Type 1 Freedom From Monitoring and Dosing Is Closer With New Technology

What many individuals with type 1 diabetes would love is freedom from the need to frequently monitor blood sugar levels, and administer insulin.

This freedom, with limitations, is what the new “artificial pancreas” is designed to provide. The FDA approved MiniMed 670G, which is actually the first “hybrid closed-loop system,” monitors blood sugar, and delivers requisite insulin doses automatically.

User Input

Although the MiniMed 670G, produced by Medtronic, is a step toward a fully functioning artificial pancreas - and will undoubtedly streamline the lives of those suited to it - the device is not completely automated. It delivers tiny insulin doses throughout the day that are largely preset by users and their physicians; however, users must also:

• Enter a carbohydrate count for the food to be eaten at meals, approve the mealtime insulin dose, and push a delivery button.
• Perform finger-stick glucose checks to calibrate the device, plus maintenance such as changing device sensors as directed.

The MiniMed 670G checks glucose levels every five minutes through a sensor on the skin, and delivers insulin via a pump and infusion patch. Doses are customized to each user’s needs, and the device can be set to shut off when blood sugar levels drop too low, diminishing the chance of hypoglycemic episodes during the night.

Currently, the device is approved for use by people aged 14 and up with type 1 diabetes, though it is being studied for use by children, and will likely be available to consumers this coming spring.

Maybe Less Worry

The hybrid artificial pancreas may also provide people with a bit more freedom from worry about glucose highs and lows, and the specter of complications owed to hyperglycemia. The evidence for this comes from a three-month MiniMed 670G trial involving 123 teens and adults:

• With the new device, participant blood sugar levels went high (above 180 mg/dl) 24.5 percent of the time, compared to 27.4 percent of the time using their previous insulin systems.
• During the night, episodes of low blood sugar were less frequent and of shorter duration.
• No severe hypoglycemia, ketoacidosis, or serious device-related adverse events occurred during the 90 days.

One of the participants, a 60 year old advertising executive and avid cyclist said, “I can track my glucose levels closely, make connections with what’s happening in my life, and see how the continuous mini-boluses of insulin help. It was mind-blowing.” Ninety-nine of the participants chose to continue with the new device after the trial ended.

More Advances Coming

While the MiniMed 670G can provide people more freedom and increased glucose control, it will not be a suitable option nor appeal to all insulin users—but there are more fully automated technologies in the works.

“There are several closed-loop systems in development right now that....can provide bolus doses of insulin for meals as well as basal insulin around the clock,” notes endocrinologist Dr. Grazia Aleppo, Northwestern University in Chicago. “It’s good to see the FDA moving toward acceptance of cutting-edge tools that can make a big difference in people’s lives.”

Source: Endocrine Web