INSULIN INSIGHTS

Medtronic Diabetes Presence at 81st Annual American Diabetes Association (ADA) Scientific Sessions

By Mamie Lausch, MS, RN, RDN, CDCES
Clinical Territory Manager/ Rochester, MN

ADA Scientific Sessions were held virtually June 25-29, 2021. Presentations can be viewed until September 29, 2021. Medtronic Diabetes therapies were the subject of many conversations! 

You are invited to watch two videos that were presented at ADA (Video 1, Video 2). They show how Medtronic Diabetes is committed to offering technology choice for all patients living with diabetes.

Conference registration is not necessary to visit Medtronic Virtual Booth! Click here.

Product Theater: Shared Decision-Making with Diabetes Technology

Dr. Robert Vigersky, Chief Medical Officer, Medtronic Diabetes shared real-world data from the MiniMed™ 770G System: 11,909 users achieved an average of 70.8% Time in Range (TIR) with only 0.4% Time below Range (TBR). Mean sensor glucose was 155.8 mg/dL and mean Glucose Management Indicator (GMI) was 7.04%. The number of patients able to achieve >70% TIR was up by 7.8% compared to MiniMed™ 670G system (56.8% vs 49%).*1

The MiniMedTM 780G System: Real-Word Evidence from the first 4000 users outside of the US was presented. This system is currently under FDA review.

Diana Isaacs, PharmD, BCPS, BCACP, BC-ADM, CDCES, FADCES, FCCP discussed InPen™ real-world data: 636 users (all ages; 71% T1D) with paired CGM data saw significant reduction in their TBR after starting InPen™. In a subset of InPen™ users (n=122) on CGM who had on average 8% TBR prior to InPen™ use were able to reduce TBR to 6.27%; in-other-words by 25 minutes per day. That is clinically significant and meaningful from a quality-of-life perspective.2

Another real-world analysis of unique InPen™ users explored the benefit of real-time dose tracking with dose calculator decision support by comparing TIR values among varying dose frequencies. 1,721 InPen™ smart insulin pen users who were also using CGM were included (all ages; 66% T1D). There was a significant greater TIR without significant increased risk of hypoglycemia among InPen™ + CGM users with 6+ injections per day compared to 1-4 injections per day. Average TBR slightly increased with the number of injections per day but remained no more than 3% across all groups.3 

Janice MacLeod, MA, RD, CDCES, FADCES, Clinical Advocacy, Medtronic Diabetes explained how shared decision-making powers data-driven care and addresses therapeutic inertia and diabetes disparities.

The hallmarks of the data-driven model are outlined below:

IDENTIFY:

  • Help every person with diabetes make informed decisions regarding technology choices including their choice of insulin delivery
  • Recognize choices will evolve over time  

CONFIGURE:

  • Help individuals get off to a strong start by configuring tools to match their care plan, circumstances, and preferences
  • Set clear expectations regarding integrating tools into daily self-care

COLLABORATE:

  • Use the data on an ongoing basis in partnership with the person with diabetes to:
  • Assess and address barriers to following care plan and taking insulin 
  • Incrementally optimize the care plan

Ali Dianaty, VP Product Innovation, Medtronic Diabetes presented future Medtronic Diabetes products with the goal to help empower people to live life on their terms!

Laurie Jung, RD, CDCES, Sr. Program Manager/Clinical Center of Excellence, Medtronic Diabetes presented: Learning Byte: Transitioning from MDI to MiniMed™ 770G System

Diana Isaacs, PharmD, BCPS, BCACP, BC-ADM, CDCES, FADCES, FCCP Endocrine Clinical Pharmacy Specialist, Cleveland Clinic Endocrinology presented: Learning Byte: InPen™ Smart Insulin Pen Product Features and Overview

Presentations to watch when you register and listen to ADA recordings:

InPen™ Smart Insulin Pen

  • “Impact of InPen™ smart insulin pen use on real-world glycemic and insulin dosing outcomes in individuals with poorly controlled diabetes” – oral presentation by Robert Vigersky, M.D. on Sunday, June 27 at 6:15 p.m. ET. 
  • “Glycemic outcomes of new InPen™ smart insulin pen users who received virtual onboarding” – poster presentation by Madison Smith, Ph.D., R.N.

Hybrid Closed-Loop (HCL) Technology

  • “Closed-Loop Increases Time-in-Range in Older Adults with Type 1 Diabetes Compared with Sensor- Augmented Pump Therapy: A Randomized Crossover Trial” – independent oral presentation by Sybil McAuley, MBBS, Ph.D., FRACP, on Sunday, June 27 at 4:30 p.m. ET.
  • “Durable insulin pumps vs. multiple daily injections for type 1 diabetes: Healthcare utilization and A1C” – poster presentation by Mona Shah, M.S.

A presentation especially insightful was: “Is Continuous Glucose Monitoring (CGM) an Effective Diabetes Management Tool in Primary Care?” by thought leaders, Dr. Amy Criego, Dr. Tom Martens, Dana Gershenoff, RDN/CDCES and Diana Isaacs, PharmD, BCPS, BCACP, BC-ADM, CDCES, FADCES, FCCP. A process for delivering diabetes technology patient reports right into their electronic medical record (EMR) was highlighted. The process involved numerous stake-holders within their clinic system plus an outside middleware company. By having ready-access to patient data, providers can have more time reviewing the data with their patients.

What’s Coming Next?

The Association of Diabetes Care & Education Specialists (ADCES) Annual Conference is scheduled to be held virtually August 12-15th. Each day is devoted to sessions on key topics:

Thurs, Aug. 12: Therapeutic Inertia
Fri, Aug. 13: Models of Care
Sat, Aug. 14: Innovation in Diabetes Technology and Therapeutics
Sun, Aug. 15: ADCES7 Self-Care BehaviorsTM

Medtronic Diabetes has a continued partnership with ADCES to help elevate the role of the Certified Diabetes Care & Education Specialist (CDCES) as the champion of technology integration. With that in mind, here are a few technology sessions scheduled that shed light on this topic and are worth noting:

  • S04 - Technology Interventions in High-Risk Populations: The Identify, Configure, and Collaborate (ICC) Framework in Action! Donna M. Rice, MBA, BSN, RN, CDCES, FADCES – The Root Cause, Inc; Deborah A. Greenwood, PhD, RN, BC-ADM, CDCES, FADCES – UT Health San Antonio School of Nursing
  • S08 - How Connected Insulin Delivery Devices Can Improve Glycemic Management. Diana Isaacs, PharmD, BCPS, BC-ADM, CDCES – Cleveland Clinic Diabetes Center; Christina Inteso, PharmD, BCACP, CDCES – Fairleigh Dickinson University/Ocean Health Initiatives
  • S16 - The Identify, Configure, Collaborate Framework To Address Technology Disparities. Janice MacLeod, MA, RD, CDCES, FADCES – Companion Medical/ Medtronic Diabetes; LaurieAnn Scher, MS, RD, CDCES – Fitscript
  • S18 - Identifying High Quality Apps to Achieve Positive Clinical Outcomes: Benefits and Challenges to Effective Utilization. Rachel Stahl, MS, RD, CDN, CDCES – New York Presbyterian Hospital/Weill Cornell Medicine
  • S21 - 2021 Diabetes Technology Update: What's New, What's Hot! Diana Isaacs, PharmD, BCPS, BC-ADM, CDCES – Cleveland Clinic Diabetes Center; Dhiren Patel, PharmD, CDECS, BC-ADM, BCACP – VA Boston Healthcare System
  • S29 - Meal Estimates Vs Carb Counting: Mobile Health Applications. Christine E. Fraley, BSN, RN – Monarch Medical Technologies; Michele Z. Dial, BSN, RN, CDCES – Ascensia Diabetes Care

For more information about any of our Medtronic Diabetes products, reach out to your local representative. You can also find helpful information on our Healthcare Professional website: https://www.medtronic.com/us-en/healthcare-professionals/therapies-procedures/diabetes.html

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*

Since the pivotal study did not include a control group, no effectiveness claims can be made. The study does support that the system is relatively safe. However, the study had limitations, including a relatively small number of patients, no comparative control group, and a study period that lasted only three months. In addition, the amount of time the system was used in the Manual Mode was much shorter than the time in Auto Mode. Due to these study limitations, caution is advised when attempting to extrapolate these results to individual patient results. There could be significant differences.

1

Bergenstal R, Garg S, Weinzimer S, et al. Safety of a hybrid closed-loop insulin delivery system in patients with type 1 diabetes. JAMA . 2016;316(13):1407–1408. NOTE: Must make clear in materials that pivotal trial is for adolescents and adults, 3-month study OR 12,000 patient days

2

Smith M, Thanasekaran S, Im G, Gaetano A, Lewis J, MacLeod J. Smart Insulin Pens Improve Time Below Range in multiple Daily Insulin Therapy.  Association of Managed Care Pharmacy 2020 Poster Presentation.

3

Smith M, Thanasekaran S, Gaetano A, MacLeod J. Increased Number of Daily Boluses Positively Impacts Glycemia in Injection Therapy with Smart Insulin Pens. Association of Diabetes Care and Education Specialists 2020 Poster Presentation.