Medtronic Launches New Pump/CGM Analysis Software for Healthcare Providers
Although no one ever said insulin pump management was easy, we’re very happy that new tools are emerging that can make pumping easier and better. We have often wondered whether most people had pumps that were under-optimized. Pumps require careful setup of several parameters (basal rates, insulin:carb ratios, sensitivity factors), and it’s been difficult over time for patients to get all these rates and ratios to work together as well as possible. Additionally, after all this attention to detail, most pumpers have neither the patience nor time to use advanced pump features like square/dual-wave bolusing and basal patterns. Thankfully, diabetes device companies have developed data management programs to help people with diabetes and their healthcare teams visualize information, identify trends and take action. For example, Animas has ezManager Max, Insulet has the OmniPod Pathfinder system, and Medtronic has two types of software for managing pump and/or CGM data: CareLink Pro for healthcare providers and CareLink Personal for individuals. We hear especially positive remarks from healthcare providers about Medtronic’s software and wanted to do a little exploration on the highly-touted newest system, the CareLink Pro 3.0. (And please stay tuned – we’ll have a Test Drive using the software in 2011 since we hear it can really help establish and refine basal rates and all the ratios on pumps.)
To use these systems, the patient connects the devices to a computer (often easier said than done), and the program downloads all the data, displays it and records it. Then the fun begins: healthcare providers and/or patients interpret the data, which is then ideally used to change therapy or behavior. Although the data summaries from these programs can be very helpful, it does take some time. Whether you’re a novice pump-user or an experienced endocrinologist, optimizing glucose control can be tricky and time-intensive.
Medtronic’s recently launched CareLink Pro 3.0 software is a welcome step forward in data analysis and presentation, offering two important features for healthcare providers. (These new tools require both pump and sensor data; for providers whose patients are using only a pump or only CGM, the CareLink Pro software will function as before.) The first new tool is the Therapy Management Dashboard, a one-page summary of insulin and glucose data. The Dashboard brings together information from various pages of previous CareLink Pro reports: overlays of sensor glucose curves, levels of basal and bolus insulin throughout the day, average carbohydrate intake (if someone has used the pump’s Bolus Wizard to calculate mealtime insulin dosage), and more. The Dashboard also includes topics such as Bolus Wizard overrides, estimated A1c, and – perhaps most helpfully – the patterns of hypoglycemia and hyperglycemia during different times of day.
The valuable other new feature, the Episode Summary, analyzes highs and lows in more detail. The Episode Summary's charts display hypoglycemia and hyperglycemia related events, along with ideas for how to improve control. The Episode Summary analyzes up to 28 different event types, ranging from "dawn phenomenon" to "carbohydrate entry of more than 80 grams" to "delayed site change." For example, if someone's low blood sugars were often the result of overcorrecting high blood sugars, the summary for the provider might say: "Consider assessing your patient's insulin sensitivity factors. Consider counseling your patient on the management of hyperglycemia."
We would like to see these kinds of decision-support features included in CareLink Personal too, so that pump users can access them directly. In the short term, the FDA blocks software that offers this level of analysis to non-healthcare professionals; companies will have to prove whether their programs are reliable enough for individuals to use on their own. In the long term, however, we are confident that analytical systems like these will help control the artificial pancreas. Generally speaking, we think that pump and CGM software is unnecessarily complex, especially with regard to uploading data from devices in the first place. Still, given the potential benefits of Medtronic's new program – saving clinicians' time, sparking productive conversations, demystifying pump management – we think CareLink Pro 3.0 could help make life healthier (and simpler) for many people with diabetes. --JS