Building an artificial pancreas might sound like something out of a science fiction story. But ever since 1980 when Alfred Mann created the company that became MiniMed Inc., that has been the company's goal. In February it moved a small but significant step toward realizing it.
A feedback mechanism…is the holy grail.
An artificial pancreas would include an insulin delivery pump combined with a continuous glucose monitoring system. More than 60,000 Americans are now wearing MiniMed's pumps. A Food and Drug Administration advisory panel in February recommended conditional approval of MiniMed's system designed to provide continuous glucose monitoring.
"This system is the first of an evolutionary series of products," says Terrance Gregg, MiniMed's president and chief operating officer. It records a signal from a sensor every 10 seconds, then uses these readings to calculate and store an average value every 5 minutes. After 3 days, the patient has to go back to the doctor's office for the numbers to be downloaded into a computer.
The world's first continuous monitoring system is currently available only for clinical trials. And unlike other meters that measure glucose, MiniMed's monitoring system measures interstitial glucose rather than blood.
He says that MiniMed plans to introduce a consumer product utilizing both a pump and a continuous monitoring system late next year. "That product will actually allow patients to look at their glucose levels live."
That product, however, won't have a feedback mechanism in the pump to produce just the right amount of insulin in response to the glucose level detected by the sensor. That's the long-sought Holy Grail of diabetes treatment.
"That is still on the drawing boards," Gregg says. "We have prototypes built, but that will require a clinical trial, which won't be started until next year."
Meanwhile, users of the current generation of MiniMed pumps have been much in the news lately. Pump acceptance is growing as more people hear about them.
It doesn't hurt that the current Miss America, Nicole Johnson, wears a MiniMed pump. "Her experience convinced Michelle McGann, one of the leading female golfers, to go on a MiniMed pump about two weeks ago," Gregg says.
MiniMed has the lion's share of the U.S. pump market. Data from Frost &Sullivan, a market research firm, indicates that MiniMed sells about three-fourths of the pumps in this country. Its only competitor, Disetronic Holding AG, headquartered in Switzerland, dominates the European market.
Both companies list their pumps for just under $5,000. That's by far the most expensive way to deliver insulin, and I thought that insurance companies seldom paid for them.
Not true, says Ray Hoese, MiniMed's marketing communications manager. More than 90 percent of insurance companies cover pumps, he says.
Medicare, on the other hand is not there yet. "There are two separate bills before Congress about covering pumps," Hoese says. "You can find information about that on our Web site at Medicare and Insulin Pumps".
The most popular page on MiniMed's Web site, Hoese says, is What Is An Insulin Pump and How Does It Work?. But the best part of the site, he thinks, is feedback from pump users.
"What's nice about the business we are in is that we change peoples live dramatically," Hose says. "Every day we get e-mails from people thanking us and telling us how they are doing."
MiniMed shares some of the best stories, like the pilot who got his pilot's license back because the pump gave him such good control, Hoese says. That story is at Alaskan Pumper Gets His Wings Back.
Another unique aspect of MiniMed's Web site is its attractiveness to adolescents. The site is colorful and provides a chat club and other information geared toward teenagers. That's gone a long way toward increasing pump sales to adolescents. "In 1998 compared to 1997 our greatest growth—more than 400 percent—was in that age group," Gregg says.
"Only in the last year have doctors realized the benefits of pump therapy for type 2 diabetics," Hose says. "So right now it's about 99 percent type 1, but that is shifting quickly."
The American Diabetes Association originally published this article on its Web site as one of my “About the Internet” columns.
Medtronic Inc. purchased MiniMed in August 2001 for $3.8 billion.
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