Medtronic Minimed 670G hybrid closed loop insulin pump

LIVINGLIVING

Taken from the April 2018 feature on

HbA1c Vs Time in range, Dr Pratik

Choudhary of Kings College Hospital in

London commented, "An HBA1c of 8%

has a mean of 50% time in range when

someone uses CGM. In our data, with

at least three blood tests per day and an

average of five tests per day, we found

that an HbA1c of 8% was associated with

50% proportion in range. Time in range is

not really new, it's just that we've not been

calling it that. Also, we can now look at

time in ranges - high, in range and low.

Looking at data in this way has been a

recent groundswell connected to the

rise in the use of CGM. The myth about

diabetes has been that it's simple - match

insulin to carbs based on a blood test

reading and it should be 'bingo', a perfect

result, but it clearly does not always

work like that. This simple formula does

not allow for exercise, hormones, or the

person's intake of fat and protein when

eating, which can also affect absorption

and the resulting blood glucose level. The

fact is that access to CGM is still limited,

but even without CGM if you can aim

to get 70% time in range or proportion

in range then this

will definitely help

with control and,

in the end, with

improved HbA1c

too. Basically,

variability - going

up, going own -

is problematic.

Improve on that,

and it all gets better."

EDITOR'S COMMENT: HbA1c will

stay around, not only because it's so

embedded in diabetes healthcare today,

but also because it does have its uses.

Getting better control needs more ways

of being assessed and 'seen' in order

that outcomes can be tweaked in various

aspects of a diabetic's daily life. Greater

clarity of trends could lead to better

control and quality of life, so it's not to

be sniffed at. It has been found that the

percentage of time spent in range relates

directly to HbA1c, therefore imkproving

time spent in range will, in time, become

a means of intervention in itself.

- Sue Marshall

Glossary

Time in range, a refresher

Artificial pancreas - while this is a

phrase that does get used in the world of

diabetes are, perceptions around what it

means range from an implantable device

to a harvested organ. Medtronic does not

use it.

Auto Mode - see SmartGuard, below.

Closed loop - this refers to a fully

automated system, while a 'hybrid

closed loop' system requires some

user interaction. Medtronic is working

towards decreasing this interaction to

further simplify diabetes management for

people living with Type 1 diabetes with a

fully automated closed loop system.

HbA1c - when haemoglobin in blood

is measured to identify the three-month

average plasma glucose concentration.

It's a three-month average because the

lifespan of a red blood cell is four months

(120 days). Normal levels of glucose

produce a normal amount of glycated

hemoglobin. As the average amount of

plasma glucose increases, the fraction

of glycated hemoglobin increases in

a predictable way. This serves as an

indicator of average blood glucose control.

Proportion in range - a way of

converting the amount of time you spend

in range into one figure, and a way of

directing control so that you are aiming

for 70% of your readings being in range.

SmartGuard - when SmartGuard Auto

Mode is turned on, a reading is taken

every five minutes by the CGM sensor.

Based on this, the dynamic SmartGuard

Auto Mode algorithm in the pump adjusts

to the persons real time glucose needs

by giving small amounts of basal insulin

every five minutes as the system target a

glucose level of 6.7 mmol/L.

Medtronic held an introductory day on the MiniMed 670G in

October 2018 at one of the company's sites in Switzerland. Two

UK bloggers who attended the event were Mel Stephenson-Gray

and Mike Kendall. Click on their websites for their insights on the

MiniMed 670G system.

Insider insights

www.lifesportdiabetes.co.uk

www.everydayupsanddowns.co.uk

Index

  1. Desang diabetes magazine diabetes information
  2. Abbott Freestyle Libre, Flash Glucose Monitoring, blood testing without lancets
  3. Desang diabetes magazine diabetes information, Sue Marshall
  4. Dr Jonathan Valabhji, MiniMed 670g hybrid closed loop insulin pump
  5. Omnipod Insulet insulin pump with insulin pods, podders
  6. Lilly nasal glucagon, free online diabetes magazine
  7. Dexcom CGM G6, continuous glucose monitoring
  8. JDRF, medical detection dogs, Input diabetes charity
  9. London Medical, London Diabetes Centre, private diabetes clinic
  10. JDRF patron HRH Duchess of Cornwall, diabetes research Dr Roman Hovorka
  11. JDRF patron HRH Duchess of Cornwall, diabetes research Dr Roman Hovorka
  12. Diabetes food news, desang diabetes magazine
  13. Diabetes food news, desang diabetes magazine, munchy seeds
  14. Diabetes food news, desang diabetes magazine, meat snacks group
  15. Medtrum Touchcare diabetes technology
  16. Medtronic Minimed 670G insulin pump
  17. Medtronic Minimed 670G hybrid closed loop insulin pump
  18. Medtronic Minimed 670G hybrid closed loop insulin pump
  19. Medtronic Minimed 670G hybrid closed loop insulin pump
  20. Medtronic Minimed 670G hybrid closed loop insulin pump
  21. Medtronic Minimed 670G hybrid closed loop insulin pump
  22. Medtronic Minimed 670G hybrid closed loop insulin pump
  23. Ascensia Contour Next One Diabetes blood test meters
  24. David Andrews violin man, Type 2 diabetes, HbA1c, metformin, gliclizide
  25. David Andrews violin man, Type 2 diabetes
  26. desang magazine, David Andrews violin man, Accu-Chek Mobile blood test meter
  27. OurPath diabetes prevention programme, Roche Diabetes Care
  28. Making Carbs Count cabbages sprouts and chestnuts
  29. Making Carbs Count cabbages sprouts and chestnuts
  30. Making Carbs Count cabbages sprouts and chestnuts
  31. Desang diabetes kitbags, free online diabetes magazine, diabetic kit
  32. Accu-Chek Insight insulin pump
  33. Accu-Chek Insight insulin pump
  34. Free diabetes magazine, living with diabetes, the diabetic diet, carb counting

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