Medtronic CGM

Diabetes is treated by administering insulin to control blood sugar levels. In Europe, closed systems have been approved that constantly monitor blood glucose levels and adjust the insulin dosage. In the U.S., the FDA is taking a more cautious approach to this sort of automation. The agency still requires a traditional finger-stick blood sample and a glucometer reading before making adjustments to insulin dosage.

The camel’s nose is pushing a little further under the tent, however. Medtronic now offers the MiniMed 530G that combines a wearable, wireless constant glucose monitor (CGM) with a wearable insulin pump. The pump administers pre-programmed doses of insulin around the clock, which means that the patient does not have to deal with needles and syringes to inject the insulin. If the patient’s blood sugar falls below a predetermined level, the system issues an alarm. What’s new about this system is that if the patient is unable to respond to the alert, the pump will automatically suspend insulin delivery for two hours. This can prevent dangerously low blood glucose levels, even if the patient is sound asleep.

As we get more experience from these automated systems (including the closed feedback loops of the European systems), the FDA and healthcare professionals will likely develop a better understanding of the monitoring and treatment of diabetes. I expect that we’ll continue to see further advances toward automating the process, leading to systems that will be able to better mimic the function of a healthy pancreas. The result could be an improvement in the quality of live for millions of diabetic patients worldwide, and a big reduction in the healthcare costs that result from complications caused by this chronic condition.