Podcast Summary: Diabetes Connections | Type 1 Diabetes

Episode Title: Tubeless, smarter & interoperable: A look into Medtronic’s future plans
Host: Stacey Simms
Guest: Lou Linterer, Chief Engineer for Automated Insulin Delivery Systems at Medtronic
Date: May 27, 2025

Episode Overview

This episode features a candid, technically rich conversation with Lou Linterer, an engineer instrumental in Medtronic’s artificial pancreas and insulin delivery systems. Stacey dives into the past, present, and future of diabetes tech, Medtronic’s approach to innovation, the challenges of designing for real people, and what’s coming next—including patch pumps, deeper AI integration, and device interoperability. The episode stands out for combining deep technical insight with a relatable, warm tone.

Key Discussion Points & Insights

1. The Early Days of Automated Insulin Delivery at Medtronic

• Lou describes joining Medtronic in 2011, as the company pivoted from “science project” prototypes to developing commercial artificial pancreas products.
• Early artificial pancreas research often relied on basic algorithms and small feasibility studies with clunky hardware (e.g. BlackBerry phones).
• Hiring engineers with expertise in feedback control systems was pivotal ("We were trying to take science project algorithms and actually turn them into a real product." [07:45]).

Memorable Quote:

"Human body, human physiology, not so much. There are no Newton laws for human physiology and diabetes...That was a real challenge."
— Lou Linterer (10:03)

2. Simplera Sync Sensor: Features and Engineering Advances

• Simplera Sync recently FDA-approved; functions with the Minimed 780G insulin pump.

• Compared to the previous Guardian 4 sensor, Simplera Sync is:

  • 50% smaller,
  • Fully disposable and pre-loaded for one-click insertion,
  • Integrated adhesive (no extra taping),
  • Calibration-free (no finger sticks required).

• Engineering behind calibration-free sensors:

  • Achieved through improved sensor chemistry manufacturing and advanced signal processing.
  • Technological advances allow for consistency that negates the need for calibration.

Notable Moment:

"As our manufacturing processes improved...and as signal processing technology also improved, we could now come up with technologies that did not require calibration."
— Lou Linterer (15:01)

3. MiniMed 780G and Meal Detection Technology

• Meal detection gives “forgiveness” for forgotten or inaccurate meal boluses by detecting characteristic glucose rise patterns and delivering additional insulin automatically.

• The system's hybrid closed loop still requires manual meal bolusing, but meal detection serves as a safety net for missed doses.

• Real-world Outcomes:

  • Clinical studies show “a very significant improvement in outcomes” for missed meal bolus scenarios ([21:08])
  • Time in range up close to 80% in real-world use (an increase of ~10% from early hybrid systems—significant since 1% = 15 mins daily).

Key Quote:

“We wanted to design a technology that could help offer what we sometimes describe as forgiveness for those situations.”
— Lou Linterer (19:29)

4. Designing for Real-World Use (and Misuse)

• A major focus is on “risk management,” not just from part or software failures but also foreseeable user misuse (e.g., missed or delayed boluses).
• The algorithm includes a “safe meal bolus feature” to avoid excessive stacked insulin if a missed bolus is remembered late ([25:15]).
• Lou admires the creativity and “inventiveness” of the diabetes community in finding workarounds and “hacking” their systems:

Highlight:

"...the sophistication of people who have diabetes...it's remarkable at how inventive and creative they can be..."
— Lou Linterer (43:15)

5. Future Devices: Patch Pumps, Screenless Pumps, and User Choice

• Medtronic is “committed” to both a tubeless patch pump and a new traditional tubed pump.
• Both new pumps: Screenless, controlled via smartphone or dedicated controller, with consistent user experience.
• Emphasis on maximizing user choice (tube/tubeless) without sacrifice to quality of therapy—same algorithms and therapy features across platforms ([26:27]).
• Aspirational work towards a system requiring “zero user interaction”—no meal bolus announcement, with outcomes still meeting ADA guidelines.

Forward-Looking Quote:

“If I didn’t think it was possible, I would not be working at Medtronic. That’s what we’re going for…what I would consider a true artificial pancreas.”
— Lou Linterer (31:28)

6. Interoperability and Industry Partnerships

• Medtronic is moving toward system interoperability.
• Recently submitted to the FDA to “open the door” for interoperability.
• Announced a partnership with Abbott for an Abbott-based CGM to be integrated with Medtronic systems.
• Lou underscores Medtronic’s desire to own the system “end-to-end” to simplify customer support and optimize sensor-algorithm coordination ([33:55]).

7. AI in Diabetes Tech

• AI is promising but still challenging for core automated therapy control.
  • Concerns: Black box decision-making, risk of “hallucinations,” and regulatory traceability.
  • Lou sees near-term use in “supervised settings,” e.g., data analytics and provider recommendations, rather than direct therapy automation.

Candid Take:

"We have to be very careful... If it’s making decisions about your therapy...that’s a completely different world."
— Lou Linterer (39:18)

8. Listener Q&A Rapid-Fire

• Remote bolusing?: Coming back; both upcoming pumps (patch and tubed) will support this via smartphone app ([32:23]).
• Android support for Guardian Connect?: New systems (Simplera) will support both iOS and Android ([32:56]).
• Would Medtronic use off-the-shelf sensors?: They’re integrating Abbott technology into their ecosystem but want optimization/control by Medtronic for best user experience and troubleshooting ([34:49]).
• Timeline for full no-interaction system?: Not imminent, but it's an active engineering goal.
• What excites Lou most?: The privilege of seeing and building technologies “five years ahead”—and seeing how much is coming to further relieve the burden on people with diabetes ([44:11]).

Notable Quotes & Memorable Moments

• On technology translating to patient life:

  “You can never lose sight of who's on the other end of that technology. There’s a human being on the other end.”
  — Lou Linterer (15:51)

• On risk & misuse:

  “We have to account for behavioral variation, like how could somebody foreseeably misuse this system?”
  — Lou Linterer (24:05)

• On customer experience:

  “If something goes wrong with the system, you call us and we'll take care of it.”
  — Lou Linterer (35:12)

• Fun moment:

  “People with type 1 especially, they are hacking their bodies on a daily basis...So I love that answer.”
  — Stacey Simms (43:47)

• Final thoughts:

  “I live in, like, a five-year time warp. I am seeing technologies today that the people with diabetes won’t see for five years. It is so exciting...”
  — Lou Linterer (44:16)

Timestamps for Key Segments

| Time | Topic | |----------|----------------------------------------------------------------------------------------| | 04:26 | Lou’s background and entry into Medtronic | | 07:45 | Turning “science project” algorithms into real products | | 11:48 | The new Simplera Sync sensor explained | | 13:57 | How sensors became calibration-free—engineering advances | | 18:02 | MiniMed 780G meal detection: How it works | | 21:08 | Clinical data on meal detection and time in range | | 25:15 | Accounting for “misuse”—safe meal bolus feature | | 26:27 | Plans for patch pump and screenless pumps—maximizing user choice | | 29:03 | Medtronic’s vision for a no-announcement closed-loop (zero user interaction) | | 31:21 | Is “slap it on and go” therapy possible? | | 32:23 | Remote bolusing and future app control | | 33:55 | Interoperability and Abbott partnership | | 37:34 | How AI could (and couldn’t yet) fit in diabetes therapy | | 43:15 | End-user creativity, workaround stories, and challenges for engineers | | 44:11 | Lou’s passion—what keeps him excited in his work |

Episode Tone

Friendly, thoughtful, and empowering—a mix of technical deep-dive with personal, empathetic perspective. Both host and guest keep patients’ lived experiences central while not shying away from engineering realities or regulatory hurdles.

Who Should Listen?

• Adults and parents of kids with type 1 diabetes
• Diabetes tech enthusiasts
• Anyone curious about the future of automated insulin delivery
• Providers seeking insight into next-generation diabetes care

Takeaway

Medtronic is racing toward a future of more personalized, flexible, and less burdensome diabetes technology—patch pumps, algorithm-driven automation, real device interoperability, and even AI-supported care. While technical and regulatory hurdles remain, the overarching ethos is clear: putting people with diabetes at the center, maximizing choice, convenience, and outcomes.