Diabetes Dialogue: Diabetes Technology and Treatment in the UK, With Ketan Dhatariya, MD, PhD, MS

Welcome back to Diabetes Dialogue: Technology, Therapeutics, & Real-World Perspectives!

In this special episode recorded live at the American Diabetes Association (ADA) Scientific Sessions 2026 in New Orleans, Louisiana, cohosts Diana Isaacs, PharmD, and Natalie Bellini, DNP, welcome Ketan Dhatariya, MD, PhD, MS, consultant physician at Norfolk and Norwich University Hospitals, to discuss the evolving landscape of diabetes care, technology access, and clinical implementation.

To begin the episode, Dhatariya shares his perspective on the challenges facing diabetologists, including workforce pressures, specialist training, and the difficulty of translating rapidly expanding diabetes guidelines and innovations into everyday clinical practice. The conversation then shifts to the differences between healthcare systems and how those structures influence access to diabetes therapies. Dhatariya discusses the UK’s publicly funded healthcare model and the ongoing challenge of balancing the cost of emerging medications and technologies with their long-term benefits. He highlights the importance of demonstrating that investments in diabetes care today can reduce complications and healthcare costs in the future.

Dhatariya then reviews the progress of continuous glucose monitoring (CGM) and automated insulin delivery (AID) adoption in the UK. He explains that CGM use among people with type 1 diabetes has become widespread, particularly among children, and that access to closed-loop systems continues to expand through structured implementation plans. He emphasizes the meaningful improvements these technologies have provided, including better glycemic outcomes among children and pregnant individuals, who may experience significant benefits from improved glucose management.

The discussion explores how diabetes technology can support people with different lifestyles and challenges, while challenging assumptions about which patients may benefit most from advanced therapies. Dhatariya highlights that CGM and AID can provide valuable support for individuals who may struggle with traditional insulin management, while also emphasizing the need for appropriate education and follow-up to ensure safe and effective use.

The group also discusses CGM use in type 2 diabetes and the growing evidence supporting broader access. Dhatariya explains that adoption has been slower because of the larger population affected by type 2 diabetes but notes emerging data suggesting CGM may help reduce complications, hospitalizations, and long-term healthcare costs. He describes the impact of seeing real-time glucose data, explaining how personal experience with CGM can help people better understand the relationship between food, behavior, and glucose patterns.

The conversation then turns to access to GLP-1 receptor agonists in the UK and how healthcare systems determine eligibility for newer therapies. Dhatariya discusses the role of national guidance and health economic evaluations in balancing access, affordability, and sustainability. He highlights how improving obesity-related disease management may have broader benefits, including helping reduce the burden of diabetes, cardiovascular disease, and other chronic conditions.

The episode also explores inpatient diabetes care and the increasing presence of diabetes technology in hospital settings. Dhatariya discusses guidance developed by the Joint British Diabetes Societies for Inpatient Care to help clinicians safely manage patients admitted while using CGM, insulin pumps, and AID systems. He emphasizes that devices should not automatically be removed and that patients may be able to continue using technology when they are well enough and capable of managing their systems.

Finally, Dhatariya discusses the importance of structured diabetes education, including the DAFNE (Dose Adjustment For Normal Eating) program, which teaches carbohydrate counting, insulin adjustment, and self-management skills. He emphasizes that as diabetes technology becomes more advanced, education remains essential for both patients and clinicians. The episode concludes with a discussion of the need for continued advocacy, specialist care, and equitable access to ensure people with diabetes can benefit from ongoing advances in diabetes technology.

Editors’ Note: Isaacs reports disclosures with Dexcom, Abbott, Lilly, Novo Nordisk, Medtronic, Insulet, and others. Bellini reports disclosures with Abbott Diabetes Care, MannKind, Povention Bio, and others. Dhatariya reports disclosures with AstraZeneca, Boehringer Ingelheim, Eli Lilly, and Novo Nordisk.