ADA: Tandem strategy chief on the software, hardware updates that'll get late diabetes tech adopters off 'the sidelines'

Insulin pumps are already used by more than a third of all people with Type 1 diabetes in the U.S., according to Elizabeth Gasser, an executive vice president at Tandem and its chief strategy officer—but the company wants to expand that reach even further.

Upping the technology’s usage will take something of a strategy switch-up, Gasser told Fierce Medtech in an interview Monday during the American Diabetes Association’s (ADA's) annual scientific sessions.

When it comes to the 37% of the Type 1 population that pump makers are already reaching, “they’ve overcome certain technology barriers along the way over the past 15 years, and they’re much more of an ‘early adopter’ audience,” she said. Reaching 50% or 60% adoption, then, will require devicemakers like Tandem to cater to “a different group of users, who’ve been on the sidelines for longer.”

“We’re spending a lot of time talking about what it is that that next wave of users will need so they want to adopt,” Gasser said. “That’s driving a lot of the software and the hardware agenda right now.”

On the hardware side, those needs include greater discretion, less complexity and more wear modes for insulin pumps, according to Gasser.

Tandem, for its part, has responded with its upcoming Mobi pump—which is half the size of its t:slim X2 system, can be fully controlled by a smartphone and is on track to receive FDA clearance and launch in the U.S. before the end of this year—and with the ability for users to integrate its pumps with a range of continuous glucose monitors from both Dexcom and Abbott.

As for software, Tandem is working on evolving both its mobile interface and algorithm, all with an aim of “optimizing the user interface in a straightforward way to deliver a compelling experience,” Gasser said.

That includes simplifying the process of setting up and programming a new pump, improving day-to-day monitoring and making it easier for users to make mealtime insulin adjustments—perhaps, “over time,” even by fully automating mealtime bolus doses, Gasser suggested, achieving that elusive goal of a completely closed-loop system for diabetes management.

Rolling out those upgrades, however, requires more than just a remote software update, she noted, “because at the end of the day, the user has to understand what’s going on. So, it’s part algorithm, part user interface, and a whole lot of application around it all to tie it together.”

Tandem offered updates on several of those new software features during the ADA conference. One study presented by Jordan Pinsker, M.D., the company’s VP of medical affairs, showed that having access to Tandem’s mobile bolus feature—which launched last summer and allows users of the t:slim X2 pump to program mealtime insulin doses from their smartphones rather than on the pump itself—increased the number of boluses delivered per day across all age groups and also added an average of 38 minutes to the time in range of users under 12.

Another study looked at Tandem’s proposed “adaptive therapy settings” feature, which automates the process of continuously calculating a user’s standard pump settings based on glucose data from the preceding days. Tandem has already shown in a proof-of-concept study that the automated tech can improve glycemic control for people with Type 1 diabetes; the new study presented at ADA focused on patients’ satisfaction with the feature, which they credited with relieving some of the burden of managing their diabetes, improving their sleep and upping their overall quality of life.

Elsewhere at the conference, Tandem also marked the launch of its new Source platform. On one end, users will see their insulin and glucose data upload “in seconds,” per Gasser, and be compiled into a trio of reports—which their doctors can also view from their own dedicated portal. The platform also serves as a single place for users to access pump software updates, order supplies and complete any needed training sessions.

But beyond simplifying the glucose management experience for both individuals and their doctors, the most “intriguing” aspect of the newly built platform, according to Gasser, is how it will eventually feed into updates to Tandem’s algorithm.

“Once we’re doing this well, once we’re pulling data into the backend properly and in a very well-structured fashion, it becomes much easier for us at Tandem to use that to drive iteration on the algorithm. We can run simulations; we can look at whether devices are performing well; we can look at outcomes across different groups of users,” she explained. “And then we can also use that data to have conversations with payers about our capacity to improve outcomes for their populations with our algorithms.”

Ultimately, she said, “I think Source offers us a lot of flexibility and potential to be really creative with how we use data to the benefit of our patients and stakeholders.”