The MiniMed Insulin Pump Settings That Matter Most for Your Patients. Explore Why They're Not the Ones You'd Expect
Steve Edelman, MD and Jeremy Pettus, MD on why insulin action time and glucose target have quietly become the highest-leverage settings on the MiniMed 780G and Flex systems, and what aggregated user data suggests where they should be set.
Steve Edelman, MD and Jeremy Pettus, MD, both endocrinologists living with type 1 diabetes, compare how these major automated insulin delivery systems weigh their settings. This video was supported by Medtronic MiniMed Inc.
When insulin pumps first came out, the settings checklist looked the same for every patient in your practice regardless of which device was being used: basal rate, carbohydrate ratio, insulin sensitivity factor, glucose target. Automated insulin delivery (AID) systems dramatically changed how we utilize insulin pumps. Now that modern algorithms adjust insulin every few minutes based on continuous glucose monitor (CGM) data and other factors, the initial settings we once thought were most important are now controlled and adjusted automatically by the algorithm, not by the healthcare professional. The impact of each setting also differs by system, so the download of the MiniMed 780G and Flex systems you review with your patients calls for a different set of questions than other systems. In this conversation, Dr. Pettus, who wears a MiniMed pump himself, joins Dr. Edelman to rank the importance of each setting across the major AID systems and explain the two most important settings for the MiniMed SmartGuard™ algorithm. These recommendations are pulled from a dataset of more than 54,000 users, where those on optimized settings held a time in range of 76.3% even without bolusing for meals – think about that!
Do you feel these three settings are the most important and do you currently review them with your patients? Let us know in the comments below!
inhaled insulin afrezza stats
10 to 12 minutes
How quickly inhaled mealtime insulin starts working, and because it moves in and out fast, it can be dosed as often as hourly.
About 1-2 hours
VS 3 to 4 hours – inhaled insulin clears the body in roughly an hour, compared with the 3 to 4 hour window of injected rapid-acting insulin, which is why injections call for more pre-meal timing.
over 10 years
Inhaled insulin has been FDA approved for adults since 2014, with ongoing post-market safety surveillance reported to the FDA.
LESS weight gain
Was reported in the inhaled insulin group compared with the injection group during the INHALE-1 pediatric study.
Higher treatment satisfaction
Kids using inhaled mealtime insulin in the INHALE-1 study reported greater satisfaction with their regimen than those on injections.
Meet Our Guest
Dr. Anna Cymbaluk is a pediatric endocrinologist at Rady Children's Hospital and served as an investigator on INHALE-1, the trial supporting the FDA pediatric indication. In this conversation she covers both the protocol she helped run and how she has been applying the option in her own practice.
Here’s what you need to know about inhaled insulin approved for kids, before your next session with the family!
Pediatric View on the Inhaled Insulin Approved for Kids!
FACTS About Inhaled Insulin Afrezza
- Inhaled insulin is fast on and fast off. It is absorbed almost immediately and clears the system quickly, allowing for dosing at the start of a meal or even after eating, instead of 20 minutes before, and for quick correction doses when the timing of a meal isn’t predictable.
- The approval was built on a pediatric study. The INHALE-1 study followed children and teens specifically, comparing a standard injection regimen against an inhaled mealtime insulin regimen and tracking glucose control, body weight, safety, and satisfaction.
- Lung function was monitored closely throughout. Researchers measured baseline lung function and at three-month intervals during the entire study. FEV1, the main pulmonary function marker used in this study showed no difference between injectable or inhaled insulin.
- Pediatric data mirrors what was seen in adults. Specialists point to more than a decade of adult use under FDA post-market surveillance, and showed no significant issues with lungs.
- It isn’t the right fit for everyone, and screening is part of the process. Inhaled insulin is generally not recommended for children with a recent history of acute asthma treatment, current cigarette smoking, or users of vapes.
- A short-lived dry cough was the most common side effect. Some people develop a dry cough when they first start, and for many, it eases with technique over time.
- It works on top of a long-acting basal insulin. Inhaled insulin covers mealtime and correction needs; a once-daily basal insulin stays part of the routine.
Supported by an unrestricted educational grant from Mannkind Corporation.
Great information!! Thank you so much for sharing!