One Step Closer to a (Fully) Artificial Pancreas

By Manny Hernandez, Senior Vice President of Member Experience and Strategic Product Alliances

September 28, 2016 is likely a date to go down in the history of type 1 diabetes as a milestone. It was the date when Medtronic received approval from the FDA for their 670G hybrid closed loop system in an impressively short 3 months since they submitted it for review by the agency.

It hasn’t even been ten years (2008) since JDRF published their landmark Continuous Glucose Monitoring and Intensive Treatment of Type 1 Diabetes study, which propelled the adoption of Continuous Glucose Monitoring, a central backbone to the Artificial Pancreas initiative. And it’s been only four years since the FDA issued its final Artificial Pancreas (AP) guidance.

As we celebrate this milestone, for those less familiar with type 1 diabetes technology, I wanted to take a moment to shed additional light around this incredible news that comes as the result of years of hard work by FDA, JDRF, the Helmsley Charitable Trust, and Medtronic.

  • An artificial pancreas (AP) system takes glucose and trend data from a Continuous Glucose Monitor (a system that monitors glucose levels every five minutes), feeds it into an algorithm, and adjusts insulin dosing through an insulin pump to help maintain in-range glucose levels.
  • In the past few years, Medtronic has been progressing towards an artificial pancreas, closing more elements of the loop. The 670G system continues that trend, auto-adjusting basal (think, “background”) insulin delivery, with automated correction boluses (think, “insulin to deal with high glucose level or to handle meals”) on the horizon.
  • Others in this space (like Tandem, Insulet, Animas, Beta Bionics, Bigfoot Biomedical, and others) are working hard to bring to market their own solutions to this complex challenge. The next few years will be packed with innovative options in this space.
  • Although it would be great if this system did away with the need for people with type 1 diabetes to check their blood glucose, the continuous glucose monitor used in the system still requires 2 finger-stick blood glucose checks per day to calibrate it.
  • While most people with type 1 diabetes are not on an insulin pump and most people with diabetes (the majority of people with type 2 diabetes) are not on insulin, the AP system has paved the way in our way of thinking about diabetes management. Automated solutions with personalized recommendations for people with diabetes not taking insulin and insulin dosing algorithms that are able to feed off of bluetooth-enabled insulin pens are in sight as tools that promise to have a broad impact.