About That "Artificial Pancreas..."

You keep using that word. I don't think it means what you think it means.

You guys. Healthcare News lost its freaking mind last week about Medtronic’s “Artificial Pancreas” getting FDA approval.

It’s always exciting when a new device or device enhancement becomes available to people with diabetes because it usually means that if I can get my hands on said device, I’ll have better blood sugar results.

But I’m concerned that the “breaking news” media reports have caused people to believe that there’s finally a solution that will relieve diabetics of our constant daily struggle to keep our blood sugar in target range.

So, no.

Medtronic’s new 670G insulin delivery system (“artificial pancreas”) is no such device.

If you look closely at the FDA’s announcement, you’ll notice that the FDA has not called Medtronic’s new device an “artificial pancreas.”

In fact, if you look at Medtronic’s announcement, you’ll notice that Medtronic, the creator of this device, doesn’t even call it an “artificial pancreas.”

Also, the Medtronic Minimed 670G is approved for type 1 diabetics only (1.25 million people in the U.S.), not type 2 diabetics (27.9 million people in the U.S.)

So let’s all hold our damned horses and chill the heck out, here.

You might be wondering whether the new Minimed 670G insulin pump/CGM system is even worth getting excited about? You bet! In fact, the new 670G system has new features that other pumps don’t have, and two of these features are what make the 670G different (and more automated) than other insulin delivery systems.

The two features the 670G has that other systems don’t have:

1. The 670G can now suspend or lower the basal or “insulin drip” rate based on the reading from the continuous glucose monitor.

1. The 670G can now increase the basal or “insulin drip” rate based on the reading from the continuous glucose monitor.

For some very basic details on insulin delivery systems and the 670G, take a look at the table below.

Based on what I’ve read about the Medtronic 670G and based on what I know about insulin delivery systems and how they work (since I’ve been using them for 16 years) Here’s my quick assessment:

1. I think the Medtronic 670G is an improvement over previous models.
   
   
2. I think the low glucose suspend feature is really awesome (this exists on a prior model, too), and may even save lives.
   
   
3. I think the high glucose basal adjustment is neat, though I’m dubious about how quickly it’ll actually lower a blood sugar. I think I’d prefer a bolus, and not a basal adjustment, if my blood sugar is high.
   
   
4. I think the media (and insulin delivery technology companies) should be more careful about calling a device an “artificial pancreas,” because its subtext implies that people won’t have to pay attention to their diabetes anymore, which is totally wrong.
   
   
5. I think that Medtronic has had annoyingly painful and inaccurate continuous glucose sensor technology for awhile now, and my hope is that this new 670G sensor is less painful and more accurate than previous sensors, because basing automated insulin decisions on inaccurate sensor data isn’t cool.
   
   
6. I’m impressed that insulin delivery technology continues to improve. But. I think that people with type 1 diabetes who use Medtronic’s 670G will still have to check their blood sugar multiple times per day using a finger stick, and I think that this pump will probably make mistakes based on inaccurate sensor data which will have to be manually corrected. But, the automation is an improvement that has a real chance of resulting in better blood sugar outcomes for people using this pump.

My verdict?

If you are a type 1 diabetic using the Medtronic 670G system, you are still going to have to work just as hard to manage your blood sugar as you always have, but, if the new Medtronic sensor is more accurate than Medtronic’s previous sensors, there’s a non-zero chance you’ll get slightly better blood sugar results from your efforts if you use this system. And a better result, no matter how slight, can make a world of difference for some.

As for me, I'm going to continue to use my old Medtronic pump along with my Dexcom sensor, even though the two devices don't interact with each other. If diabetics using the 670G start raving about the painlessness and accuracy of the new Medtronic sensor, then maybe I'll give the 670G system a try. And if you are using the 670G, I invite you to add your opinion in the comments section below. For now, because I've been scarred (emotionally and physically) by Medtronic's prior sensors, I just can't give up my Dexcom (which, thus far, has been a far superior CGM) anytime soon.