Reply: In the Budget Speech 2023-2024, it was announced that Continuous Glucose Monitoring machines would be provided to some 1,000 Type1 Diabetes patients and that some 450 high-risk diabetic patients would be provided with insulin pumps. However, according to available records at my Ministry, 1,061 patients are currently undergoing treatment for Type 1 Diabetes. I am informed that until now, the budgetary measure could not be implemented as several factors had to be taken into consideration, namely – (a) The cost associated with implementing the project. Insulin pumps and Continuous Glucose Monitoring machines and the associated consumables are costly. Even in high income countries, these devices are generally available through private medical insurance, depending on the level of insurance coverage; (b) The proper and safe use of these advanced technologies require a system with trained Endocrinologists, diabetes nurses and appropriate clinical environment to download the glucose data from the Continuous Glucose Monitors, and our healthcare system in Mauritius is not currently adapted to implement this project; (c) Introducing new services, the safety of patients has to be taken into consideration as new technologies may lead to an increase to stress, anxiety and burnout which, in turn, can lead to psychological problems; (d) In case of misuse, the automatic administration of insulin by the pump may lead to uneasiness, hypoglycaemia and potentially to critical conditions, including death; (e) Comprehensive education programs for patients, healthcare officers and dieticians in diabetes technology would have to be provided. This awareness program should include training on the use of diabetes management tools and technologies, workshops and webinars to share experiences and knowledge, and (f) Furthermore, personalised training would have to be conducted for patients by considering their lifestyles factors, age, comorbidities and personal preferences. My Ministry has considered all risks associated with the use of insulin pumps and Continuous Glucose Monitors. Accordingly, the proposal for Type 1 diabetic patients to be

157 provided with Continuous Glucose Monitors is being given due consideration. This project would cost around Rs120 million annually and would be implemented in a phase-wise approach.

158 VALLÉE DES PRÊTRES – INCINERATOR – OPERATIONALITY