Technology update: Hybrid Closed Loop System

Laura Gandrud, MD

As new diabetes management technology becomes available it is important to know how it differs from what else is out there in the diabetes market. Recently, the FDA approved the MiniMed 670G System with Smart Guard Hybrid Closed Loop Technology, the first FDA approved hybrid closed loop system. This system consists of a subcutaneous insulin infusion site, a subcutaneous glucose sensor, and a computerized insulin-dosing algorithm that all work together to keep blood glucose as close to a pre-set target of 120mg/dL. Studies of the device demonstrate users spent more time in range, had less hypoglycemia and the A1c improved an average of 0.5%. Though it has been referred to as an “artificial pancreas,” it is truly a hybrid (or partial) closed loop system as it still requires data input from the user (entering carb amounts, manual blood glucose tests, and adjustment for exercise) periodically throughout the day. Unlike a traditional insulin pump, the hybrid system algorithm will make micro adjustments to the insulin basal rate based on the glucose sensor reading to respond to rising or falling blood glucose and exercise. The system will ask for additional information as needed if glucose is not responding as predicted or if the pump senses an error in the system.

While it is exciting to have new diabetes technology and devices available, it is important to keep in mind that it may not be a suitable choice for everyone. Please consult with your diabetes care clinician or educator with further questions regarding this new technology.

Priority access program participants will be able to get the system as early as June and training will occur during the summer and fall to transition these patients from the MiniMed 630G to MiniMed 670G. The MiniMed 670G will be available to all patients starting sometime in the fall for all other interested patients not currently on the 630G pump.

Nels Thompson