Two years ago, Roche was the first to take the plunge, inviting a bunch of diabetes bloggers to visit their headquarters for a day of frank conversations and an "inside look" at how they make the products that keep us ticking. And they hosted us again last year at the CWD Conference.
On Friday, about 25 of us online advocates from the diabetes community were invited to Los Angeles for a day of similar interaction with Medtronic. Admittedly, we always jump at the chance to gather in person for a DOC pow-wow — yet we were once again somewhat leery of what the day would entail, especially since the agenda was kept secret until the last second (when we arrived by multiple cars from our downtown LA hotel to Medtronic's HQ in Northridge, CA).
The day turned out to be surprisingly relaxed and informal-feeling, aided by the convivial demeanor of the featured (famous and well-revered!) speakers Dr. Fran Kaufman and Dr. Richard Rubin, both former presidents of ADA.
Kudos to Roche for paving the way. I think none of us were as tense as in those first two years, when we were really wary of what a pharma company might want from us...
... so instead of grappling over the impact of social media itself, we were able to focus on much bigger issues in patients' lives: like where is the technology going at what pace, and how can we help patients everywhere deal better with the psychological and social struggles brought on by diabetes?
Not that we solved all the world's D-problems in one day, but it definitely felt like Medtronic, the biggest pump company and a leader in the Artificial Pancreas effort, "got" what we were saying about what's hardest for patients. (And the fact that we all hate that floppy-shell-shaped sensor that's part of their Guardian CGM — uncomfortable!!)
A lot was discussed. Here are some highlights:
We also got a "sneak peek" look at their brand new iPhone app for pump customers called MyMedtronic Connect, in the usability testing phase now. It allows users to record their pump settings and order supply refills online, and also contains video tutorials and info on alerts and alarms, etc. It's initially available for iPhone, iPad, and iTouch and they say they're "looking at Android too."
Our group was less than enthusiastic, given that this app is a just a place for Medtronic customers to store settings and get product-specific info — yet it's not an actual logging program and does not connect with CareLink (?)
Behind the Scenes
At one point in the day, we were divided up into small subgroups for about 20 minutes of "one-on-one" time with Medtronic executives. This was an excellent chance to speak our minds on what we think is wrong with industry now, and where they ought to be going. And also to ask a lot of probing questions — although the FDA was always looming in the background, so lots of answers included the obligatory "that's all I can say at this point."
We also got to don hazmat suits for a tour of the "cleanroom" facility where Medtronic currently manufactures ALL of its CGM sensors for the entire world.
It seemed rather small to me for that... but when you view the amount of expensive, intricate machinery, the precious metals being meticulously processed, the scores of diligent workers threading tiny filaments into plastic molds by hand — it certainly gives you another perspective on the supplies that we generally take for granted! And on the costs thereof. This stuff ain't trivial. Each and every sensor goes through a 33-step manufacturing process, including being driven down to San Diego for a specialized sterilization process and then returned to the Northridge plant for further processing. Wow!
Finally, I wanted to share some interesting "trivia" I picked up throughout the day:
* Medtronic has rights to conduct "data mining" in its CareLink database — meaning they can access "anonymized" customer data to conduct studies. Seems creepy, but probably a very useful thing
* The company's launching a new eLearning system to train people before they start on the pump, etc.
* In their sensor-augmented pump therapy research (toward the closed loop), they learned:
- patients who are most successful use more smaller boluses more often, taking more corrections
- so best practices for pump use = more boluses/day
- four or more basal rates are sensible. About 4-5 is a reasonable number
* The reason the Paradigm Veo system with automatic shut-off is held up at FDA is because FDA considers it having "crossed the line into the artificial pancreas area — it's the first time a sensor is telling the pump what to do"
* One idea is for companies to push for a first step: closed loop at night only?
* The new Dexcom and Insulet combo product will be called the "Vibe" (unrelated to Medtronic, but I happened to hear it Friday)
Thank you, Medtronic. This was a useful gathering. We have our issues with all of the vendors of course, but I do believe that exchanges like this one help patients everywhere.