Medtronic links automated insulin delivery to sustained glucose control benefits

Last year, Medtronic released data that linked the MiniMed 780G insulin pump to significant improvements in blood glucose levels and time in target range compared to manual multiple daily injections (MDI).

Now, Medtronic has released data from the second part of the study. The patients using MiniMed 780G from the start of the trial continued to use the pump and retained the improvements they experienced over the first six months. Over the second six months, blood glucose, as measured by mean HbA1c, rose slightly, from 7.3% to 7.4%, and time in range slipped from 70.4% to 69.7%. The bigger changes were seen in the cohort of patients who were in the MDI control group for the first part of the trial: in the six months after switching to MiniMed 780G, mean HbA1c fell from 8.9% to 7.5%, and mean time in range increased from 43.6% to 70.7%.

“There is a growing body of clinical evidence demonstrating the superiority of using automated insulin delivery systems as first-line treatment for type 1 diabetes, rather than the standard stepwise approach of starting patients on a CGM first,” said Jennifer McVean, MD, Senior Medical Affairs Director, Medtronic Diabetes. “These results demonstrate patient success earlier in the course of their disease and across the age spectrum. Considering this compelling evidence, we’re committed to expanding access to our MiniMed 780G system so more people living with diabetes have an opportunity to improve short- and long-term health outcomes.”

Furthermore, data recently presented addressed one of the remaining hurdles of delivering a closed loop system — the ability to manage complex meals and exercise. Today, individuals need to calculate the number of carbs they are consuming and input it into their pump so the correct amount of insulin can be delivered (called ‘announcing a meal’).

However, The MiniMed 780G system was designed to anticipate real-life needs where carb counts aren’t always exact and meal doses are often missed. Professor Amir Tirosh of Sheba Medical Centre Israel, presented studies that confirmed that the MiniMed 780G system was able to handle unannounced meals up to 80 grams of carbohydrates, and that there was no deterioration in glycaemic control when small amounts (up to 20 grams) of carbs were unannounced. In addition, he presented data that precise carb counting, often seen as a prerequisite for access to advanced diabetes technology, is not as important as once thought.

As Medtronic advances its SmartGuard algorithm towards a fully closed loop system, the company is evaluating the use of the MiniMed 780G system integrated with its proprietary Klue smartwatch app which leverages hand gestures detected by a smartwatch to announce meals to the pump with the goal of eliminating manual meal announcements.

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