In just the last few years, diabetes technology has grown exponentially smarter. Top of mind now for many devicemakers is the creation of a truly closed-loop system for insulin delivery—a system often referred to as an artificial pancreas.
This approach links continuous glucose monitors with insulin pumps and uses artificial intelligence to translate blood sugar data from one into optimal doses from the other. The result is a system that tracks a user’s glucose levels and automatically adjusts insulin as needed, without requiring much input from the wearer.
But while existing artificial pancreas systems handle much of the burden, they typically still require a small amount of manual tuning—though perhaps not for long, if Medtronic has anything to say about it.
In an interview with Fierce Medtech during the American Diabetes Association’s (ADA’s) annual scientific sessions on Saturday, Robert Vigersky, M.D., chief medical officer of Medtronic’s diabetes business, described how the medtech giant aims to completely close the loop on insulin management.
A truly closed-loop system would start with Medtronic’s insulin pumps and glucose sensors. Combining the latest versions of each—the MiniMed 780G and the Guardian 4 sensor—has been proven to help keep users within their ideal glucose ranges for an average of 73% of the day and even longer if they stick to the systems’ recommended settings, according to new real-world study results presented at the ADA meeting.
Those results echoed the findings of previously published studies, Vigersky said.
“The upshot of it is that the outcomes, which were great in the first place, have remained great. There’s no significant differences between the times in range, times below range—the significance of this is the patient satisfaction, with very high ratings on patient satisfaction across the board,” he explained. “The outcomes that we’re getting are the best in class by far, which is really gratifying for our patients and their healthcare providers.”
With those positive long-term results in the rear view and FDA review of the MiniMed 780G well under way, it frees up some space on the docket for Medtronic to begin plotting future upgrades to the all-in-one diabetes management system. First up: eliminating the need for users to analyze every meal they eat and using those calculations to manually adjust bolus insulin doses.
“Our algorithm team has developed some new algorithms that appear to deal with this in a way that we think will almost fully close the loop, so that it won’t require a person to actually announce a meal. They may still do so, but just being relieved of the burden of having to do it and still getting great outcomes is something that we’re really very hard at work at,” Vigersky said, adding that the first study results of those algorithms should arrive within the next year.
That technology could get smarter still, as Medtronic works on integrating gesture-tracking technology from Klue—which it acquired in late 2019—into the closed-loop system.
Klue’s algorithm is embedded in a smartwatch, where it analyzes hand and arm movements to detect when a wearer is eating and for how long. Those findings “can ultimately go into informing our algorithm of how much insulin is needed,” Vigersky said, further reducing the need for people with diabetes to manually track every change in their glucose levels.
Medtronic is also integrating the InPen smart insulin pens it acquired in its 2020 purchase of Companion Medical into the closed-loop family. Altogether, according to Vigersky, these efforts are advancing the company’s goal of “democratizing the use of closed-loop therapy”—simultaneously making it easier for individuals to manage their diabetes and bringing those low-effort tech offerings to more people around the world.