Interview conducted on 23d January 2024
BT: Could you tell us a bit about yourself and how you became interested in the topic of type 1 diabetes?
DT: I am 51 years old and I grew up near Helstone. Diabetes UK called me and said there was an appalling track record for managing the pathway for diabetes in the South West. So I agreed to join the All-Party Parliamentary Group (APPG) on Vascular and Venous Disease, and we did some work with the commissioning groups, now the Integrated Care Boards (ICBs). They changed the diabetes outcomes, so Cornwall now is not the worst. We are a lot better than we were.
I met the surgical team and clinical teams in Truro and we had lots of meetings to understand what the issue was and how to support the pathway to managing diabetes. The standard is 6 months checkups with Diabetes Nurses for an adult but not everybody in Cornwall will be getting that. That is why I got involved because I could really see the need to do something but also an opportunity to change it.
There has been quite a significant uptake of flash glucose monitoring. I think 25% of all people in Cornwall who are entitled to them have got them.
BT: I see, but your constituency falls under one of the 11 out of 42 Integrated Care Boards (ICBs) in England with no published policy on providing access to flash and CGMs under the National Institute for Health and Care Excellence (NICE’s) national guidelines.
DT: It was recently when I got the latest figures from Abbot which is one of the organisations I work with. They viewed distribution as being quite good. But I agree with you. Unless the GP or Diabetes Nurse says this is what is available and this is what you need, they do not really know. The great thing about being an MP is that I can write to Kate Shield who runs it and ask why they are not meeting the right standards.
When I went to the diabetes group in Helstone, about two months before Christmas, I was asked about that. Many of them didn’t know it was available or qualified. I would hope a GP or nurse would look at that person and think if they are not managing their condition or their blood sugar levels, a glucose monitor would help.
Glucose monitors are brilliant because they give 3 months of data rather than the very minute you do a finger prick.
BT: Could you tell us a bit about your work as chair of the then all-party parliamentary group on diabetes (APPG)?
DT: Once I got stuck into the APPG, I was approached by Abbot and other companies saying they had these devices, but the NHS did not fund them or NICE had not licensed them for use. Partha Kar, part of the Diabetes Co-Lead in NHS England, is an absolute inspiration and he drives and drives and drives the agenda. He was commissioning these libre flash glucose monitors before they were available on the NHS by just using his NHS budget.
I had meetings with Nicola Blackwood at the time who was the Minister. We got to a place where NICE agreed that flash glucose monitors were a good thing to have on the NHS.
Then Philip Dunne became the Minister. He was brilliant because he had just come from the armed forces as a minister, and he was in charge of procurement. In terms of the libre flash glucose monitor, he decided that the NHS in London would buy them and would give them free of charge to the commissioners which is how we got to where we are.
BT: Why did the APPG on diabetes go defunct? Is there anything now in Parliament which has replaced it?
DT: There were staff changes and then it got to the end of year when the AGM was coming. I said that I would not be able to chair it any longer because I chaired the APPG on Brain Tumours and I also chaired the APPG on Rural Services.
I still work very closely with Diabetes UK and they are brilliant. I chaired for a long time an expert working group to try and address the problems you mentioned about the postcode lottery and different levels of care based on where people live.
BT: Could you explain the distinction between type 1 and type 2 diabetes?
DT: Type 1 is something which just stops working properly in your younger life. Generally, it will be in the earlier part of your life when you get type 1.
BT: Do you support Diabetes UK ‘Diabetes Tech Can’t Wait’ campaign which aims to ensure fair and equal access to type 1 diabetes equipment?
DT: I think if there is a bit of kit out there which helps you manage your condition better, we are foolish not to make it available. If you manage your type 1 diabetes, then you are going to have a perfectly good career and you are probably not going to have much impact, even though it is going to be a bit of an irritant.
But diabetes tech will give you a better outcome. Without these devices, we are distancing people to quite life limiting choices and changes. And I find that beyond irritating. The reason why I worked so hard on the libre is because it gave confidence to industries to carry on developing these devices. If there is no market, there is no point in doing it so we lose the opportunity of giving great tech to people because industries would go elsewhere.
BT: How can we best raise awareness of type 1 diabetes, particularly amongst students who may be living with the condition at school or university but are unaware of the symptoms? Is something such as the four T’s (Toilet, Thirsty, Tired, Thinner) something we can advertise more?
DT: Teachers in school probably need to know the symptoms of diabetes because people can get seriously ill if they are sat in the classroom and are not getting the right kind of intervention. So we should look at how teachers are taught to look for the symptoms and signs, and parents as well.
But also, I wonder if it’s beyond the wit of a man to produce posters and fliers for secondary school and universities, and colleges. I don’t know if you get welcome packs but I know you have fresher’s week. There should be some way where everybody has access to basic information. I mean look at measles now. Measles is in its prime state but a lot of people won’t necessarily think that they’ve got measles.
We have a flurry of activity on getting people to know what to look for and then it all goes quiet. But I think you’re right. We are all on smartphones and things now. Maybe the government should run adverts on Instagram and Facebook and stuff to look out for the stuff. That is probably the quickest way to get to your generation.
BT: Thank you very much.
