MiniMed 770G Automated Insulin Delivery Cleared for Children
By Eliza Skoler
By Eliza Skoler and Katie Mahoney
The MiniMed 770G system has been cleared by the FDA for people two years of age and older with type 1 diabetes. Its Bluetooth-connected pump and smartphone app make data uploading and sharing far easier; plus, a big win, 770G users can upgrade to the MiniMed 780G – the next generation MiniMed closed loop system – for free when available, for “automatic” updates
Editor's note: this article was last updated on November 23, 2020
Medtronic’s MiniMed 770G hybrid closed loop system was recently cleared by the FDA for people with type 1 diabetes as young as two years of age. This makes the 770G the first automated insulin delivery (AID) system available in the United States for children between two and six years old.
As background the 2018 MiniMed 670G hybrid closed loop system was the first commercial “artificial pancreas technology,” using the 670G pump, the Guardian Sensor 3 continuous glucose monitor (CGM), and the MiniMed AID algorithm. When the 670G system is used in “auto-mode,” the algorithm controls basal insulin release every five minutes, while the user is responsible for bolus insulin delivery for meals and to correct high glucose levels. The MiniMed 770G uses the same algorithm and Guardian Sensor 3 CGM (which has a sensor life of seven days), but has a different pump: the MiniMed 780G pump. The 780G pump is Bluetooth-connected to allow the user and their care-partners to see glucose data on their phones; this sharing can be especially helpful for parents, who can see their child’s glucose levels on their phone in real-time. Medtronic is working to bring its advanced hybrid closed loop system, the MiniMed 780G, to market in the US. The 780G system will use the MiniMed 780G pump and the Guardian sensor 3 CGM with a new, highly-regarded algorithm to allow for automated correction boluses and a reduced glucose target.
Here’s more information on the MiniMed 770G system that was just approved by the FDA in September:
The pump in the 770G system is Bluetooth-connected, meaning users will be able to view pump data on their phones and upload data or update their pump wirelessly.
The MiniMed smartphone app will allow users to easily share glucose and insulin data with their care-partners for remote monitoring, as well as with healthcare professionals and diabetes care and education specialists. This is an important feature for all people with diabetes, especially during COVID-19. It will also provide in-app alerts when blood glucose levels are out of range.
The MiniMed 770G also includes the Guardian Sensor 3 CGM and the Roche Accu-Chek Guide Link blood glucose meter for calibration. You will need to perform a minimum of 2 confirmatory fingersticks each day in order to inform insulin dosing decisions – this is particularly important to stay in Auto Mode.
People who purchase the MiniMed 770G system will be able to upgrade to the 780G algorithm for free when it is available in the US. The 780G is already available in Europe and is expected to launch for adults in the US before April 2021. While the 770G system can adjust basal insulin rates every five minutes (like the 670G), it does not offer automatic correction boluses, reduced alarms, or an adjustable glucose target down to 100 mg/dl (which the 780G will include, down from 120 mg/dl with the 770G). Note: the trial for pediatric use of the MiniMed 780G system is now expected to complete in January 2021, so we’re hoping that the 780G will become available to children with diabetes later in 2021.
A three-month study of the MiniMed 670G system in kids age two to six years old showed improvements in time in range and A1C: the MiniMed 670G algorithm reduced A1C by 0.5 percentage points (from a baseline of 8.0%) and increased time in range from 55% to 64%, an additional two hours per day spent in range! Surprisingly, there was no change in time spent in hypoglycemia (with glucose below 70 mg/dl), and the researchers recorded no episodes of severe hypoglycemia.
The FDA clearance includes a minimum and maximum daily insulin dose required for use: the Auto Mode should only be used in people who use at least 8 units and no more than 250 units of insulin per day. This is important to note for younger children who may use less insulin.