Rachel Connor, Director of Research Partnerships in the UK reacts to the announcement that the US Food and Drug Administration has approved the Medtronic 670G – making this the first commercially available system that can automatically adjust insulin delivery to limit hypoglycaemia and hyperglycaemia.
On hearing the news that the Medtronic 670G had received FDA approval my first thought was ‘Woohoo!’ the second was ‘What a long way we’ve come’ and the third, hot on its heels, was ‘there’s still work to do!’ Let me explain:
FDA approval means that Medtronic can now market the 670G to people with type 1. Outside of carefully regulated and controlled clinical trials, people living with type 1 can use this artificial pancreas (AP) technology and benefit from its sophisticated ability to automatically adjust insulin dosing based on information about changing glucose levels.
What a long way we’ve come
I joined JDRF in 2008. It was big news at that time that clinical trials with a closed loop system were beginning at the University of Cambridge with a control algorithm making decisions about insulin dosing overnight. These trials involved a nurse manually making the changes to insulin delivery using a commercially available pump, according to the calculations of a control algorithm running on a nearby computer.
As the years have passed, those early overnight trials in hospital beds (where no-one got much sleep) have moved to trials where people have used AP systems at home for six months and more. Where academic enthusiasm once met commercial scepticism, there is now true partnership between academia and industry, and a shared vision of technological tools reducing the burden of living with type 1 diabetes.
I’m proud that JDRF has been a driving force in making these changes real – our commitment has been validated by more and more funders taking an interest in this technology over the years.
There’s still work to do
The reason my third thought on hearing this news was about the work still left to do, is that as significant as this milestone is, commercial availability in the USA does not equal widespread availability to people with type 1 – in the UK, Europe or even the USA.
So what happens next? Right now, the Medtronic 670G does not have marketing approval in Europe. This is the first step towards access to this technology in the UK and we believe this will follow soon. JDRF will fight for access to the 670G and other artificial pancreas technologies, and we are optimistic that the health benefits these technologies can bring to people with type 1 will be recognised.
There is currently supportive NICE guidance for pumps (and sensor-augmented pumps), and a clear list of circumstances in which health care professionals should consider the use of continuous glucose monitors(CGMs) was published in 2015. JDRF will be engaging with NICE to underscore the importance of availability of artificial pancreas systems such as the Medtronic 670G.
It isn’t a cure
Progress on artificial pancreas technologies is hugely important and I believe that better type 1 technology has the power to help many people live life with type 1 with less effort and less fear of hypos and other complications.
But technology is just part of the JDRF story: ultimately we’re here to find the cure for type 1. The cure that will consign type 1 to the history books and means that no-one will ever receive that life-changing diagnosis again. Research to shut down the immune reaction behind type 1 and to protect, replace and restore those vital insulin producing cells is happening right now. And it’s moving forward fast. There weren’t that many clinical trials in type 1 diabetes to write about when I joined JDRF; now there are more great ideas for trials that could change the face of type 1 than we can currently fund.
Today is a great milestone for people with type 1 – but it is just a marker along the way. We have plenty more work to do. Thank you for being part of the story so far, and for helping us to continue this work into the future.