It’s traditionally been particularly difficult to manage diabetes in highly active, still-developing children, but increasingly advanced glucose monitors and insulin delivery systems are aiming to make it much easier.
Case in point: A range of study data presented by Medtronic at the American Diabetes Association’s (ADA's) annual scientific sessions over the weekend touts the benefits of its newly FDA-approved MiniMed 780G insulin pump technology for kids and teenagers.
The MiniMed 780G system is equipped with an updated version of Medtronic’s SmartGuard technology. The pump connects to Medtronic’s Guardian glucose sensors; not only can the SmartGuard algorithm continuously adjust basal insulin delivery based on a sensor’s blood sugar readings, but it can now also automatically deliver correction bolus doses of insulin if, for example, a user forgets to account for mealtime carbohydrates.
The pump was cleared by the FDA earlier this year for people with Type 1 diabetes who are at least 7 years old.
One analysis presented at the ADA conference looked at the impact of the 780G system on more than 3,500 children aged 15 and younger across Europe, the Middle East, Africa and Latin America. According to the results, using Medtronic’s tech helped the kids achieve an average time spent within a healthy glucose range of about 74%. Those results climbed to 78% when they used the system’s recommended settings—which aims to achieve 100 milligrams of glucose per deciliter of blood and two hours of active insulin time—about the same time in range that Medtronic has previously reported for adult users of MiniMed 780G.
Plus, with help from the SmartGuard auto-correction feature, the pediatric users were able to reduce their amount of time spent above a healthy glucose range, with 23% of time spent above 180 mg/dL across the whole group and around 18% for those who used the recommended settings.
Another analysis homed in on about 2,500 kids aged 15 and younger in Europe, who were grouped according to their glycemic control before starting to use the MiniMed system. All together, they started at a baseline time in range of about 60%, which rose to 72% with MiniMed’s help. The biggest improvement was seen in those who started the study with the lowest glycemic control: Using Medtronic’s tech—with the aforementioned recommended settings activated—helped them achieve an average time in range of 64%, up from a baseline of just 41%.
Ensuring the system works well in a younger population is especially important because kids and teenagers historically have the highest HbA1c levels and “are not achieving the recommended metabolic goals,” Jennifer McVean, M.D., a pediatric endocrinologist and director of medical affairs for Medtronic’s diabetes business, said in an interview with Fierce Medtech on Friday.
“So what do these results mean for children and adolescents? I think it means that managing diabetes is just easier. If the system is picking up some of that slack in the background, then they’re not having to worry about it so much,” McVean said.
“I also think about those teenagers who are out with their friends, and maybe they don’t want to be different, they don’t want to pull out their pump,” she continued. “Now, of course, we always suggest patients bolus before they eat, but we know the reality is that sometimes they don’t, so the ability of the 780G to combat hyperglycemia is going to be very helpful.”
Another of Medtronic’s studies focused on making it easier for teenagers to input those mealtime carb counts. The study, led by Goran Petrovski, M.D., Ph.D., an endocrinologist at Qatar’s Sidra Medicine, split 34 teenage MiniMed 780G users into two groups: one tasked with entering the usual precise carb calculations and the other given a set of three standard carb counts—for small, medium and large meals—customized to each teen’s typical meal sizes and glycemic needs.
After six months, though the precise-entry group had achieved a lower time in range and average A1c, at 79% and 6.6%, respectively, the fixed-entry users were close behind, with a time in range of nearly 73% and an average A1c of 6.9%. The preset carb counts also helped significantly bring down the amount of time that group’s members spent in hyperglycemia—in which glucose levels rise above 250 mg/dL—from more than 28% to just over 5%.
With those promising results behind it, the simplified carb-counting method could be another way the MiniMed 780G system reduces the burden of diabetes management for young users, Petrovski said in an interview with Fierce Medtech.
“This system is a means of focusing more on creating a better quality of life for these patients,” he said, noting that kids typically face a barrage of orders to be better about tracking their glucose levels and counting carbs, potentially burning them out on glycemic control by the time they’ve become teenagers.
“But I’m curious to see how these patients fare after five or six years using this system,” Petrovski continued. “From my experience with the 780G, the attrition rate is very low. The system is very appreciated by the patients because they see the results immediately.”