When Dr. Fran Kaufman became Chief Medical Officer for Medtronic Diabetes back in 2009, she predicted that by the time she'd retire, we would finally have a closed loop system on the market. Nearly a decade later, that day has come, and she was right! As Dr. Kaufman prepares to step down, Medtronic has the first and only early artificial pancreas system available.

In early December, the respected California endocrinologist announced that she will retire from Medtronic at the end of 2018. She is known for her leading work as a clinician and researcher, for making a global impact on diabetes care in developing countries, and for the past decade of work in the diabetes device industry that has culminated in the Miimed 670G Hybrid Closed Loop system.

The timing of this announcement was based on both personal and professional reasons, she told us, when we had a chance to talk with her by phone recently to learn the details of her departure and review her storied career.

While Kaufman is leaving her industry role, she doesn't plan to disappear. Nope, she will continue seeing patients at her Los Angeles clinic and also expects to remain a visible part of the Diabetes Community -- from possible consulting roles, to conference speaking and teaching, along with worldwide travels to places like Haiti where basic diabetes care and access remain at crisis levels.

"Right now, I want to relish the time I’ve had at Medtronic and the many accomplishments, and take some time for family and friends and philanthropy," she says. "The clock goes so fast. The last part of the journey is the most personal, in deciding how you want to do that. I’m so fortunate to be able to make my own definitions, to change and morph as I need to going forward. I am grateful for all the opportunities I’ve had and all that I will going forward."

 

A Distinguished Career and Medtronic Diabetes Wins

Before joining Medtronic Diabetes in 2009 as CMO and VP of global medical affairs, Kaufman was already a distinguished leader in the world of diabetes. She is a former president of the American Diabetes Association who was consistently named one of the Best Doctors in America, with a resume that could knock your socks off.

She worked for more than 40 years as a pediatric endo in Los Angeles before joining industry, and also served as director of the Comprehensive Childhood Diabetes Center, and head of the Center for Endocrinology, Diabetes and Metabolism at Children's Hospital Los Angeles (where she continued practicing part-time during her time with Medtronic). Now with her industry retirement, she hopes to increase her time at the clinic seeing patients and also help guide younger generations in the medical field.

When asked directly why this was the time to step away from Medtronic, Kaufman immediately mentions the personal reasons -- wanting to spend more time with family and close friends. But from a professional standpoint, Kaufman says "the time has arrived" where it makes the most sense for her to move on from Medtronic. 

The 670G is out on the market, she notes, and that was a key milestone for her own career as well as Medtronic Diabetes. She reflects on the comments she made back in 2009 in a guest post she penned for DiabetesMine, saying then if and when a commercial closed loop system was achieved, “I think I will retire a happy woman.”

Laughing about that now, she says: “We have reached that point and I am a happy woman!”

Of course, over the past decade, the changes in the US FDA regulatory pathway and diabetes device industry have constituted a dramatic paradigm shift for our D-Community. The agency has become much more efficient at supporting innovation, and is now considered a friend to our community -- rather than a hurdle adding delays and slowing down progress for people with diabetes. Notably, in the push to get a so-called "Artificial Pancreas" to market, Medtronic worked with the FDA for more than two years on the 670G Hybrid Closed Loop before even submitting it for approval. Then the agency moved more quickly than anyone would have imagined possible, surprising the entire industry and even creating supply and manufacturing challenges for Medtronic due to the rapid product approval and demand.

Kaufman gives credit beyond herself and Medtronic -- noting that JDRF, patient groups and other medtech companies all played a part in helping push FDA to reform and eventually get a commercial closed loop device to market for the first time in 2017. While that didn't happen quite as quickly or smoothly as promised, the 670G is now fully launched in the US.

“There were lessons learned and I have been honored to see that occur,” she says. “The next version is pretty much done and through feasibility (studies), getting ready for the pivotal trial. And the teams I’ve lead are incredible, doing what needs to be done without me. So that is part of the timing, and this is time at age 68... It’s not an infinite amount of time I have left, so I want to make the most of the next stage.”

 

DOC and Advocacy Changes

In her years with Medtronic alone, Kaufman has seen -- and often been a key part of -- not only pivotal changes in the regulatory world but also a remarkable evolution in patient advocacy and the Diabetes Online Community. In turn, this patient-led movement has had a huge impact on how the diabetes industry and regulators have evolved over the past several years, now increasingly addressing unmet needs and what PWDs (people with diabetes) really want in their diabetes tech and tools.

“That helps push us forward and farther, from the industry perspective. As a healthcare provider starting my career 40 years ago, it was daunting to realize how much the decision was left to the healthcare provider, when it should be up to the patient what they want. Now, it’s about shared decision-making and I am way back in the passenger seat listening and trying to help guide as needed," she says.

We've attended DOC forums hosted by Medtronic Diabetes at their Northridge HQ over the years, and Kaufman has always been on the scene sharing her role and details on the latest D-tools under development. We've certainly appreciated the chance to have that dialogue, and share our own frustrations at times when it comes to specific products, corporate business practices, or just overall issues that impact our lives with diabetes.

 

Global Diabetes Impact

In addition to all of this, Kaufman has been hugely influential in how diabetes care is managed outside the USA in developing countries. She has traveled the globe observing and working to implement change -- to India, where girls aren't even considered worth saving so they end up dying once diagnosed with diabetes; to South Africa where orphanages are the only places care is available, that's where kids diagnosed with T1D are sent; and to Haiti, where there's an astonishing 85% mortality rate in the first year of a type 1 diagnosis!

She has been vocal about her time in Haiti after the 2010 earthquake, working with Academy Award-winning actor Sean Penn, who bought a nine hole golf course in Port-au-Prince and turned it into a camp to house roughly 50,000 homeless people in makeshift tents and shanty structures that she described as made out of plywood and looking "like floorless doghouses."

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Photo courtesy of Medtronic Diabetes Loop blog

"It's like stepping through a glass mirror," Kaufman says about the developing world, compared to the US and other developed countries.

Over the years, we've heard Kaufman describe her experiences going from clinic to clinic, working to develop standards of care for people living with diabetes in these developing parts of the world.

In her first year in Haiti for example, they didn't have any glucose meters in the hospitals at all. Only urine strips were available, even for patients in comas. Eventually, some meters were provided, but fingerstick test strips remained too tough to get, so there's limited use and access. The same goes for basic medical equipment -- she says you can open up a closet and all kinds of equipment falls out, unused because they're missing batteries, or other supplies have run out. She taught an ad hoc "medical school" program in Haiti, where the students basically know little to nothing about diabetes and they have no textbooks or other materials; they see only what is shown on slides and taught by the instructors like Dr. Kaufman.

This same lack of education and care exists in Indonesia, and across Africa and Asia, she says. Her goal is to help teach the caregivers basic skills and techniques.

Now thanks to retiring, Kaufman says she hopes to have more time for philanthropic work across the globe, for projects like starting camps in places like Ecuador where kids can get their first diabetes education.

"I've been lucky enough to be able to do it," she says. "The most transformative and life-affirming experience for me -- where I have made the most impact -- is this global work. Where you get out of your box, and don't know what you're walking into or how you can really help. It's all truly amazing."

Working with the International Diabetes Federation's Life for a Child program has been a huge part of these efforts for Kaufman, helping to get insulin and diabetes supplies to children in need, along with key education and support resources where they just don't exist. She expects to expand on that work going forward as well, especially as it involves building more standards of care and education in the developing world.

 

Next Chapter of Career and Life

On the personal front, Kaufman is also eager to do more writing, that she somehow managed to fit in with her clinical and industry work. In 2015, she penned her first novel Rhythms, a 300-page story about a physician navigating the final days of her aging mother's life and reflecting on her younger years. The story takes place over the course of three days, jumping back and forth through time as it exposes the protagonist's life.

During our call, Kaufman shared that she's just enrolled in a creative writing course and is planning to publish a short story at some point soon. She also may reinvigorate her "grandma blog" that she started years back but hasn't updated anytime recently.

She also remains involved with Extend Nutrition, the provider of low-glycemic nutrition snack bars, shakes and products that she launched many years back and we've reviewed (and given away!) many times here at the 'Mine. That company recently invested in a run of commercials on TV and there's talk of developing more products, so Kaufman says that will certainly be something she can turn her attention more toward now that she's leaving the corporate world.

Of course, as mentioned, Kaufman emphasized that she's most looking forward to spending more time with family and friends.

"I'm so happy, and don't have any regrets from the past 10 years in making the leap to industry," Kaufman tells us. "I've so much appreciated Medtronic giving me time to do things that I love along with that, and now maybe just in my older age I am greedy and want even more time for that. I can also look around and explore, see if there are any other innovative things I can get involved with to challenge myself. No doubt, I will be busy but with a wider palate."

On a personal note, we wish Dr. Kaufman all the best in this next chapter of her career and life, and send our appreciation for all she's done to make a difference for people with diabetes. We'll look forward to seeing you around as we move forward, Fran!