Mr Deputy Speaker, Sir, I wish to inform the House that Type 1 diabetes mellitus is insulin dependent diabetes where the patients are administered insulin. At present, 1,114 patients living with Type 1 diabetes are following treatment in our public institution in the Republic of Mauritius, with none in Agaléga, 32 in Rodrigues, and 1,082 in Mauritius. I am further informed that insulin pump is a device containing insulin which is attached to the body of the patient on a 24-hour basis and tracks the glucose level in real time. Mr Deputy Speaker, Sir, the proposal to introduce Insulin Pumps and Continuous Glucose Monitoring Systems was made by the former government in 2023 without proper consultation with the technical staff of my Ministry. When our Government took over, we had this measure examined by a group of technical experts and it was subsequently based on the technical advice that the introduction of insulin pumps was found not feasible in the local context due to – (a) Lack of personnel to support insulin pump use and continuous glucose monitoring who will monitor the use by children who are Type 1 diabetics in schools; (b) Lack of support to cater for emergencies arising from faulty insulin pump; (c) High cost involved as the insulin pump has several costs associated to it. Moreover. an insulin pump has to be replaced on average after four years of use, and (d) Insulin pumps provide a modest reduction in HbA1c blood test, conducted for evaluating blood sugar level for the last three months. Moreover, Professor D. Owens, the imminent diabetologist from the United Kingdom, has also not recommended the use of those insulin pumps. As such, the insulin pump and

51 continuous glucose monitoring were found to be impracticable in the public health services. Thus, they are not recommended at this point in time. Mr Deputy Speaker, Sir, I am further informed that at present, my Ministry is already ensuring all services for the required treatment of Type 1 diabetes patients as per international standard, including dedicated specialised Type 1 diabetes clinic in each health region with a multi-disciplinary team of anthropologists, paediatricians, diabetes specialised nurses and dieticians. The services offered include – (i) Access to insulin supply, and (ii) Pin prick blood glucose monitoring devices. Diabetic children aged 0 to 16 years old are managed are by paediatricians. All Type 1 diabetic patients, including children have regular foot care and dental check-up and are provided glucose meters and glucose strips free of charge. Adults are referred to retinal screening unit once yearly. Mr Deputy Speaker, Sir, my Ministry has set up seven retinal screening unit all over the island for early detection of retinopathy diabetes and eleven-foot care units for prevention of amputations. This Government is prioritising the prevention and control of non- communicable diseases, including diabetes which remains a major public health challenge in Mauritius. Following a policy decision in 1987 under the Labour Party, a dedicated prevention unit was created within the Ministry under the first national NCD survey. This unit now forms part of the NCD Health Promotion Research Unit and is actively engaged in a wide range of screening and prevention activities across the island. These include the screening in the community and at workplace as well as screening of students of secondary school for Grade 7, Grade 9 and Grade 12 aged between 13 and 17 for the early detection of NCDs, including diabetes. Students with diabetes are referred to paediatricians in regional hospitals and those with prediabetes are referred to nearest mediclinic, area health centre and community health centre for further investigation and treatment. This Government has taken the bold measures, as enunciated in the very first budget presented by the hon. Prime Minister, who discouraged the high consumption of sugar by the population by increasing excise duty on sugar content and sugar sweetened products from 6 cents to 12 cents per gram as from 06 June 2025 and the

52 increase in excise duty will be extended to chocolates and ice cream as from 01 October 2025.

Do you have a supplementary?

Just one supplementary. Not being a medical technician, from what the hon. Minister said, are there any alternatives for those requiring daily testing at home?

I think that is a bit difficult for the time being because of lack of paediatricians.

Hon. Dr. Aumeer!

I heard the hon. Minister’s answer. With review to the technical report by Professor Owen, who is an eminent endocrinologist and diabetologist, did the team also said that continuous glucose monitoring should not be part of national policy for juvenile diabetes Type 1?

No, he did not say that. It was in reference to the new system that was proposed by the previous government. He did not speak about it.

The hon. Second Member for Grand’ Baie & Poudre d'Or! MELVILLE, GRAND GAUBE – BUS SERVICE IRREGULARITY