 Rwy'n meddwl i'r next item of business, which is a member's debate on the part of Emma Harper on 100 years of insulin. I would ask those members who are wishing to speak in the debate to press their request to speak buttons now. I call on Emma Harper up to seven minutes, please. I welcome the opportunity to bring this 100 years of insulin debate to chamber this evening, and I thank all colleagues who have supported it. Thanks to Diabetes Scotland for the briefing ahead of this debate, and I want to thank them for the amazing work that they do to continually support people living with diabetes, especially during this Covid pandemic. People with diabetes have exposed to Covid are at a higher risk of severe illness, hospitalisation and even death. Figures released early in the pandemic showed that 20 per cent of Covid-related deaths were people who had diabetes. Insulin is life-saving for all persons diagnosed with type 1 diabetes. Insulin is a hormone excreted by the pancreas directly into the bloodstream so that glucose can move from the blood circulation into the cells of our body. Insulin is vital for metabolism and vital for survival. Type 1 diabetes occurs when the beta cells in the pancreas fail and the pancreas is unable to produce any insulin at all. I am one of those people with type 1 diabetes, and therefore note this for the record. My two sisters and my mum also have type 1, but that is a whole other story. This year is 100 years since the discovery of insulin. It is one of the most significant advances in the history of medicine. Insulin was discovered in April 1921. Frederick Banting, Charles Best and Scotsman John James Rickard Macleod isolated insulin from the pancreatic islets of dogs. Initially, James Collop assisted with purified cattle insulin so that it could be administered to human patients with type 1. Before 1921, it was extremely rare for people with type 1 diabetes to live more than a year or two. In 1921 injection was the only delivery method for insulin, and in 2021 it still is. My mum sterilised and reused a small glass syringe and sterile needles in boiling water from a wee sister when Buffy was diagnosed at nine years old in 1977. It worked, but it was not the most practical. By the time I was diagnosed in 79, plastic syringes were supposed to be one time use were available—less pain and easier to use. Scotland has played its part in supporting the development of technology to treat diabetes. As well as Scotsman John Macleod, my motion mentions Dr Sheila Reith, consultant at Southern General in Glasgow. Her daughter had type 1, and Dr Reith had the idea for a more portable insulin cartridge, pen-like delivery device. Dr Reith worked with a colleague at Dr Ireland in the late 70s, and the Penject device, as it was called then, was subsequently created. Insulin pen delivery devices have evolved and are still used today as part of multi-dose therapy for type 1s and type 2s. So 100 years on from the discovery of insulin, where are we now? Well, insulin is still the safest method of reducing blood glucose levels, and things have improved significantly. Technology advancements, such as insulin pumps, closed-loop systems, basically an external pancreas, and digital blood glucose monitoring devices, buttons in our arms—they are helping people to live better with less complications, and today, green is good for me. Apologies for the prop, Presiding Officer. Diabetes complications pose a huge cost burden on the NHS. In Scotland, the advancements have been so good with the pumps and everything, so we can reduce complications that have a huge cost burden, such as that. In Scotland, there are 312,000 people with diabetes, and the rates of diabetes are 80 per cent higher in the most deprived communities. Type 2 diabetes is a health inequality issue. Estimates are that £1 billion is spent in Scottish NHS on diabetes—that is 10 per cent of the budget. Avoiding complications will help benefit the people with diabetes and also benefit our NHS. Managing type 1 is a complex issue. A 2014 Stanford study found that people living with type 1 make an extra 180 decisions each day than someone who is not diabetic. That is one extra decision every five minutes while awake. Decisions like what is my glucose level now, how many carbs are on my plate, are the fast carbs or slow carbs, should I eat now, should I wait for two hours, what happens when I am driving home, I do not want to go hypoglycemic, should my programme, my pump, deliver in so slowly or quickly, do I have replacement supplies in my car, in my home, in my office, in case the pump canula gets pulled out. Having diabetes is not a piece of cake, presiding officer. It is complicated. We have amazing support from our NHS staff, our endocrinologists, our dieticians, specialist nurses and healthcare support workers. They are fantastic in supporting patients and I thank them for their work. There is a lot in the Scottish Government's refresh of the diabetes improvement plan, which I welcome, including continued collaboration with third sector and stakeholders. I would like to bring attention to the minister, the work of brothers Anthony and Ian Whittingdon and their fixing dad, fixing families and fixing us programmes. They helped their dad lose five stone in weight and he reversed his type two by engaging in the family in the fixing dad social prescribing programme, which was created by Ian and Anthony. It worked. Maybe fixing dad could help inform actions to include in the diabetes refresh strategy as it evolves. I agree with Diabetes Scotland that everyone should have free and equal access to what they need to live healthy lives. In a recent survey of over 1,000 people living with diabetes in Scotland, one in five said that they were having difficult to get in key diabetes technology devices. I therefore welcome that the diabetes plan mentions access to diabetes technology in priority number two and the commitment to review access to diabetes technology. I would ask the minister if she can provide information as to the timescales for this review and when the review of the data will be available that will no doubt help inform future care approaches. I would also like to ask if guidance could be produced for all Scottish health boards to ensure that all who could benefit from diabetes tech can access it free of charge. Now is the time to ensure that everyone can access what they need, and I would be grateful if the minister could commit to doing that in closing. There are so many issues to address and speak about, and many I couldn't cover, but I look forward to hearing colleagues' contributions this evening on the 100-year anniversary of insulin. Thank you, Ms Harper. I now call David Torrance to be followed by Sandish Gohani. Thank you, Presiding Officer. I would like to thank Emma Harper for bringing such a noteworthy motion to Parliament today, an acknowledgement and celebration of a 100-year anniversary of the discovery of insulin. In November of 1920, a group of highly talented and determined individuals came together at the University of Toronto, Canada, to help each other in the pursuit of a single purpose. That purpose was to understand the cause of type 1 diabetes, for the understanding and cause meant having a chance of treating the condition and drastically improving the lives of millions across the world. The discovery of insulin and its rapid clinical deployment effectively transformed type 1 diabetes from a fatal diagnosis into a medical manageable chronic condition, becoming the first life-saving treatment for diabetes. Scotland has a rich history and a tradition of innovation, as Scots have always been at the forefront of the advancement of humanity. Scotland's legacy when it comes to the development of insulin pen is no exception, as Dr Sewell Reef, Dr John Island and John Payton, all medical specialists within the Greater Glasgow area, began their journey into improving the lives of those with diabetes roughly 60 years after the first pioneers from the University of Toronto discovered insulin. The invention and subsequently refinement of the insulin pen has been such a success that the vast majority of insulin used worldwide is now administered for the use of an insulin pen, increasing doses of accuracy, reducing pain and, most importantly, promoting the ease of use. Insulin pen has had the effect of allowing those with diabetes to more constantly manage their condition and reduce serious complications related to disease. However, it is not merely enough to refine ways of managing diabetes, there is still much work to be done in reducing the number of people in Scotland with the diabetes. The prevalence of type 2 diabetes remains a significant health challenge that we face as a country and is the leading cause of ill health in Scotland. The latest data has shown us that the all-time high of roughly 312,000 individuals of Scotland now live with diabetes, while 6,400 people died from complications related to diabetes in 2019 alone. In addition to those figures, it is estimated that roughly 10 per cent of those with diabetes remain undiagnosed. The Scottish Government has taken positive steps towards tackling those issues and has made significant progress in introducing a previous diabetes improvement plan in 2014, with ever-increasing access to technologies to help both adults and children, as well as prevention campaigns such as Think, Check, Act and a £42 million worth of investment in the type 2 diabetes prevention framework. The Scottish Government is committed to making Scotland a healthier country. However, there is more that we can do and progress must continue. The centenary of the discovery of insulin represents an important opportunity to improve the prevention, treatment and care for all people in Scotland who are affected by diabetes. The diabetes improvement plan of 2021 to 2026 reflects the current challenges facing people who are living with diabetes, and it is an important step forward, building on all the progress to date and supporting continued improvements in diabetes care. However, those improvements will only be meaningful if there is a fair and equal actress for everyone living in Scotland. That is why I am so pleased to see equality of access identified and listed as one of the eight priority areas in the improvement plan. There are many factors that can impact and disadvantage diabetes care and outcomes for people, and it is vital that those are addressed. Back in 2018, I met with a number of patients living with type 1 diabetes in my constituency, and I campaigned alongside them to have free-style labour systems approved for use in Fife following the receiving Scottish approval in 2017. The system has been shown to offer life-changing improvements for people with diabetes intensively using insulin, reducing complications of diabetes, including blindness, amputations and renal failure, and helping them to live healthier and fewer lives. They will never forget the strength of feeling and overwhelming emotion response from local people living with diabetes to news that supplement approval by NHS Fife of a free-style labour system. To conclude, I once again like to thank Emma Harper for bringing this motion to Parliament and acknowledging its celebration of the 100-year anniversary of the discovery of insulin, and I hope that the future of medical innovation surrounding the care and treatment of diabetes is groundbreaking and will bring about a world in which diabetes can do no harm. Thank you, Deputy Presiding Officer, and thank you for bringing this debate to the chamber, declaration of interest. I am a practicing doctor as on the register. You've all heard about insulin and its invention from many of the other MSPs who have spoken, so instead I would like to answer this simple question. What actually is insulin and why is it so important? Well, just here behind your stomach sits an organ called a pancreas. In a healthy person, it makes insulin in response to your blood sugar levels. Your insulin drops the blood glucose levels and it drives it into your cells, giving the cells energy. People with type 1 diabetes, unfortunately, cannot produce insulin because their own immune system is attacking and destroying the cells that produce insulin in this pancreas. It is autoimmune and there is nothing patients can do about contracting type 1 diabetes. We have incredible new delivery methods that improve people's lives, but not everyone has access to them, so I urge the Scottish Government to look at this as mentioned earlier. But type 1 diabetes is less than 10% of the story. Type 2 diabetes presents a huge and growing concern here in Scotland and across the world. In Scotland, new cases have been growing year on year with the majority of cases being in the over 40s. Diabetes is a huge problem for us in the NHS. It accounts for 10% of the entire NHS budget and of this money 80%, that's 8% of the entire NHS budget, is spent on complications of diabetes such as loss of sight, loss of feeling, heart attacks and strokes. It also affects our black and Asian communities far more with large numbers completely undiagnosed. We need to prevent people from contracting type 2 diabetes, so I have been working hard to get people active. I visited the Woodland Trust in Dunbarton, which provides an incredible area for our families to explore. I visited the RSPB, close to Beersden, where people with anxiety can be referred, but also provides wonderful areas for exploration and even picnics. I'm also the path champion for the Ramblers to encourage the upkeep of paths so that we can enjoy the countryside. By doing this, I hope to promote simple activity and mindfulness to get Scotland moving, especially with such amazing nature on our doorstep. I have met supermarkets to promote healthy eating and to promote healthy foods rather than unhealthy foods. I thank the member for taking an intervention. What you are describing with Ramblers and outdoor access is often referred to as social prescribing. Do you think that there are some challenges in how we market that language, because some people do not know that outdoor access might be social prescribing? Social prescribing is a very important part of the armory that we as GP have. It is getting patients to understand the importance of eating well, of being able to go and do some exercise. People think that exercise is going to the gym and sweating and feeling horrible at the end of that session. That is not what we want for exercise. We are just talking about going for a walk and enjoying the walk. Social prescribing is something, and if you look at the Lothian, they are actually being able to refer patients in to get this, so this is something that we can take forward as a profession. I would hope that the Scottish Government supports what I am doing to help to prevent people contracting type 2 diabetes. In conclusion, the invention of insulin by doctors, McLeod and Banting, has quite simply saved millions of lives. It is a testament to how amazing this discovery is that, 100 years on, it is still the mainstay of treatment and being quite rightly uploaded in this chamber as a medical miracle. Let us not pat ourselves on the back. Let us actually try to reduce and prevent new cases of type 2 diabetes. That would be a legacy that Drs McLeod and Banting would be proud of. Thank you, Deputy Presiding Officer, and I begin by thanking Emma Harper for helping to bring this debate to the chamber. I recognise how close the issue is to her heart. Indeed, I thank Diabetes Scotland for their work and for their very informative briefing. We often forget how far scientifically we have come in comparison to 100 years ago. We have already heard that 100 years ago, diabetics did not have many ways to treat their condition and indeed did not lead long lives, as there was very little medicine that could provide for them at that time. Thankfully, we have seen a remarkable leap in technology and medicine to help people to live with diabetes. As we have already heard the statistic tonight, that 312,000 people in Scotland have diabetes, which equates to one in 20 people in Scotland. With that in mind, it is very likely that we all in the chamber know people whose lives are affected by it. I myself have close family and friends who are diabetic and rely on insulin to live their daily lives. Indeed, my dad has been diabetic for many years and I have seen firsthand the changes that have come as he has lived with his condition, particularly technological advances in monitoring his blood sugars and administering insulin. Indeed, I have also seen the universal power of insulin to un-sending borders. Once when I was on a family holiday to Rome, my dad forgot his insulin. I am not sure if Emma Harper has ever had that experience. The Italian medics advised that we should go to the Vatican pharmacy to see if they had any of the insulin that is prescribed here in the UK. Alas, they did not have any, but the medical staff ensured that Italian insulin works just as well and that it prescribed them some. Deputy Presiding Officer, I also want to mention one of my younger constituents this evening, Louisa Galt, from Port Glasgow. Louisa is eight and was diagnosed as a type 1 diabetic during lockdown, having been rushed to A&E thanks to the quick action of her GP and practice nurse. After her mum and dad, Jan and Jo, noticed the forties, toilets, tired, thinner and thirsty. During an extremely challenging time for the NHS, the family have embarked on a roller coaster journey in which insulin has played a huge part. Louisa is now insulin dependent and her intake of carbohydrates is closely monitored. She makes many of the decisions at age eight that Emma Harper referred to. Indeed, the family has described all of that as a huge learning curve, but they have commended the support of our NHS, particularly at the Royal hospital for children in Glasgow and at Inverclyde Royal hospital. Charities such as the juvenile diabetes research foundation, the GDRF. At a young age, she is showing great courage and a desire to show that she won't let diabetes hold her back. She is a budding gymnast and she tells her mum and dad that she wants to be a diabetic nurse one day. I hope that the minister will take note to reserve a future training place for her. The reason that I mention Louisa tonight is to reflect on how far we have come in the past 100 years. Life has been changed and dramatically improved by developments in medicine such as insulin. Just think where we can be when Louisa is an adult and beyond that with another 100 years of research and development, but we must ensure that access to advances are available to everyone who needs them. We know that constant glucose monitors, for example, allow a greater level of freedom for people with diabetes, allowing them to understand their bodies and what works for them. However, as we have already heard alluded to, access to those technologies is not always equal due to variations in what health boards are able to provide. I know that members in the chamber this evening will agree with me that we must do better to bring a greater equal level of quality care to those living with diabetes in Scotland. The Government has the opportunity to issue strong guidance to health boards to ensure that high-tech monitoring equipment is available to all patients who require it. In concluding, Diabetes Scotland has also called for a greater public health approach to be taken to help our children to understand their foods and to make healthier choices to reduce the risk of developing type 2 diabetes. We have to see far more work in that field to help us to develop as a healthy society. I hope that the minister will say something on that in her closing remarks. With actions such as those, we can help people to have healthier lives and make Scotland a happier place and create a world where children like Louisa can thrive. I thank my friend and colleague Emma Harper for bringing it to the chamber. Emma is passionate about the education, care and treatment of diabetes, and no better person could have introduced it to Parliament today. Thanks to a helpful briefing from Diabetes Scotland, we learned that more than 312,000 people in Scotland live with diabetes and that it is one of the fastest-growing and potentially most devastating health crisis of our time. The number of people diagnosed has more than doubled in the last 20 years. That is the bad news. The better news is that, with advancements in tech from blood glucose monitors to insulin pumps and looping, there is a range of options that can support someone in taking insulin, checking blood sugars and managing their condition. For people living with diabetes type 1, thanks to 100 years of insulin, it is no longer the death sentence that was prior to 1923, when Scottish doctor John McLeod and a Canadian colleague Frederick Banting jointly received the Nobel Prize for the discovery of insulin. Prior to the discovery, it was exceptional for people with type 1 diabetes to live for more than a year or two. Despite the great medical and technological advances that have been made since then, sadly, people living with diabetes are being hit hard by Covid. Almost 20 per cent of coronavirus-related deaths in Scottish hospitals are people with diabetes. Those figures were released at the start of the pandemic, so they may be a bit higher now. The condition has exacerbated inequality, as we have heard, with rates of diabetes 80 per cent higher in our most deprived communities. In addition, people living in poverty are more than twice as likely to develop life-changing complications such as heart problems and strokes. In Diabetes Scotland's recent survey of over 1,000 people living with diabetes, one in five said that they are having difficulty accessing key diabetes technology. While we celebrate 100 years of insulin, we must look to the improvements that can be made for all people, whether they live wherever they live and whatever their background and if they are living with diabetes now. I was shocked to learn just how many people are living with diabetes to 90 per cent, according to the briefing. Almost as shocked as I was when I was diagnosed with it two years ago. Fortunately, after a short spell on medication, a change in diet and lifestyle, I managed to reverse it in three months. It is preventable and can be reversed. The care and advice that I receive from diagnosis at my GP to the NHS support services for eye care and dietary advice was exemplary. Of course, no one could have predicted lockdown lifestyle in early 2019, and now many of us find that a lot of repair work is needed to reduce sugar levels, but it can be done and I am determined to do it again. We must recognise that structural factors make it difficult, sometimes impossible, for people to make healthy choices. The Government must continue to address the social determinants of health inequality and the reality of the damage that poverty can do. I have family members living with type 1 diabetes and I hear from them how relentless and overwhelming it can feel, and Emma Harper particularly outlined those difficulties. Diabetics must be supported at every level. Thankfully, much support can be found online from Diabetes Scotland, NHS Inform, information websites by way of dietary advice, which includes some delicious healthy eating recipes, exercise and lifestyle advice. In conclusion, we must ensure that the best diabetes care for everyone, no matter their post-coror background. Of course, we know that new technologies can change lives for diabetes once sufferers. Indeed, I feel fortunate that I can keep my condition at bay without the need for insulin that so many people rely on. However, the onus is on me. Diabetes type 2 is preventable, so let's stem the tide of this mushrooming condition by making healthy food and lifestyle information available for everyone. We can save the NHS of fortune and take control of our own wellbeing. Thank you, Emma, for bringing the debate to the chamber. I was really interested to see it on the agenda and really interested to hear Emma's contribution this evening on her motion, knowing the expertise that she brings in her role as a nurse. I didn't know also as a patient, so I have learned. I too, in a previous role, have some experience of working with patients using insulin. I spent many years in the NHS working as a dietician, and in my early career I covered diabetic clinics along with the specialist diabetic nurse and other members of the multidisciplinary team. Diabetes is a condition that patients manage and live with, and I learned so much about the adaptability, resilience and the humour of people following diagnosis of such a life-changing condition. It also gave me a lifelong admiration for the dedication of NHS staff, building relationships with patients who have enormous hurdles in many years of treatment to overcome. I give a big shout-out to all the staff, from the porters to the caterers, the medical and clinical staff and, in particular, my own colleagues and allied health professionals, a group of incredibly dedicated health service workers. As the motion points out, insulin is one of the greatest medical breakthroughs in history. It changed life for many millions of people, changing diagnosis of type 1 diabetes from a death sentence to a life worth living. Before insulin, it would have been unusual to live past two years, as people have said. Yes, 100 years of insulin is definitely worth celebrating. There are so many elements that we could bring to tonight's debate, as people have around diabetes diagnosis, diabetes treatment and diabetes as a life. They are such a short debate that we have a chance to raise one or two issues. For the short time that I have, I want to talk just a little about tackling the inequalities around diabetes care, in particular the link between inequality and diabetes outcomes. I thank Diabetes Scotland for the briefing notch, which reminded me of the realities of living with diabetes, particularly if you come from a more deprived background. While insulin means type 1 diabetes is no longer necessarily a death sentence, type 2 diabetes remains a disease on the increase. The day-to-day complications around heart health, eye care and foot care mean that it is an incredibly hard condition to live with. Living with diabetes can be relentless and managing it can feel overwhelming, and it is important that we acknowledge that. Managing lifelong conditions can take its toll on individuals and their families, so it is important that, as parliamentarians, we acknowledge our role in fighting for services and every possible advance to be made and made accessible to all. The poorest people in Scotland are actually over twice as likely to have diabetes at any age than the average person, and once they have the condition, those in the most deprived homes are twice as likely to develop complications of diabetes than those in less deprived areas. Those stark figures show the reality for so many. Where you are born and live unfairly lays out your future, particularly when it comes to health. Tackling the root causes of health inequalities has to be a key fight here in the Scottish Parliament. We need to tackle inequality and income, access to suitable housing and access to healthy food. We need to acknowledge the role that we all have here. We need to have policies which transfer power and wealth. The great achievement in diabetes care can continue. We just have to work hard in this place of power to ensure that the factors are in place to give economic justice to all. The briefing from Diabetes Scotland gives us the stark figures. Rates of diabetes are 80 per cent higher in most deprived communities in Scotland, and that is unacceptable, and we must act. Let's celebrate the 100 years of Vincent and let it remind us that things can change. With the creative structural changes in society, we can head towards Diabetes Scotland's vision of a world where diabetes can do no harm. I would like to thank Emma Harper for bringing this debate to Parliament. As the motion states, there are more than 312,000 people living with diabetes in Scotland, with this number having more than doubled in the last 20 years. My younger cousin was also diagnosed with type 1 diabetes at a similar age to Paul O'Kane's constituent, and many of the decisions that Emma Harper has talked about this evening, I very much recognise that my aunt had to take and that we are not popular with a cousin that had three non-diabetic cousins. We need a greater focus on prevention if we are to reduce the number of people being diagnosed with diabetes. Ninety per cent of people with diabetes have type 2, and reducing levels of obesity will help to prevent further diagnosis. Tackling the obesogenic environment will be central to achieving that, and I look forward to the Government introducing legislation to restrict the use of promotions on food and drink high in fat, sugar and salt. We must also address the health inequalities that continue to plague Scotland. Obesity rates are highest among those from the most deprived communities, and no one should be subject to food insecurities in 21st century Scotland, but it is still the case that food banks are being used. According to a report published by the UK Parliament's select committee on food, poverty, health and the environment, the inability to access a healthy balanced diet places people at greater risk of developing obesity as they may be overnourished with calories at the same time as being undernourished due to a lack of nutrients. As I have mentioned, our food environment is also saturated with low-cost unhealthy foods. The select committee found that healthy food has been shown to be three times more expensive calorie for calorie than less healthy alternatives. We cannot expect people to eat healthier diets until we address the fundamental issues of poverty and access to affordable healthy food. We also need to address unequal access to care that has been highlighted tonight. Many complications arising from diabetes are preventable as they mainly arise through poor glycemic control, where blood sugar levels are too high. In the last few years, great advancement has been made in the development of technologies that help people to maintain good glycemic control. However, those technologies are not available to all, and we have a postcode lottery in Scotland. Constituents have written to me about being unable to access this technology, which monitors glucose levels day and night and can make a substantial difference to high people with diabetes manage their condition. Some people with diabetes have had to pay for those technologies themselves, but not everyone is able to do so. Diabetes Scotland is calling for clear guidance to health boards that technologies such as glucose monitors, insulin pumps and looping should be made available to all those who need them. I urge the cabinet secretary to give serious consideration to that, and I would be grateful if the minister had anything to see. Covid-19 has highlighted the health inequalities that continue to plague Scotland, and we cannot afford those to widen further. Health and wealth are inextricably linked to the poorest people in the UK who are two and a half times more likely to have diabetes at any age than the average person. It is also the case that people with diabetes in deprived areas or for minority ethnic backgrounds are less likely to have key health checks, putting them at increased risk of developing complications. We need to ensure that everyone has access to the resources that they need to manage their condition and prevent complications, but also dedicated information campaigns that raise awareness of the symptoms and encourage people to get checked. Having a long-term health condition can undoubtedly take a huge toll on your mental health, and giving having diabetes makes you more vulnerable to developing a serious illness. If you catch Covid-19, the pandemic may have been a particularly distressing time for people with diabetes. Some people with diabetes will have been shielding, which may put them at greater risk of isolation and loneliness. Others may have had appointments postponed, all of which can have a serious impact on mental health. People with diabetes are more likely to experience anxiety and depression, and research conducted by Diabetes UK found that seven out of 10 people with diabetes feel overwhelmed by their condition and are not getting the emotional support that they need. It is vital that we do not view diabetes as simply a physical condition in isolation from mental health. We need to talk more openly about how long-term conditions can affect mental health and ensure that emotional support is integrated into physical healthcare. There have been incredible advancements in diabetes care and treatments since the discovery of insulin, and now we must do more work to ensure that everyone can benefit from those. If we give people the tools, resources and support that they need to manage their diabetes, we can substantially improve their quality of life. I am absolutely delighted to respond on behalf of the Government to the debate, and I thank Emma Harper for lodging the motion. I note that this evening in the chamber we have almost the full multidisciplinary team, so I should declare that I am a pharmacist. I hope that that ensures that we make better policy in this place. I want to join Ms Harper in celebrating 100 years since the discovery of insulin and to take the opportunity to highlight the progress that is made in diabetes treatment and care in Scotland. Diabetes is a significant challenge across the world, and Scotland is no exception. We know from the 2019 Diabetes Survey that approximately 312,000 people in Scotland had a diagnosis of diabetes. Of those, just under 88 per cent have type 2 diabetes. The Scottish Government is committed to delivering safe and effective person-centred healthcare treatment and support to people who are living with diabetes. We all know that the most effective treatment for diabetes is insulin, and we have heard about the group of scientists in Canada, one of whom was Scottish, John James Richard McLeod, a Scottish physiologist who discovered insulin. Prior to that, diabetes was a death sentence. It was exceptional to live beyond a couple of years. It is still one of the greatest medical discoveries of the last century, and, as people have commented, it is one that is still in daily use. In the 100 years since insulin discovery, diabetes treatments continued to evolve. Here in Scotland, Dr Sheila Reith, a consultant physician, worked with colleagues to develop the insulin pen in the 1970s. Like Emma Harper's mum, Sheila had a young daughter with type 1 diabetes, who found daily injections with glass syringes and steel needles extremely frustrating. She set out with colleagues to make treatment easier, creating a prototype insulin pen, a simple cheap alternative to traditional injections. After much testing, the nova pen was released to the open market in 1988. That shows you the length of time that is required to develop these innovations. We do not underestimate the impact of these discoveries for people living with diabetes. Not only have they transformed treatment and care, but they have also opened the door for many other innovations in diabetes. Diabetes is a clinical priority for the Scottish Government. In 2014, we published the First Diabetes Improvement Plan, which outlined eight priority areas and a focus set of actions overseen by the Scottish Diabetes Group. We recognise that the needs of people living with diabetes continue to change, and that has been particularly evident during the Covid-19 pandemic. We continue to respond to the needs of those living with diabetes and the services that provide the care and support. In February this year, we published a refreshed Diabetes Improvement Plan. The plan builds on significant progress made to diabetes care in Scotland, but we know that there is more that we can do, and the plan clearly sets out that ambition. We will track progress over the life of the plan to continue to demonstrate the improvements that are being made. That is why each of the commitments in the Diabetes Improvement Plan has an associated outcome measure and a plan for data collection. We are committed to sharing regular updates with the diabetes community as we progress. Emma Harper raised that during her opening speech. We collect a huge range of data on Sky Diabetes. There is not a single review point. It is about sharing that information and learning time and time again at a dynamic situation in which we continue to improve using quality improvement methodology. We will measure the data over time and track progress against the data in the Scottish Diabetes Survey and continue to improve the care, and make sure that that is shared with the wider Diabetes Society. There is no doubt that the on-going development of new technologies has transformed lives, and many members have mentioned that the Diabetes Improvement Plan sets out our continued approach to increasing the provision of technologies such as insulin pumps and continuous glucose monitors. We know that those technologies reduce clinical complications such as hyperglycemic episodes and admissions to hospital. We also know that those technologies have a positive impact on quality of life, providing more flexibility to daily life and reducing anxiety. In December 2016, the First Minister announced £10 million of additional funding to support the approach. In March this year, we allocated another £5 million to health boards to allow them to increase access to those technologies. In fact, in the latest diabetes survey, we saw insulin pump therapy in those underage of 18 was at the highest level since those data were first collected in nearly 40 per cent. That is likely to be a key factor in the substantial improvements in glycosylated hemoglobin, a measure of the good control of diabetes, which was first seen in Scottish children over the past decade. We know that advances in technology continue to benefit people living with type 1 diabetes, and we are also aware of the role of technology in type 2 diabetes care models. We know that obesity and type 2 diabetes are closely linked through targeted and evidence-based interventions. We can help people to manage their weight, improve their physical activity and reduce the risk of type 2 diabetes and its complications. We published the type 2 diabetes intervention early detection and intervention framework in 2018, with a five-year plan to take it forward. This financial year will invest £7 million for boards to implement and enhance treatment pathways for those at risk of and living with type 2 diabetes. That is 40 per cent more than last year's budget of £2 million increase. That funding enables boards to establish and deliver targeted weight management services, targeted community interventions, includes and is usually delivered in groups and specialist NHS services for more complex cases. Scotland is an international exemplar on type 2 diabetes remission due to the ground vectoring direct study, a study led by scientists at Glasgow University and funded by Diabetes UK. The direct study has changed the treatment paradigm for type 2 diabetes, showing conclusively, for the first time, that a dietary approach can put type 2 diabetes into remission, as Rona Mackayr described. For this reason, our funding to all health boards support the remission service for people living with type 2 diabetes. We know that the impact that diabetes can have on people, and as we continue to implement our diabetes improvement plan, there will be a strong focus on health inequalities. We know that both type 2 diabetes and excess weight disproportionately affect those living in deprivation, and women live with further disadvantage compared to men in terms of weight-related morbidity. One of the biggest challenges in type 2 diabetes is the delivery of appropriate and accessible self-management education. We know that people from areas of deprivation face more barriers to access that, and that will be a focus of our inequalities work. I loved hearing about Louisa Paul O'Kane. I thought that raising the story of a young person diagnosed during the pandemic with type 1 diabetes and the challenges that she faces and the ambitions that she has was wonderful to remind us of the impact that that condition has on people from a very young age to getting 180 extra decisions every day but still planning to be a gymnast and a diabetic nurse. I absolutely anything I can do to support her in our ambitions, I am more than happy to. I want to finish by acknowledging the significant advances in diabetes treatment and care over the last century. Insulin and the technologies that followed its discovery have been life-changing for people with diabetes, and we continue to support world-class innovations in that area. The Covid-19 pandemic has undoubtedly had an impact on people with diabetes. There are new challenges for the staff, new challenges for the services and new challenges for the people experiencing diabetes. We will keep on learning, we will keep on sharing our learning, and we will keep on improving the services. We are very grateful to the continued efforts of Diabetes Scotland and the clinical community for their unwavering commitment, and by combining our efforts, we can make a real difference to those living with diabetes in Scotland. I look forward to continuing those constructive and productive discussions and to continuing our improvement of diabetes care in Scotland. That concludes the debate, and I close this meeting.