It’s notoriously difficult to manage blood sugar levels in children and teenagers with Type 1 diabetes because of their high activity levels, constantly fluctuating hormones and ongoing growth and development. But Medtronic may have developed a solution, as evidenced by the success of a recent pediatric study of its new MiniMed 780G insulin pump.
The 780G pump is designed to work with Medtronic’s Guardian sensors to continuously monitor glucose levels throughout the day and automatically adjust insulin dosage every five minutes as needed. It received CE mark clearance in Europe in 2020 and is currently undergoing FDA review in the U.S.
In the study, more than 3,200 European patients aged 15 and younger used the 780G system in tandem with the Guardian Sensor 3 to manage their Type 1 diabetes. After one year, their average time in range—indicating the percentage of the day spent within target blood sugar limits—closely mirrored that of adult diabetes patients.
Overall, the group experienced an average time in range of 74%, comparable to the adult average of 77% and higher than the usual rates for children. Additionally, the pediatric patients’ time in range jumped to match the adult rate of 82% overnight, indicating that the “advanced hybrid closed-loop” algorithm embedded in the 780G pump works especially well while patients of all ages are asleep.
“Because the algorithm in the MiniMed 780G system adjusts basal and correction insulin doses in near-real-time every five minutes, thereby providing near-real-time course correction, it helps make up for underestimated carbohydrate counting and occasional late or missed meal doses,” said Robert Vigersky, M.D., chief medical officer of Medtronic’s diabetes business.
Throughout the study period, the pediatric patients relied on the SmartGuard algorithm to automatically manage their insulin dosages for about 93% of the time, slightly above the 92% reported by users older than 15.
In a subset of young patients with continuous glucose monitor data spanning at least 10 days both before and after beginning use of the algorithm, adding SmartGuard to a glucose management regimen was linked to a 12% bump in time in range, which comes out to an extra 2.8 hours per day spent within the target blood sugar range.
“The Medtronic AHCL algorithm offers advanced protection and permits unprecedented personalization in insulin delivery by offering a wide range of Active Insulin Time settings and three different glucose targets,” Vigersky said. “These improvements reinforce that the MiniMed 780G system is a better alternative than previous therapy these patients were on, even for those who were relatively well-controlled.”
Previous studies of the next-gen MiniMed system have found that it’s similarly effective in improving glycemic control for those older than 15, too. Results of one such study presented last year showed that the 780G system increased time in range by about 10 percentage points for patients aged 14 to 29.
Those teenagers and young adults also met the target time in range of 70% at a rate three times that of the baseline average; in comparison, Medtronic’s previous 670G model only doubled the number of patients who consistently reached that level.