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Francine Kaufman Part 1, Medtronic 670G Insulin Pump

In part 1 of this Exclusive Interview, Dr. Francine Kaufman explains the “automation” of the 670G pump in a conversation with Diabetes in Control Publisher Steve Freed during the ADA meeting in San Diego, California.

Dr. Francine Kaufman was named Chief Medical Officer and Vice President of Global Medical, Clinical and Health Affairs in April 2009. In this role, Dr. Kaufman is the key architect of the company’s global diabetes strategy, as well as a leading voice for multidisciplinary medical strategy across Medtronic.

Transcript of this video segment:

Steve: This is Steve Freed with Diabetes in Control and we are here at the American Diabetes Association 77th scientific session 2017, and we are here to present you with some really exciting interview with some of top endos from all across the world. We have a very special guest, Dr. Francine Kaufman who has a long history of being involved with diabetes, including being president of the American Diabetes Association.

Dr. Kaufman: That’s true. In 2003.

Steve: Maybe we can start off and tell us a little bit of what do, because you’ve done many different things.

Dr. Kaufman: Well, I am a pediatric endocrinologist, and I went on staff at Children’s Hospital in Los Angeles, which is part of the University of Southern California in 1980, and I’ve been there 4 years before for my training, including my pediatric endocrine fellowship, and I was the head of the division for a decade or so, and in 2009, I became the Chief Medical Officer at Medtronic Diabetes.

Steve: Talk a little bit about Medtronic and their new breakthrough in diabetes, that’s the new pump. There is a little bit of confusion about that, that is not truly an artificial pancreas, but everybody keeps calling it an artificial pancreas, maybe you can explain what it actually is.

Dr. Kaufman: The goal from quiet some time, and maybe the original dream was Al Mann’s when he started MiniMed. And when Medtronic bought MiniMed in 2000, they bought the building, the pumps, the sensors and Al’s dream, so the goal has always been to take that marriage of the pump and the sensor, and automate aspects of insulin delivery, so the patient has less burden in managing diabetes, and hopefully the outcomes are actually better, since for the most part machine can do a pretty good job of flying planes, controlling temperature, maybe even having self-driving cars. So, at Medtronic, the goal was to go incremental, and it has all been put in the category of artificial pancreas, which just means automating insulin delivery. And that category means that the patient is not in total control of insulin delivery, which makes it kind of an “artificial pancreas.” But I think when most of us think about artificial pancreas, we think that the device will control all insulin delivery, and these first iterations, all the way to our MiniMed 670G system, are not complete automation of insulin delivery. So, the 670 G system automates basal insulin, so there’s no basal rates that are preset anymore that operate when somebody is in what we’re going to call auto mode, which means the algorithm every 5 minutes determines how much basal insulin to give, is a little stroke. And instead of 5 minutes, it may be to a maximal amount that’s determined by the algorithm and adapted every day, or it may be actually no insulin for a while day if the glucose values are either low or falling. So, that automation of insulin delivery done by the algorithm, done by the pump and sensor is married to now the delivery of bolus insulin, for meals by the patient. The patients determine how many carbohydrates they are going to eat, they enter that in the bolus wizard, the pump then gives them their bolus for their meal. And for correction dose, if the glucose value is elevated, the pump will do the calculations but ask the patient to confirm. So, it’s kind of autopilot and a co-pilot depending what’s going on, but it is much more automation than we’ve ever seen, and as result we’ve shown with our pivotal trial, it’s both safe and actually resulted in lower A1C and more time in the target range for more patients.

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