It is hard to care for young patients with diabetes, particularly after they go to school and are away from their parents’ watchful eyes. So the US approval of Medtronic’s MiniMed 770G – an automatic system for sensing blood sugar and delivering insulin – in type 1 patients aged between two and six, will be very welcome. The device, a form of artificial pancreas, is the first of its kind approved in this age group, but the approval was based on a study in just 46 patients and must be bolstered with a post-market study. This is certainly an advance for the world’s largest device maker, but the crucial approval on the horizon remains that of the MiniMed 780G. In the diabetes market Medtronic is under sustained assault from Abbott and Dexcom, who, in collaboration with each other and with smaller groups such as Insulet and Tandem Diabetes Care, are edging Medtronic out of this market with their highly effective blood glucose sensors. Approval of the 780G, possible next year, ought to enable a bit of a fightback, though its pivotal trial results were not quite a slam-dunk.