Diabetes
Update on the implementation of hybrid close loop technology across South East London
We have received several queries from our residents living with type 1 diabetes about hybrid closed loop technology and access to this via NHS services.
Hybrid closed loop (HCL) systems link continuous glucose monitoring (CGM) with insulin pump technology to monitor blood glucose and automatically adjust the amount of insulin given through a pump to people living with type 1 diabetes. HCL has been shown to improve glycemic control, reduce hypoglycemia and reduce the burden related to daily living with type 1 diabetes.
In December 2023, the National Institute for Health and Care Excellence recommended that HCL technology should be rolled out in a phased implementation, over the next five years.
Over the next five years, we will be expanding access to HCL systems across South East London, including residents in Southwark, Lambeth, Lewisham, Greenwich, Bexley, and Bromley. HCL systems will become available incrementally for the following groups:
First priority groups
- Children and young people (under 18 years old) living with type 1 diabetes
- Women, trans men and non-binary people living with type 1 diabetes who are pregnant or planning to become pregnant.
Second priority group
- Adults living with type 1 diabetes who have poorly controlled diabetes despite best possible management with:
- continuous subcutaneous insulin infusion (CSII)
- real-time continuous glucose monitoring
- intermittently scanned continuous glucose monitoring
In South East London, we will be prioritising access based on clinical need to ensure that patients with the most pressing needs are supported first. This may mean some individuals will have to wait between one to three years for access. Access will be provided through our existing diabetes outpatient services, and patients do not need to contact their GP about HCL systems, as they will be contacted directly by the diabetes specialty services. If you are not using secondary services, please discuss your options with your GP. All people living with type 1 diabetes should continue attending their regular appointments, where treatment options, including access to HCL systems, will be discussed.
Thank you for your patience and understanding.
What we do
We provide coordinated, all-round care for people with diabetes who live in south east London. We also see people from outside this catchment area who have more complex type 1 diabetes.
We offer:
- treatment
- group and one-to-one support to help you manage your condition
- and access to peer support.
Our coordinated approach means you will see experts from a range of fields of medicine, and from different healthcare professions, based on your specific needs.
We also have an active research programme, which gives our patients access to state-of-the-art therapies, as well as well-established treatments.
Preparing for your outpatient clinic appointment
Your appointment may be face-to-face, or by telephone or video.
Depending on which clinic you are attending, the healthcare professional who completes your consultation may be a:
- doctor
- diabetes specialist nurse
- dietitian
- psychologist
- or another member of our multidisciplinary team.
Face-to-face appointments
Face-to-face appointments take place at the hospital.
Please see the ‘When you arrive‘ page. This covers how to tell us that you have arrived for your appointment.
After you have told us you have arrived, you can take a seat in the waiting area.
You will have some standard tests and checks. Your name will appear on screens on the wall for some or all of the following:
- a HbA1c blood test
- a urine sample
- to download information from any diabetes technology you use. Please bring all your diabetes devices.
- your blood pressure, height, and weight will be recorded.
You can then return to the waiting area. When your healthcare professional is available you will be called to your consultation.
Video and telephone appointments
Video and telephone appointments do not require hospital attendance. Video appointments are sometimes called telemedicine.
Find out more about how our video appointments work.
Your blood tests, including a HbA1c, may have already been done by your GP. If needed, your healthcare professional can book them to be done at King’s and review the results after your appointment.
Preparing for a clinic appointment – checklist:
Please prepare for your appointment in advance. The more information you can give, the more you will get from the consultation:
- Complete any questionnaires that we have sent you prior to your appointment. This will allow us to focus on what’s important to you in your consultation.
- Make a note of the main things you would like to talk about. For example, issues, questions, upcoming events or changes.
- If you want to talk about specific insulin dose adjustment issues, for the two weeks before your appointment make a note of your carbohydrate portions and meals, exercise, and insulin doses.
- Have an up-to-date list of your medication to hand
- Have a copy of any blood, urine, and eye screening results done in the last 6 to 12 months to hand
- If you use a diabetes device or technology, upload this beforehand so that the data can be reviewed during the appointment. You can find more information about this in the ‘Self-management resources’ section of this page.
- If your appointment is face-to-face, bring any diabetes technology or devices you use, and your glucose diary
- Re-read your last clinic letter.
Specialties
- Type 1 diabetes clinics, including type 1 diabetes with disordered eating
- Diabetic foot care
- Preconception and antenatal care
- Young person’s clinic
- Diabetes with complications
- Diabetes psychiatry and psychology
- Diabetes inpatient service
- Islet cell transplantation
- Latent autoimmune diabetes in adults (LADA) and pancreatic diabetes
- Cystic fibrosis-related diabetes
- Diabetes with end-stage renal disease on dialysis
- Transplant-related diabetes
Self-management resources
General diabetes websites
NHS website – diabetes information
Advice and links for adults who have diabetes
Information and news on all aspects of living with diabetes
Film library to help self management and share the experiences of people living with diabetes
Diabetes Research and Wellness Foundation
Charity providing information and support to help people with diabetes manage their condition and enhance their quality of life
Type 1 diabetes
An NHS-funded website with tools, resources, and short online courses accessible to everyone
Breakthrough T1D (formerly JDRF)
Charity dedicated to type 1 diabetes research and support
Courses about diabetes
Diabetes education and training available to people in south London
Association of British Clinical Diabetologists – educational resources for people living with diabetes
Type 1 diabetes
Online courses and resources
DAFNE.nhs.uk and https://www.dafneonline.co.uk/
Dose Adjustment For Normal Eating (DAFNE)
Online diabetes education courses
Type 2 diabetes
NHS – Healthy living for people with type 2 diabetes
A free online NHS programme that supports people to live well with type 2 diabetes
Food and carbohydrate counting
Diabetes UK – eating with diabetes
Information about making healthy food choices.
Book and app that makes carbohydrate counting easier using photos of different portion sizes
Type 1 diabetes
From Diabetes UK
Type 2 diabetes
From Diabetes UK
Type 2 diabetes diet information
From the Association of UK Dietitians
Bolus calculators and trackers
By Nutrition and Diet Resources UK (NDR-UK)
By Nutrition and Diet Resources UK (NDR-UK)
Diabetes management app
Diabetes management app
Managing illness and sick day rules
What to do when you are ill. This is sometimes known as sick day rules.
Type 1 diabetes: what to do when you are ill
From Trend Diabetes
Type 2 diabetes: what to do when you are ill
From Trend Diabetes
Hybrid Closed Loop (HCL) System: Information Leaflet
Includes information on HCLs and sick day rules. From the Association of British Clinical Diabetologists.
Exercise
From Diabetes UK
Hybrid closed loop systems and exercise (video)
From The Association of British Clinical Diabetologists
Exercise and the FreeStyle Libre (video)
From The Association of British Clinical Diabetologists
EXTOD (Exercise for Type 1 Diabetes)
Includes information on managing blood sugar levels when exercising
From Breakthrough T1D diabetes charity (formerly JDRF)
Hypoglycaemia
Why do I sometimes feel shaky, dizzy and sweaty? Hypoglycaemia explained
From Trend Diabetes
What is a hypo (hypoglycaenia)?
From Diabetes UK
Diabetes.co.uk
Diabetes technology
Hybrid Closed Loop System: information leaflet
From the Association of British Clinical Diabetologists
To link your account to King’s College Hospital: in Account settings, click My practices and enter code: 11457101
Ask your healthcare professional to email you the link to share your data
Diabetes management app for use with Ypsopump
Advice including placing devices and preventing skin irritation.
Pregnancy
Planning for a pregnancy when you have diabetes
From Diabetes UK
From the NHS website
From DTN- UK
From the Association of British Clinical Diabetologists
Type 1 diabetes
From Breakthrough T1D diabetes charity (formerly JDRF)
Psychological support
You can refer yourself to NHS talking therapies
Islet cell therapy
Islet transplantation for people with type 1 diabetes
Islet cell transplantation for type 1 diabetes
From Diabetes UK
From NHS Blood and Transplant
Total pancreatectomy and auto-islet transplantation
NICE guidelines
Driving and travel
If you need to speak to your diabetes team about travelling, do this at least two weeks before you go away. Also check you have appropriate insurance.
From gov.uk
Tell the DVLA about a medical condition
From gov.uk
Diabetes: Safe driving and the DVLA
From Trend Diabetes
From Diabetes UK
Location
Most outpatient appointments are held in:
Ground Floor, Venetian Building, King’s College Hospital, Caldecot Road, SE5 9RS
To confirm your appointment location, check your appointment letter or text.
Contact Details
Appointments
First outpatient appointments: 020 3299 1919
Follow-up appointments (Outpatient reception): 020 3299 7419 and 020 3299 7420
Diabetes secretaries: 020 3299 0803
Appointments email: [email protected]
Technology and devices
For troubleshooting issues, go to the ‘Diabetes technology’ section, above. If you have a technical problem with your pump, manufacturers provide 24-hour helpline support:
Roche: 0800 701 000
Medtronic: 01923 205 167
Insulet (Omnipod): 0800 011 6132
Ypsomed: 0344 856 7820
Air Liquide for Tandem T slim: 0800 012 1560
Advanced Therapeutics for Dana: 01926 833273
King’s diabetes technician: [email protected]
Patient information leaflets
| Title | File Size | Link |
|---|---|---|
| Flash and real time continuous glucose monitoring: NICE diabetes guidance update | 135 KB | |
| Patient-initiated follow-up (PIFU) for diabetes patients | 37 KB |
How to refer
GPs
GPs should refer via NHS e-referral (e-RS).
To make an urgent referral, use NHS e-Referral and state that the referral is urgent.
Secondary care
To refer, email: [email protected]
To discuss urgent referrals contact the Diabetes secretaries via the switchboard on 020 3299 9000.
Other Queries
Diabetes Outpatient Department, tel: 020 3299 8570
Key Clinical Staff
| Name | Role |
|---|---|
| Dorcas Awosode | Diabetes Care Navigator |
| Anita Beckwith | Lead Diabetes Dietitian |
| Malcolm Bennison | Diabetes Specialist Nurse |
| Comfort Bright-Davies | Diabetes Specialist Nurse |
| Dr Marilia Calcia | Consultant Liaison Psychiatrist |
| Dr Yee Seun Cheah | Consultant Diabetes Physician; Type 1 Diabetes Lead |
| Geraldine Gallen | Diabetes Specialist Nurse; Type 1 Diabetes Service Lead |
| Dr Carol Gayle | Consultant Diabetes Physician |
| Babita Gurung | Diabetes Specialist Nurse |
| Dr Sophie Harris | Consultant Diabetes Physician |
| Dr Kate Hunt | Consultant Diabetes Physician; Pregnancy Lead |
| Professor Khalida Ismail | Professor of Psychiatry |
| Janice Jimenez | Diabetes Specialist Nurse |
| Emily Jordan | Diabetes Specialist Nurse |
| Dr Vasiliki Kolovou | Consultant Diabetes Physician |
| Jawairia Latif | Diabetes Dietitian |
| Kaylee Lovie | Lead Diabetes Specialist Nurse |
| Dr Chris Manu | Consultant Diabetes Physician; Diabetes Foot Lead |
| Dr Omar Mustafa | Consultant Diabetes Physician; Inpatient Lead |
| Georgia Noble-Bell | Diabetes Specialist Nurse; Inpatient Services Lead |
| Vivian Obah | Diabetes Technician |
| Vidya Purhigail Sathish | Diabetes Specialist Nurse |
| Helen Rogers | Nurse Consultant in Diabetes; Joint Lead for Pregnancy |
| Dr Miranda Rosenthal | Consultant Diabetes Physician |
| Dr Marietta Stadler | Consultant Diabetes Physician and NIHR Clinical Scientist |
| Genevieve Storie | Diabetes Dietitian |
| Dr Erika Vainieri | Consultant Diabetes Physician |
| Mahima Varghese | Diabetes Specialist Nurse |
| Dr Prashanth Vas | Consultant Diabetes Physician |
| Emma Whight | Diabetes Specialist Nurse |
| Dr Martin Whyte | Consultant Diabetes Physician |
| Gizem Yandas | Diabetes Specialist Nurse |
| Susana Yalley | Diabetes Specialist Nurse |