Sean Saint

There's various cells in the pancreas that in effect are killed off.

It's an autoimmune disease, and you need to replace that insulin.

You need to do it on a daily basis or you're going to be in big trouble.

So historically, patients have had to take insulin multiple times a day, either through what we call multiple daily injections, shots, or through an insulin pump.

Now, of course, we've been doing shots since 1921, I think insulin was first formulated.

Pumps, of course, are more recent.

They came about in the 80s.

And the reason for pumps at that time is that insulin itself was really not great.

It took a long time to act.

It was not flat in the way it acted on your blood sugar.

And what we realized is that if you give a little bit of these comparatively poor insulins every five minutes, it flattens out their response and makes them nice and predictable.

And that was the original benefit of an insulin pump, again in the 80s.

You get into the 2000s and we've got better insulins that are really flat by their very nature.

And interestingly, during the 2000s, we struggled as an industry to see if there was a clinical benefit of insulin pumping fundamentally.

The trials at that time were not really showing that.

you could do just as well with multiple daily injections as you could with an insulin pump.

What was beginning to be a benefit at that time was CGM, continuous glucose monitoring, that really became a patient-centric tool in 2006 with Dexcom.

And that was the first time that a patient could really react to their blood sugar in quite a bit more rapid way.

Rather than three to five to 10 blood sugar measurements a day, you get one every five minutes for 288 points per day.

What that led to, though, was the combination of continuous glucose monitoring and insulin pumps, which allowed us to put algorithms on top of that to close the loop and respond to your blood sugar in real time.