Living with Type 1 diabetes is like having a full-time job on top of managing a day job and life commitments — one that involves making constant risk assessments and difficult decisions throughout the day.
“‘How many carbs did I eat? How much insulin do I need for that? Am I going to exercise later today?’ There are countless decisions you have to make every day, in particular when there’s no automation,” said Richard Jonkers, principal medical science advisor and access lead for endocrinology at Medtronic Canada, during Benefits Canada’s 2022 Tech Insights conference in mid-April. “That is a big burden on your daily life.”
Someone with the disease will need to check their blood glucose level and potentially deliver a correction bolus multiple times a day, including when they wake up, before they go to bed and before and after meals, he pointed out.
That’s why Medtronic developed the MiniMed automated insulin delivery pump system. The body-worn insulin pump and infusion set automates insulin delivery every five minutes, depending on the wearer’s glucose concentration. The system’s continuous glucose monitor tracks the wearer’s sugars at all hours of the day and night, predicts highs and lows in advance and adjusts insulin dosing on a real-time basis in response.
MiniMed is enabled for adults and children as young as two years old and is meant to take away the “mental math” that those living with type 1 diabetes constantly perform, said Jonkers.
Patients’ glucose needs constantly vary on a day-to-day and even hourly basis, so automating insulin delivery is key, he said, sharing insulin data from one anonymous patient that showed the user’s insulin needs looked “completely different” on two nights, despite those nights being only a week apart.
Remaining in the ideal glucose level range 100 per cent of the time may not be possible, he added, but automating insulin dosage makes it easier for patients to stay in range for longer.
Recent data from Medtronic showed that, prior to enabling auto mode, 41 per cent of MiniMed users achieved their glucose management indicator target after enabling auto mode, compared to 27 per cent before enabling it. Half (49 per cent) achieved their time-in-range target after enabling auto mode, compared to 28 per cent before.
Achieving those targets not only helps users feel better and reduces the risk of short-term impacts such as fainting or going into a shock, but also lowers their risk of long-term complications such as cardiovascular disease, said Jonkers.
The system also decreases the burden of living with and managing a chronic disease through its smartphone app, which notifies the user if their glucose level is going high or low, he noted. “You don’t always want to show that you’re living with a chronic disease, so by having that Bluetooth connectivity with a smartphone app you can very discreetly check . . . how your blood glucose management is going.”
Medtronic’s separate Care Partner app allows for remote monitoring by a partner, parent or child, something that Jonkers said gives peace of mind to loved ones. He shared the example of a parent whose child has type 1 diabetes and could see through the app when their child was going low and that they drank a juice box to address their low insulin levels, thus saving them from having to leave work or constantly check in on their child.
Jonkers said plan sponsors can support employees who are living with type 1 diabetes or caring for someone who has the disease by providing access to innovative new technologies in their benefits plans.
“Automation is a major technology advancement and it will continue to make an impact in diabetes care. Until there is a cure, technology really helps to decrease that burden of living with diabetes. When people feel better they do better, it definitely decreases the risk that they need to stay home.”
Read more coverage from the 2022 Tech Insights conference.