This morning, the Medtronic Diabetes Group held a conference call for a small group of diabetes writers to give an update on its new MiniMed 670G system, otherwise known as the world’s first hybrid closed loop system. Louis Dias, Chief Patient Officer of Medtronic Diabetes and Mike Hill, Vice President of Marketing for Medtronic’s Intensive Insulin Management Business were both on the call, as was Karrie Hawbaker, Senior Manager of Social Media.
First, a recap on what the system is and what it does:
The MiniMed 670G system is a combination of an insulin pump and a continuous glucose monitor. What sets it apart from its predecessors—and, for that matter, every other pump on the market—is that it can actually give you insulin. This makes it a major step forward toward the goal of a truly closed loop system.
How does the 670G system work?
Users must program their insulin-to-carb ratios, calibrate the system twice a day with a blood glucose reading from a finger stick, and give the system a “meal announcement” when they’re about to eat by entering the number of grams of carbohydrate that they intend to consume.
The system then uses the grams of carbohydrate users have entered and their insulin-to-carb ratio to estimate an initial bolus to cover the meal. In the hours that follow, the system makes tiny tweaks to basal rates in order to get blood sugar levels as close as possible to 120 mg/dL.
This means that you don’t need to enter correction boluses and that there’s no longer such thing as dual wave or square boluses—the pump is taking care of it for you.
How’s it different from the most recent MiniMed pump?
Medtronic Diabetes’s current top-of-the-line pump is the MiniMed 630G system with Enlite Sensor. The 530G uses something called SmartGuard™ technology to suspend delivery of insulin after the sensor determines that your blood glucose is low, but the system can’t take any predictive action—let alone give you insulin to correct a high blood glucose reading. (SmartGuard is also referred to as threshold suspend or low-glucose suspend.)
Another important difference from previous systems is that the 670G uses a new sensor called the Guardian 3. While the Guardian transmitter—that’s the part that you wear on top your skin—looks the same as the Enlite transmitter, the sensor itself is totally different. It’s 80 percent smaller than the Enlite (again, we’re talking about the part below the surface of your skin), longer lasting (approved for 7 deays instead of 6) and considerably more accurate.
It achieves this accuracy in part by using another new feature: a built-in self-check system within the sensor itself. As Hill explained it, each sensor actually has two sensors: one that’s sending information to the pump, and one that is making sure the first sensor is accurate. If the system thinks it’s getting out of whack, it’ll send you a request for an additional calibration.
According to Hill, that self-check system means that users can be confident that when the system is running with no calibration alert, it’s “rock solid.”
Hill and Dias say that the Guardian 3’s accuracy is “comparable” to the Dexcom G5 Mobile CGM System, but that it’s hard to measure since the two systems have never been directly studied in a controlled clinical trial.
The new 670G is also “more robust” than Medtronic Diabetes’ previous pumps (i.e. it’s less likely to break if you drop it). It’s also waterproof for up to 24 hours at a depth of 12 feet, which is the same as the 530G, but a big improvement over Medtronic’s previous pumps, as well as most others on the market.
Also important: while the “Auto” mode is by far the most exciting aspect of the 670G, the pump also has two other modes: “suspend on low” (which is what the 530G does), and “suspend before low” (in which the pump will suspend basal delivery if it predicts that you will experience a low in the near future). You can choose which mode you want to use, and switch back and forth between them as you like.
How can I get one?
Dias called the system Medtronic’s “most important launch ever” and explained that in order to make sure the launch goes smoothly, Medtronic is doing it in stages.
The first, which started when the system was approved last September, is a Priority Access Sign-Up period, which gives priority to people who are on the 530G system—or who just bought it—and would like to upgrade. (Pumps aren’t shipping yet; it’s just a sign-up period.)
This week marks the beginning of the next phase: a small trial with a select group of customers and healthcare providers to test Medtronic’s roll-out plans. On the call, the 670G system was described as “almost the launch of a new therapy”—meaning that there is a lot to learn, for users, healthcare providers, and Medtronic Diabetes itself. The company wants to make sure that the training process runs smoothly and that employees are adequately prepared for issues and questions that might pop up once they do a full launch. This phase is scheduled to run through the summer.
While these are happening, Medtronic Diabetes is also working on getting coverage for the 670G from insurance companies (there are some 400 payer contracts that need to be negotiated). Hawbaker said it’s been a smooth process so far—but nonetheless, the process takes time. Worth noting is that the 670G system will be the same price as the 630G, which is helping to speed things up.
Medtronic plans to start shipping the 670G system to Priority Access customers in June 2017. Then, once those orders have been filled, Medtronic will begin taking orders for the 670G from everyone else.
In other words, you can’t get the system yet, but you will be able to very soon.
The 670G marks a huge milestone in the journey toward a fully closed loop system, but Medtronic knows we’re not there yet. Even as the company prepares to roll out the 670G, it’s working on next generation pumps and sensors that will bring us even closer to the goal of a fully automated system.
In the words of Dias, “We are on a journey.” But at the moment, “we feel that the 670G is a tremendous step forward for long-term health.”