ALT T1DE is a serious and under recognised issue, with too many people being unable to access support. While we welcome the development of the NHS England T1DE pilot programmes and entirely agree with the report’s recommendations that these should continue and grow, we also recognise that for many people with T1DE and their families that making the decision to access treatment is difficult and that there are many barriers to achieving this. We also believe that the best treatment for T1DE is prevention, and that this is best achieved through the development of the diabetes psychology workforce and research, and the integration of specialist psychologists into diabetes teams. We thank all the witnesses, particularly those with lived experience for their powerful testimony, and we send our best wishes to all those who have lost loved ones to T1DE.