The incidence of Type 1 (insulin dependent) diabetes in children has trebled in the last 30 years. Scotland now has one of the highest rates in the world for this condition. Yet insulin pumps to help children with recovery are being denied this by some NHS Boards such as NHS Ayrshire and Arran, and NHS Lanarkshire.

The charity Children with Diabetes has this to say about insulin punps “The number of people using insulin pump therapy to manage their diabetes is growing rapidly; roughly 250,000 people around the world use an insulin pump. Their reasons for choosing the pump are many, but generally "pumpers" all agree that it gives them tighter control and more flexibility -- both in terms of their schedule and lifestyle. This control and flexibility includes advantages such as: · Eating what you want, when you want, · Worrying less about low blood sugars, · Living life on your terms, not a schedule of snacks and shots. There are many scientific studies that demonstrate that insulin pump therapy results in better outcomes for teens and adults with type 1 diabetes. There are also studies that show that insulin pump therapy works well in toddlers and pre-school children.

Because of the low provision David Stewart (Highlands and Islands) (Labour) raised a motion at the Scottish Parliament. Here is a summary of the debate. “I welcome the opportunity to debate increased access to insulin pumps specifically, but also the bigger picture of diabetes and its role in health care management. The motion has widespread support across the political spectrum and I thank members who supported it. As for those who have not, I always welcome sinners who repent. First, I acknowledge the work of the cross-party group on diabetes, which Karen Whitefield convenes and of which I am a member. I warmly welcome the visitors in the public gallery, particularly the representatives of Diabetes UK Scotland.

Members will be aware of the major causes of concern about diabetes. It is the main cause of blindness among people of working age; half of all non-traumatic lower limb amputations are due to diabetic complications; and diabetic care costs the national health service in Scotland the phenomenal sum of about £0.5 billion.

The pump is an external device that continually infuses insulin into the patient's body and thus controls their glycaemic levels, which many patients otherwise struggle to achieve. That alternative way of maintaining insulin levels can contribute to more stable wellbeing by reducing the risk of hypoglycaemia and replacing several daily injections with only two to three a week. With the pump, insulin levels can be increased by simply pressing a button on the pump instead of using a pen needle, which can be embarrassing for patients, particularly when they inject in public. Insulin pumps empower patients to have greater control over their condition as they give them a more flexible and reliable means of managing glycaemic levels. Improved control over one's own health means improvement in the quality of life of many patients: it means fewer hospital visits, a more productive work life and less stress at home. Fewer hospital admissions and a reduction in primary care contacts also mean that there is less strain on the NHS. Diabetes UK Scotland has argued that there is a saving of more than £23,000 over two years, which would comfortably offset the cost of pump therapy.

Less than 1 per cent of sufferers of type 1 diabetes receive insulin pump treatment. That is in stark contrast to other parts of the world, where rates of pump use are much higher. For example, in Germany and the United States 15 per cent to 20 per cent of patients enjoy the benefits of insulin pumps."

Nicola Sturgeon said in a Scottish Parliamentary debate that “More than 200,000 people in Scotland have a diagnosis of diabetes. Every one of them needs access to high-quality services and appropriate educational programmes to optimise self-management. People with type 1 diabetes, who need insulin to survive, make up about 13 per cent of the total. That means that more than 27,000 people need access to structured care, timely advice and local education programmes. There are 263 people on an insulin pump, whereas applying the NICE criteria suggests that the number should be somewhere in the range of 260 to 530."

Nicola Sturgeon added "I am always happy to follow up issues individually with health boards. We will encourage boards to continue to increase the number of people who use insulin pumps, but we need to acknowledge that that must be a managed process, in part because a key factor is the availability of staff to deliver the education programmes that are needed before pump therapy commences, to ensure that the regime is used optimally. Structured education is very important in maintaining and improving blood glucose control in all 27,000 people with type 1 diabetes and is an important adjunct to insulin pump therapy. I acknowledge the importance of the issue and I support the thrust of the motion. I will ensure that I and the Scottish Diabetes Group continue to monitor closely insulin pump programme availability throughout Scotland and on a board-by-board basis, particularly when the new NICE criteria are available."

Extract from Scottish Parliament document