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[IP] UK recommends pump therapy for some with type 1

ate=20030226&ID=2346199">MSN Money - News: Investing</A>
UK National Institute for Clinical Excellence Recommends Insulin Pump Therapy
for Some Type 1 Diabetes Patients
February 26, 2003 09:02:00 AM ET

NORTHRIDGE, Calif.--(BUSINESS WIRE)--Feb. 26, 2003-- Insulin Pump Use
Expected to Increase - Device Can Enable Tighter Blood Sugar Control to
Improve Health and Extend Life for Many Diabetes Patients

The UK National Institute for Clinical Excellence (NICE) has issued guidance
to the National Health Service (NHS) on the use of insulin pump therapy,
recommending for the first time that insulin pumps be made available to some
Type 1 diabetes patients in England and Wales. The new guidance states that
insulin pump therapy "may enable people with diabetes to have greater control
over their condition."

For many people with diabetes, an insulin pump enables greater control over
blood sugar (glucose) levels than any other insulin delivery method. This
greater control is vital, as maintaining near-normal glucose levels can
prolong life, and significantly reduce the risk of blindness, kidney failure,
amputation, impotence and cardiovascular disease.

NICE recommends insulin pumps as an option for Type 1 patients who, despite
multiple daily injection therapy, have not been able to maintain recommended
hemoglobin A1c (HbA1c) levels of 7.5 percent or less without experiencing
repeated and unpredictable episodes of hypoglycemia that require assistance
from another person. Such episodes frequently result in anxiety about
recurrence and have a significant adverse effect on quality of life. The
guidance applies to Type 1 patients who meet these criteria, including
children, adolescents and women during pregnancy.

"Funding insulin pumps for people with Type 1 diabetes who meet the selection
criteria is a significant step forward," said John Davis, founder of INPUT,
an independent agency supporting pump therapy. "INPUT believes this guidance
could benefit many more people with diabetes. We hope, in time, NICE will
give all people with insulin-dependent diabetes an opportunity to use an
insulin pump."

In its guidance, NICE noted that patient representative groups and diabetes
management experts reported that many people have "had their lives
transformed by (insulin pump) therapy." The NICE report states that patients
who transferred from multiple daily injections to pump therapy "saw a
significant improvement in blood glucose levels, experienced less anxiety
about hypoglycemic episodes and found a great improvement in their quality of
life because of the increased flexibility of their lifestyle."

"Insulin pump therapy has the potential to substantially improve quality of
life for Type 1 patients, as well as the course and outcome of their
diabetes," said Dr. William V. Tamborlane, MD, Yale University School of
Medicine. "People with diabetes who have used pump therapy are able to
achieve better blood sugar control, which can improve their health, and lead
a more flexible life than with other insulin delivery methods."

With the new guidelines, NICE estimates that England and Wales could
potentially realize a fivefold increase in pump use among Type 1 patients.
Even with this increase, England and Wales will lag considerably behind many
other European countries, which, in turn, lag behind the United States. To
demonstrate, nearly one in five American patients with Type 1 diabetes uses
insulin pumps, which are covered by private insurance and government
programs, such as Medicare and Medicaid. Yet even this figure may not
represent all of the patients who could potentially use an insulin pump. For
example, according to a survey published in Diabetes Educator, healthcare
professionals with diabetes adopted pump therapy at a rate nearly 10 times
greater than the general Type 1 population.

Data Supports Insulin Pump Use

The landmark 10-year Diabetes Control and Complications Trial demonstrated
that maintaining near-normal glucose levels can reduce the risk of
diabetes-related eye disease by up to 76 percent, nerve disease by up to 60
percent and kidney complications by up to 56 percent. In addition,
maintaining tight glucose control, which is optimal with an insulin pump for
many diabetes patients, can prolong life an average of five additional years.
Pump therapy reduced the incidence of severe hypoglycemia by approximately 85
percent, and mild to moderate hypoglycemia by 60 percent in separate studies.
Hypoglycemia, which is common among diabetes patients, can lead to increased
doctor visits and hospital admissions; in severe and recurrent cases, brain
damage and blindness can occur.

Pump therapy has been shown to decrease health risks associated with diabetes
management. In the two-year study Improved Clinical Outcomes with Intensive
Insulin Pump Therapy in Type 1 Diabetes, Type 1 diabetes patients using pump
therapy experienced 33 percent fewer emergency visits, 35 percent fewer
episodes of severe hypoglycemia, and 19 percent fewer hospital admissions,
compared with those using multiple daily injections.

Details About Insulin Pumps and Diabetes

An insulin pump is a small, battery-operated device (about the size of a
pager) that can replace injections for patients managing diabetes. The pump
infuses faster-acting insulin from a reservoir inside the pump to the body
through a thin plastic tube (called an infusion set). The pump's insulin
delivery rates more closely mimic insulin delivery of a healthy pancreas than
multiple daily injection therapy, automatically delivering a constant rate of
insulin in tiny pulses -- called a "basal rate"-- to help keep blood glucose
in the desired range between meals and overnight. Users can easily program
additional insulin delivery during mealtimes to manage increased blood sugar

In people with diabetes, the body is prevented from properly using energy
from food. Type 1 diabetes occurs when the pancreas is unable to produce
insulin. To survive, a person must administer insulin using injections or an
insulin pump. Type 2 diabetes results from the body's inability to make
enough, or properly use, insulin. Insulin is a hormone that is needed to move
glucose from the bloodstream into the body's cells, where it is then
converted into energy. The HbA1c level is currently the standard used to
assess patients' blood sugar control and risks of diabetes-related
complications. HbA1c is the average amount of sugar in a person's blood,
typically over a two- to three-month period. The American Diabetes
Association recommends that diabetes patients maintain an HbA1c of less than
7.0 percent in order to reduce the complications associated with the disease.

Medtronic MiniMed (www.minimed.com) designs, develops, manufactures and
markets advanced infusion systems with a primary emphasis on the intensive
management of diabetes. The company's products include external pumps and
related disposables, and a continuous glucose monitoring system. Medtronic,
Inc. (www.medtronic.com), headquartered in Minneapolis, is the world's
leading medical technology company, providing lifelong solutions for people
with chronic disease. Information regarding the NICE guidelines may be
accessed at http://www.nice.org.uk. In addition, United Kingdom pump therapy
information may be accessed at http://www.minimed.co.uk. Facts and figures
may be accessed at http://www.diabetes.org.uk/infocentre/fact/fact2.htm.

Any statements made about the company's anticipated financial results and
regulatory approvals are forward-looking statements subject to risks and u
ncertainties such as those described in Medtronic's Annual Report on Form
10-K for the year ended April 26, 2002. Actual results may differ materially
from anticipated results.

Contact Information:
Medtronic, Inc.
Deanne McLaughlin, 818/576-4325
Kevin Lee, 763/505-2695

) 2003 BusinessWire
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