The small, lightweight pods changing the lives of people with diabetes

Naomi Durham and Matthew Davies have experienced an epic transformation thanks to the ‘sci-fi like’ advancement

It is a piece of technology which has proved life-saving for people across Wales. Two years ago, the NHS rolled out a ‘sci-fi like’ hybrid closed loop insulin pump system, also known as an artificial pancreas, to tens of thousands of people with type one diabetes, helping to control high blood glucose levels.

The way it works is the device links a continuous glucose monitor with automated insulin pump technology. It helps keep blood glucose levels stable by automatically adjusting insulin delivery using an algorithm, removing much of the mental burden of living with diabetes, especially around mealtimes and during the night.

One person who knows only too well of how much of a difference it can make is Naomi Durham, a student children’s nurse from Cardiff. Never miss a Cardiff story by signing up to our daily newsletter here.

She was diagnosed with type one diabetes at just 16. Her diabetes journey has been shaped profoundly by her mental health. After the birth of her second child, she developed severe postnatal depression, which deepened over time and eventually developed into T1DE, an eating disorder specific to people living with type one diabetes.

Managing insulin doses during recovery from an eating disorder is extraordinarily complex and dangerous, and Naomi described the burden as “enormous”.

But now, the artificial pancreas automatically corrects her insulin without her needing to intervene, removing a layer of complexity that had been particularly destabilising during her recovery.

Knowing it is managing her levels gives her family and healthcare team reassurance and gives her the mental space to focus on getting better.

Naomi says: “I was in my first couple of weeks of sixth form at the time, my dad is type one diabetic and my mum noticed the symptoms very early on. I was in hospital for a few hours and they sent me home on insulin. I didn’t really think much of it and I accepted it straight away.

“It wasn’t until my pregnancies in my late 20s that it began to really affect me. My first pregnancy was difficult but it was ok, but it was my second in which I struggled with it. I was diagnosed with post-natal depression – I just had compete apathy and didn’t really care about myself.

“I didn’t really notice myself, initially, that it was linked to my diabetes. It was probably after about a year that I realised I didn’t really care for my diabetes, and it was not my priority and my blood sugars were getting out of control. I was doing everything I needed to do for the kids and I was placing myself way down the list.

“For a year to two years after she was born, things were pretty bad and I was finding myself in hospital every month with DKA (diabetic ketoacidosis) because I was not taking my insulin as I was supposed to.

“Not long after my second child, I was given an insulin pump, in 2012, which was amazing and changed diabetes for me and made it a lot easier to manage. It is programmed to my individual ratios.

“In 2021, I got an artificial pancreas, or the hybrid closed loop pump. It is a pump, and a sensor, and they communicate – my sensor tells the pump what my blood sugar is, and whether I need more or less insulin. I just programme when I have carbohydrates, I put in the number of carbs I eat, and it does it for me.

“I have had a difficult relationship with food for the last six years, and I have had eating disorder therapy, but the pump has been instrumental in helping me as it takes some of the focus away from food. Being diabetic I can never not think about what I’m eating, but my pump takes away some of that pressure, and if I don’t get it exactly spot on, it will compensate for me.”

The 34-year-old, whose daughters are aged five and eight, has found enormous strength in connecting with others living with T1D and is now driven to ensure others know they are not alone. The diabetes advocate now has an active Instagram following of nearly 2,000, where “anything goes” when it comes to what can be discussed.

“What helped me was finding other people with diabetes who had gone through similar experiences,” Miss Durham said.

“That lived experience has massively helped. I have got a diabetes Instagram account and I have found people all over the world who I can relate to and talk through things with. I met up with them as well which I have found hugely healing knowing people have been in similar situations and that I’m not alone.

“At one point I didn’t think that I would get back to Cardiff University, where I study children’s nursing, and now I am four weeks off qualifying. I recently had really good feedback from another nurse and it was the first time I really felt proud of myself.

“It is really important to know that you are never alone, visit your GP, and if you are not comfortable speaking to anyone, there are online platforms, not just social media, but things like text message support with platforms like Shout and local community groups you can find.”

Another person who has benefitted enormously from the technology is Matthew Davies, a 52-year-old former Greenhill School, Tenby deputy headteacher and PE teacher from Templeton.

He was diagnosed with type one diabetes at 24, mid-way through training to become a PE teacher and rugby coach. Active and sporty his whole life, the diagnosis hit hard.

Originally from Rhondda, Mr Davies began experiencing classic diabetic symptoms including unquenchable thirst, which led too his diagnosis. He pushed on with his career and continued to pursue sport. But in 2015, the reality of living with uncontrolled diabetes caught up with him when he signed up for an Ironman event and was unable to finish.

Reflecting on his journey, Mr Davies told WalesOnline: “I’d gone to university in Cardiff, Cardiff Met as it is now, and finished my teacher training and my degree, and I just wanted to be a PE teacher, sport was everything to me. I was fit as a fiddle.

“All I was doing was teaching PE throughout the day, coaching sport after school, doing my own sport, playing rugby and cricket in Narberth where I lived, in west Wales.

“I reached a point where all I wanted to do was drink – I had an unquenchable thirst. I found out in 1998, when I was 24, that I had diabetes, during my second year teaching. It came totally out of the blue. I didn’t know what was wrong. I went into see my GP and blood tests confirmed it.

“I didn’t know anyone who was diabetic and there had been nothing in the family history, it was a real shock, but the NHS support I had was great, they really simplified things and made things as common sense and as straight forward as possible. There was very little in terms of technology then compared to what we have now.

“It didn’t change anything when it came to what I wanted to do, but when it came an Ironman event in Tenby I trained for in 2015, I didn’t complete it. It was one of the first things I really wanted to do and couldn’t see it through.

“I’d completed the swim, which went great. If your blood glucose was tested now, it would be between four and seven, but when I came out of the water, my blood glucose was 27, which was unheard of.

“When I got to the transition from swim to bike, I started riding hoping the blood glucose would come down and it hadn’t. I decided to take out my insulin pen and inject myself with a small amount of insulin, but as a consequence, within 30 minutes, I was on the side of the road with my bike experiencing hypoglycemia, and that happened six times over the course of the next five hours.

“I ended up cycling for 98 of the 112 miles, but I just ran out of time, and I couldn’t finish.”

After the Ironman event, Mr Davies’s GP recommended the artificial pancreas, which he described as “completely transformational”.

The now regional social value co-ordinator for Abergavenny firm Alun Griffiths, went on to complete an Ironman in 2022 race and multiple other triathlon events, feats he once feared were beyond him. He also still coaches at Narberth Athletic.

He added: “The pump has been truly transformational and made a total difference in my life. It immediately brought the averages of my blood glucose down.

“I did a few more triathlons and I entered the Ironman in 2022. It was a hell of a thing to compete in your local area but also to start and complete the race in an area you know so many people and have so many connections.

“It was quite an emotional moment personally reflecting what I’d been through having worked toward this one goal.

“We hear so many challenging things with the NHS, and the NHS is in such a difficult position, but we need to understand that there are people out there who are so brilliant at their job. The people who helped me were at Glangwili Hospital in Carmarthen, the diabetic centre there. My advice would be to work with your GP and look at the specialist team like at Glangwili Hospital because they have got a team which is truly incredible.

“I’m 52 now, I still train, I still coach rugby, I run, I do lots and lots of things but irrespective of what your age is you can still achieve these things. Diabetes is a challenge and something extra to think of, but with the right technology and support it can be done.”

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