Opinion
Advances in diabetes technology and the importance of access
‘It is vital that access gaps do not overshadow quality care’, write Dr Ben Nash and Dr Morgan Rayner.
‘People without access are more likely to experience poorer glycaemic outcomes, higher risk of hypoglycaemia, and greater diabetes distress.’
In recent years, the field of diabetes care has undergone a technological renaissance.
Automated insulin delivery (AID) systems now offer people living with diabetes unprecedented opportunities to improve their glycaemia, reduce complications, and enhance quality of life.
The benefits are well established, and these systems are now considered first-line treatment for all people living with type 1 diabetes.
How do they work?
AID systems automatically adjust insulin delivery based on sensor glucose readings every few minutes.
If hypoglycaemia is predicted, insulin delivery is temporarily reduced or suspended. If hyperglycaemia is predicted, additional insulin is delivered to maintain near-normal glucose levels while avoiding subsequent hypoglycaemia.
Although these systems are highly advanced, they are not completely hands-off – we still recommend that users let the system know before eating or exercising.
Even so, AID significantly reduces the burden of day-to-day diabetes management and alleviates diabetes distress compared with usual care.
From a hardware perspective, AID systems combine three key components: a continuous glucose monitor (CGM), an insulin pump, and a control algorithm that links the two.
For GPs and primary care teams, the rapid pace of innovation can raise practical questions:
- Which patients are eligible for CGM, insulin pumps, or an AID system?
- How can we support people using these systems in the community?
- What differentiates the various technologies in terms of sensors, algorithms and connectivity?
- How can we clearly explain the benefits of AID to people living with diabetes?
An equally important question is who actually has access?
In Australia, despite AID devices being recognised as standard of care in many high-income countries, access remains inequitable. Fewer than one in five Australians with type 1 diabetes currently use an AID system.
Those from higher socioeconomic backgrounds are twice as likely to have access compared with those from lower-income groups.
High private health insurance premiums and complex funding models mean many people simply cannot afford AID.
This inequity matters for primary care providers for several reasons:
- Clinical outcomes – people without access are more likely to experience poorer glycaemic outcomes, higher risk of hypoglycaemia, and greater diabetes distress
- Equity and advocacy – primary care teams are often the first to identify people with diabetes who would benefit from tech, but system barriers mean referral alone may not translate into access
- Workload and escalation – when community management is limited by technology access, people with diabetes are more likely to require hospital-based care for acute or chronic complications
How can virtual services help?
Virtual services, such as the
Victorian Virtual Specialist Consults,
Mater Queensland eConsult,
Western Sydney Diabetes,
SA-Virtual Clinical Care and
DiabetesWA provide GPs, nurses, and allied health professionals across Australia with timely access to specialist endocrinology input, including advice on diabetes technology.
Through virtual consultations, you can discuss cases with an endocrinologist when support is needed in assessing appropriateness for AID therapy, managing technology in the context of complex comorbidities, or addressing recurrent hypoglycaemia or hyperglycaemia within a community-based framework.
Virtual diabetes clinics aim to strengthen primary–specialist collaboration, reduce avoidable hospital presentations, and support continuity of care across geographic and socioeconomic divides.
In the context of rapidly evolving diabetes technology, it is vital that access gaps do not overshadow quality care.
As GPs, you play a pivotal role in identifying those who could benefit from AID systems, recognising technology-related barriers, and working through them in partnership with specialist services.
Diabetes tech is only as good as the system that supports it, and by working together we can ensure that its benefits reach all people living with diabetes,
not just those with the right postcode or bank balance.
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automated insulin delivery continuous glucose monitor diabetes care diabetes technology type 1 diabetes
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