News from the Medtronic Q3 2019 conference call

Medtronic’s Fiscal 3rd quarter 2019 ended Jan 25, 2019. Here’s the news from the conference call, as I see it.

The conference call transcript is available at

They expect to launch the 780G advanced hybrid closed loop with bluetooth in fiscal year 2020, which for them means May 2019 - April 2020. They expect to improve time in range to over 80%. They will be “automating insulin delivery following a snack or meal” (more on that later) and will have remote monitoring and “remote software downloads” which suggests to me user-upgrade of pump firmware although they didn’t state this clearly.

Within a few months they expect to apply to the FDA for dosing from their CGM without confirmatory fingerstick (the so-called non-adjunctive indication). They didn’t stop to remind us that this is a requirement for Medicare to cover their CGM.

" I hope you saw our announcement this morning that the FDA has granted breakthrough device designation through our personalized closed-loop system." The buzz-phrases are “real-time personalized algorithms,” “continuously adapts to the user,” “insights and predictive diagnostics,” and “unique to the individual.” And to contrast with current hybrid closed loop, they say “…today’s algorithms… behave the exact same way for every single patient even though every single patient is different.” They plan to talk more about it at ADA 2020. (Which is mid-June 2020.)

To me, these are alluding to the capabilities they’re getting from their purchase of the Nutrino Health company. Nutrino has a predictive glycemic response algorithm that considers food, insulin, physical activity, water intake, stress, sleep, and probably more. The Nutrino app can pull data from MiniMed Connect, Apple HealthKit, Runkeeper, Moves, Jawbone, Withings and Fitbit, among others. They count carbs from images as well as text input. For restaurant eating they use menus and nutrition data from 200,000 US restaurants, and can make meal suggestions based on past meal choices, location, food preferences, dietary restrictions, and allergies. They have a barcode scanner feature to look up packaged food in the grocery. They aspire to give advice and guidance in dietary choices for T1 and T2. More at

To me it looks like Medtronic’s strategy is to reduce the burden both by improving the operation of the pump, but also by operating the human via real-time advice, for T1 and T2.

If they can pull it off, I can see how this could become a big help for those who really would rather not figure out carb counting and dosing and all that, but just have an AI advisor tell them what to do. Of course my fear is that they end up creating an intolerable nanny. “Are you really sure you should be eating that? Wouldn’t you rather have a nice crunchy carrot? You’ve been sitting too long. Get up and go take a walk!”

Although I’m skeptical by nature, I can see that this reflects a significantly broader view than just combining a CGM with a pump and developing a really good automated dosing algorithm. There is real potential for Medtronic here, although the difficulty-level is huge.


Thanks for the write-up @bkh, It sounds like MDT believes that they have the technology to get most insulin using diabetics with a high A1c down to a reasonable A1c. The more interesting question will be if they can stop being so risk averse and allow their algorithms to really shine and get people down to an A1c of 5 that desire it. I have no doubt that the algorithm engineers can pull it off, the question remains if their risk averse lawyers will allow it.


@bkh, great write-up, thanks so much.

Like @Chris, I am wondering if their next attempt will have the same problems as the 670G.

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Suffice to say I am extremely skeptical on the timeframes.