A pediatric endocrinologist shared that nearly 40 percent of new users of the Medtronic 670G closed-loop insulin pump stopped using the device over a 15-month period, according to a Medscape report.
In an observational study presented over the weekend at ENDO 2019: The Endocrine Annual Society Annual Meeting, Dr. Gregory Goodwin of Boston Children’s Hospital shared the findings generated by tracking 93 mostly pediatric patients with type 1 diabetes at his practice who began using the Medtronic 670G for the first time over a 15-month period. Researchers discovered that 35 patients discontinued use of the closed-loop insulin pump system within an average of 9 months after beginning use.
According to the Medscape report, the main reasons reported for stopping use of the 670G were:
– Forced exits from the closed-loop automated basal delivery mode
– Frequent alarms
– Sensor issues of accuracy and supply
– Skin adhesion issues
Dr. Goodwin says that most people who discontinued use stopped using the insulin pump system for good, but the Medscape report did not indicate ultimately how many patients stopped using the 670G permanently. Dr. Goodwin did say that more than half of those who stuck with the device saw significant reductions in HbA1c levels, however.
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In response to a request for comment to the study, Medtronic spokeswoman Pamela Reese noted that clinical trials conducted by the company of more than 1800 people showed positive clinical outcomes with the 670G. In an email, she also noted that Medtronic has made many improvements to the 670G since its first release.
“We have made enhancements to the system since this study was done which would likely mitigate many of the issues experienced,” Reese wrote. “Specifically, we updated the software in the transmitter that sends sensor information to the insulin pump. When the MiniMed 670G system was initially launched 2 years ago, it included an additional layer of protection which, in certain instances, can create a continuous request for blood glucose entries. To improve the patient experience, we created a software enhancement that removes the additional safety check without compromising patient safety. All MiniMed 670G systems shipping today have this enhanced transmitter, and we are replacing the transmitter for anyone experiencing an issue.”
Currently, the Medtronic 670G is the only closed-loop insulin pump with automated basal rates on the market. In recent years, it has been the first company to incorporate new insulin pump technology – its 530G was the first to suspend insulin delivery when a low is detected and its 670G was the first to offer automatically adjusted basal insulin delivery.
The medical device maker has been able to leverage these advances to gain more than 60 percent of the insulin pump market. Last month, UnitedHealthCare, the largest medical insurer in the United States, recently announced that the Medtronic 670G will be its preferred pump for all people with diabetes ages 7 and up, a move that critics say limits pump choice for those covered by its insurance plans.
Diabetes tech users likely soon will have other options for closed-loop insulin pump systems. There are more than a dozen active projects being undertaken by 20 different companies to develop closed-loop systems, according to a chart recently shared by Close Concerns, a diabetes industry newsletter produced to support the diaTribe Foundation. Recently, the FDA began issuing new diabetes device designations that should clear the way for companies to collaborate to bring closed-loop insulin companies to market.
This is a relatively small study, but it echoes findings raised by at least one other observational study. In that 2018 study of 31 pediatric and young adult patients with type 1 diabetes, researchers with the Barbara Davis Center for Diabetes and others warned that there was a steep learning curve with adoption of the 670G, and that clinicians should be prepared to support patients and their families.
3/26/2019 – This story has been updated to include comment from Medtronic about the study.