassion, education and understanding is a model of best practice. It is truly fantastic. It shows the difference that a service can make to people's lives when it is well designed and supported. Today, let us choose to lift the weight off the shoulders of those who are trying to keep their balloon in the air, act with urgency, compassion and clarity so that people understand where we are going, and drive forward quality standards for diabetes care.

1,009 words. Text as published by the Northern Ireland Assembly.

Assessment

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Assessed 21 October 2026 at 12:28 UTC by jev-1.13.0 (requested as typesafe/jev) under rubric 2026.10-r9, methodology 1.9.

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