# 780 Users



## SB2015

There have been quite a few posting that they are about to start or have recently started using the 780, so I thought it might be useful to gather our experiences together in one thread, so that we can support each other.

Fire away with any questions about the system and finding workarounds for anything. 
There seem to be a few more of us now using the system in closed loop (Smartguard - which confusingly is what they called their previous system which was not closed loop with the 640)

I am aware of @Fio62 @matthewthomas @Annette Arundell @JohnWhi and @Phil65 using the 780.
I know some others have been offered a choice and may not have made the decision yet.


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## SB2015

I found the switch to the 780 difficult as I was moving from another manufacturer so not familiar with Medtronic’s terminology. I previously used a Combo along with a Libre.  In spite of the sensors I found that I still had loads of hypos On my old pump as I did not have the auto corrections and switch off with my Combo.  I was then offered the 780 and the option of self funding the sensors to use it as closed loop.  This has reduced my hypos to about one per week (apart from when I had to adapt to this extreme heat) , and I think about my diabetes a lot less.  I am now very used to it, and would not want to be without a closed loop system. 

The others I did my training with  (via Zoom with someone from Medtronic alongside the DSN who was also learning with us), were already used to the 640 and found the switch a lot easier.  The trainer tailored the training to suit us and I ended up 1 to 1 after the first session.  She could not have been more helpful. The Pump support team are excellent and we’re very patient helping as I struggled with the switch.  There is access to online support but I still tend to phone. 

The ordering system for consumables seems to vary, but I have generally had very few problems once things were set up.  You will read of others that have had some issues with this.  If I want to change my regular orders I have to get my DSN to email them, but that is reasonable since it is them that is paying for those.  having read on here the issues that others have had I make sure that I plan ahead and don’t leave things to the last minute.  I have got caught out when away on holiday and they have always helped and had stuff delivered to where I was staying.

I self fund my sensors and set up an account with them which gave me access to these at a reduced price.  I have recently been told by my consultant that I should get funding by the end of the year.

I recently switched from Guardian 3 to Guardian 4 sensors.  I am amazed at their claim that you only need one finger prick at the start and that is it.  But it is true.  One for callibration at the start of a sensor and that is it.

I would always want to be using closed loop now.  You will read of irritations using the 780 and also ones from those using the t-slim.  No pump is perfect but we each find workarounds that work for us.  If you have any questions happy to help.  There are now a few of us on here using the 780, or about to start.

Any questions and ideas, just add them on.


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## mindii

@SB2015, I started using the 780g last November. I self funded the actual pump part of the system but couldn’t afford to do the sensors too so lived with the libre 2 for the past wee while… tomorrow I go “live” with the guardian 4 sensors though!


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## SB2015

I hope all goes well today @mindii 
Let us know how it goes.


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## mindii

SB2015 said:


> I hope all goes well today @mindii
> Let us know how it goes.


Will do! A wee bit excited and equally terrified at giving “control” to this wee box of genius! Feel Percival’s getting a massive promotion today


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## SB2015

I hope Percival behaves well. Mine is Hermione (a more friendly name for the replacement for Humphrey - He got quite a lot of abuse in the first few weeks)


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## mindii

I’m loving that people have named their pumps!  Percival is behaving beautifully so far! And I can’t believe that already I’m in range 90% of the time (it has only been 24 hrs but I’m counting the win and looking for it to continue! ) x


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## PhoebeC

mindii said:


> I’m loving that people have named their pumps!  Percival is behaving beautifully so far! And I can’t believe that already I’m in range 90% of the time (it has only been 24 hrs but I’m counting the win and looking for it to continue! ) x


Yes I didn’t know people named them and I am so here for it!


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## mindii

PhoebeC said:


> Yes I didn’t know people named them and I am so here for it!


Do you have pet names for your pens?


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## SB2015

mindii said:


> I’m loving that people have named their pumps!  Percival is behaving beautifully so far! And I can’t believe that already I’m in range 90% of the time (it has only been 24 hrs but I’m counting the win and looking for it to continue! ) x


I hope that things continue to work well.  I know that I now enjoy regular nights of sleep with no checking in the night.


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## PhoebeC

mindii said:


> Do you have pet names for your pens?


Not at all. Does anyone?


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## PhoebeC

SB2015 said:


> I hope that things continue to work well.  I know that I now enjoy regular nights of sleep with no checking in the night.


It’s the low alarms I would like to get rid of


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## SB2015

For me those are now a rarity overnight as the pump makes adjustments throughout and catches any drops, and also sorts out any miscalculations if carbs within four hours from the end of my meal.
During the day I still get the odd hypo where the change is too quick for the pump to sort it, eg during intense or prolonged exercise. 
I think lots and lots of sleep is one of the biggest bonuses of looping.


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## PhoebeC

SB2015 said:


> For me those are now a rarity overnight as the pump makes adjustments throughout and catches any drops, and also sorts out any miscalculations if carbs within four hours from the end of my meal.
> During the day I still get the odd hypo where the change is too quick for the pump to sort it, eg during intense or prolonged exercise.
> I think lots and lots of sleep is one of the biggest bonuses of looping.


That’s all I want in my life, I can manage the days but I need level nights to help me stay healthy and sane. Some weeks I don’t get a night of full sleep


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## SB2015

I had a couple of times in the last couple of days when my pump went into the three dots in the shield.  
My initial reaction was that my new sensor was faulty but ….

I have remembered stuff that I read at the start again and looked at the list of reasons why this could happen, apart from a faulty sensor and the circumstances were all around rapidly rising glucose levels

I put my new sensor in quite a while before breakfast as we had visitors staying.  Breakfast was two hours later and soon after that the warm up ended So it wanted my BG.  I had not been able to pre bolus as I had no idea when the visitors would be up for breakfast so I was spiking.  The pump kept telling me it was updating
Solution
I now know that I should have snoozed the BG request for 45 min and also in those circumstances had a smaller carb breakfast to reduce the rapid rise


We were at a funeral and timings etc were all awry, so again no pre bolus time.  Too many nibbles from the buffet and a bounce after a hypo from walking to the wake.  Rapidly changing BG and the dots appeared again and an updating message again As well as high glucose warning
Solution
I think in such circumstances I would possibly go back to manual mode and do an extended bolus as I would have done before.  (Or be more sensible with food, but it is difficult to focus on that in those occasions)
Smartguard is great but Inhad completely forgotten that it will get a bit stroppy if my BG and SG are rapidly becoming mismatched.


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## trophywench

(Totally Off Topic here, I know, but it just occurred to me.  I named my very first Combo, El Pumpo.  Now I'm 2 years into my second Combo it plain that El Pumpo hasn't moved forwards whatever, still thinks he's in 1970, expects me to have a scrunch dried perm, be size 12 and active.  Were he a person, he'd have a comb-over.  I would have had a 780, but was only allowed to choose the 640 at the time so discounted that)  Time the ruddy clinic and the CCG moved on as well as their ruddy pump choices ....


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## SB2015

I hope you get the option of the 780 next time @trophywench 

@mindii how are you getting on?


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## mindii

Hey SB2015, I’m doing well thanks.  Had the odd disaster with bleeding when placing sensors but other than that I love the whole system! How are you? X


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## SB2015

mindii said:


> Hey SB2015, I’m doing well thanks.  Had the odd disaster with bleeding when placing sensors but other than that I love the whole system! How are you? X


Good to hear that it is going well Mindii.  Cannulas and sensors went wrong at times when I was on my old pump, but with this system suddenly the pump expects me to start doing more stuff again!! How unreasonable.  The hiccoughs I have had are good reminders of how different the new system is.


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## Radders

I have been AWOL a long time as I became somewhat obsessive and decided to stop checking in as part of relegating diabetes to where it belongs in my list of “interests”!

However my third pump (accu chek Combi #2 after a 6 year stint with a Spirit) has now reached the end of its warranty and I have been offered the choice of a Medtronic 780G, Omnipod Dash or Tandem T-Slim. In an ideal world I’d like another Combi but that’s not a possibility.

The Medtronic is top of my preferences, mainly because of deal-breaking features of the other two (rechargeable batteries, lack of buttons, inability to adjust pump position). 

I moved from MDI having done DAFNE to a Spirit first which had no remote control, no bolus wizard etc so I got very accustomed to doing all the sums in my head. Apart from very rare occasions on cruises where wardrobe requirements meant I had to, I don’t use the meter as a handset to control the pump,  and just press the buttons on my pump to dose insulin. I don’t feel I need the closed loop system, especially since having the alarm on my Libre. 

Am I right in thinking that this is possible with the 780 please? I don’t want to tell my pump my full life story every time I eat. Can I just use it as a standalone insulin delivery device?


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## SB2015

I switched from a combo to 780G.  There are many similarities, and you can use it as a stand alone pump,in much the same way as the Combo.  The major difference is that you need to access the pump at meal times, and enter the carbs in the pump, and confirm the bolus, rather than doing this via a handset.

iuse. Ine in closed loop with the Medtronic Sensors G4.  I don’t tell the pump my life story, I just tell it my carbs at a meal, as you would in manual mode.  The rest of the time I let the pump make adjustments to my basal every 5 minutes which works brilliantly.  I think a lot less about diabetes and let it get on with it.  It does a lot more than the alarms on the Libre as instead of me heading off highs and ,wow it does it for me.  It lifted my TIR from in the 70s to in the 80s and often in the 90s with so much less effort.  I do however have to self fund the sensors and transmitter to use the closed loop.  I would not want to have a pump without closed loop now.

Any questions just keep asking.


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## Radders

SB2015 said:


> I switched from a combo to 780G.  There are many similarities, and you can use it as a stand alone pump,in much the same way as the Combo.  The major difference is that you need to access the pump at meal times, and enter the carbs in the pump, and confirm the bolus, rather than doing this via a handset.
> 
> iuse. Ine in closed loop with the Medtronic Sensors G4.  I don’t tell the pump my life story, I just tell it my carbs at a meal, as you would in manual mode.  The rest of the time I let the pump make adjustments to my basal every 5 minutes which works brilliantly.  I think a lot less about diabetes and let it get on with it.  It does a lot more than the alarms on the Libre as instead of me heading off highs and ,wow it does it for me.  It lifted my TIR from in the 70s to in the 80s and often in the 90s with so much less effort.  I do however have to self fund the sensors and transmitter to use the closed loop.  I would not want to have a pump without closed loop now.
> 
> Any questions just keep asking.


Thank you! I don’t actually use the handset and bolus wizard with the Combi: my rather tongue in cheek remark about not wanting to tell it my life story was mainly about not wanting to plug in carbs at all. I do the suns in my head so all I want is to tell it how much insulin to give me. Will I still be able to do that on the 780?


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## Pigeon

Radders said:


> Thank you! I don’t actually use the handset and bolus wizard with the Combi: my rather tongue in cheek remark about not wanting to tell it my life story was mainly about not wanting to plug in carbs at all. I do the suns in my head so all I want is to tell it how much insulin to give me. Will I still be able to do that on the 780?


Yes, you can do a manual bolus entry


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## SB2015

Pigeon said:


> Yes, you can do a manual bolus entry


I don’t t think that you can do a bolus without entering the carbs when in closed loop on the 780, as the pump needs to know how much of the active insulin is attached to carbs, and what is a correction.  This information is used as part of the algorithm where it is making adjustments to the basal insulin every five minutes.


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## Radders

SB2015 said:


> I don’t t think that you can do a bolus without entering the carbs when in closed loop on the 780, as the pump needs to know how much of the active insulin is attached to carbs, and what is a correction.  This information is used as part of the algorithm where it is making adjustments to the basal insulin every five minutes.


Thank you, that’s useful to know, I am not intending (and don’t think I need) to get the sensors so that won’t be an issue for me but it does explain why some of the pump trainers were so dogmatic about the need to enter everything.


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## LoLiz

Hello! I am on the 780 plus G4 sensors and have been a for a few months. I'm totally NHS funded as I have no warning symptoms and drop like a stone. I've found it hasn't managed to sort out my morning rise in BS - I think it's because I have a fairly small TDD, and it won't correct too much as a percentage of that - but I need lots of insulin in the morning and hardly any in the afternoon. I have to have a no-carb breakfast and give myself an insulin bolus of 15g pr more for nothing! Apart from that it is great fun having a pump that does seem to keep me ok most of the time. Still have a few hypos though. Just got my results today and despite not being that good, it's at 49 which in old money is 6.6. However, I've had a crash with my egfr which is always at 90 - it has gone down to 71 which has shaken me. Have to be retested.


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## Tempyyyyy

I’m very excited! I went to the DSN 3 weeks ago and enquired about a pump (I have been a pen user for 25 years) and they set up another session to discuss further. Had that a week ago and they confirmed I could get the 780g! Woohoo.

To top it all off I was told 6-8 weeks for a pump start session and I’ve just got my letter for 23rd November. 

Loving reading all the info you are all posting. Can’t wait to get started.


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## SB2015

LoLiz said:


> Hello! I am on the 780 plus G4 sensors and have been a for a few months. I'm totally NHS funded as I have no warning symptoms and drop like a stone. I've found it hasn't managed to sort out my morning rise in BS - I think it's because I have a fairly small TDD, and it won't correct too much as a percentage of that - but I need lots of insulin in the morning and hardly any in the afternoon. I have to have a no-carb breakfast and give myself an insulin bolus of 15g pr more for nothing! Apart from that it is great fun having a pump that does seem to keep me ok most of the time. Still have a few hypos though. Just got my results today and despite not being that good, it's at 49 which in old money is 6.6. However, I've had a crash with my egfr which is always at 90 - it has gone down to 71 which has shaken me. Have to be retested.


Hi @LoLiz 
Great to hear that you have full funding for the sensors.  Are you using the system in closed loop (Smartguard which confusingly is what they also called the system with just alarms on the 640)?

I think that there are quite a few of us who get the Dawn Phenomonon with a rose as soon as we get up.  My system does not stop the rise, but if I pre bolus before I get out of bed and then eat within 30 min it minimises it.   Great that you are in the upper forties with HbA1c on this system.  I accepted a light increase in that for the sake of a large improvement in my TIR which is usually in the 90s or high 80s now.  I feel that gives a better picture of what is happening.

sorry to hear that eGfr has dropped but glad that you are getting a repeat test.  Let us know how you get on.


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## SB2015

Tempyyyyy said:


> I’m very excited! I went to the DSN 3 weeks ago and enquired about a pump (I have been a pen user for 25 years) and they set up another session to discuss further. Had that a week ago and they confirmed I could get the 780g! Woohoo.
> 
> To top it all off I was told 6-8 weeks for a pump start session and I’ve just got my letter for 23rd November.
> 
> Loving reading all the info you are all posting. Can’t wait to get started.


Great to hear that you now have the okay for the 780.  Will you be using it with the sensors?
let us know how you get on with your pump start session.  This will be a big change from pens but, after some initial work, should give you a lot more flexibility.  Let us know how you get on.


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## Tempyyyyy

SB2015 said:


> Great to hear that you now have the okay for the 780.  Will you be using it with the sensors?
> let us know how you get on with your pump start session.  This will be a big change from pens but, after some initial work, should give you a lot more flexibility.  Let us know how you get on.


I’ve been told I will get them eventually but not to start with, I don’t think the funding is there for them in my area yet. Will continue to get the Libre 2 to start with though. I will keep you updated, I’ve booked a week off to adapt to the change.


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## SB2015

The week off is a good idea.  Be patient as they help you adapt your basal rates to suit your personal needs.  It is well worth the effort.  I choose to self fund the sensors in order to use their closed loop system, but it is still important p know how to use the pump in manual mode.  I look forward to hearing more from you as you progress.


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## LoLiz

SB2015 said:


> Hi @LoLiz
> Great to hear that you have full funding for the sensors.  Are you using the system in closed loop (Smartguard which confusingly is what they also called the system with just alarms on the 640)?
> 
> I think that there are quite a few of us who get the Dawn Phenomonon with a rose as soon as we get up.  My system does not stop the rise, but if I pre bolus before I get out of bed and then eat within 30 min it minimises it.   Great that you are in the upper forties with HbA1c on this system.  I accepted a light increase in that for the sake of a large improvement in my TIR which is usually in the 90s or high 80s now.  I feel that gives a better picture of what is happening.
> 
> sorry to hear that eGfr has dropped but glad that you are getting a repeat test.  Let us know how you get on.


Yes, I'm in Smartguard. 

I have tried the insulin as soon as i get up, but that is too early for me, as I then shower, dress, take the pup into the garden, feed the dogs and only then have breakfast, and by then am often too low. But any later and the same thing happens, i mean the rise. It's a real pain. 

eGFr wise, my urine test came back as normal, and my consultant said then don't worry about it. So now i have no idea what that means - does she mean she thinks it is an anomaly, or in the absence of protein an eGFr of 71 is not a problem (but all my reading tells me it is). I simply do not know now what to do with this info, but am having the repeat on Weds so at least I'll know if it an anomaly or not - it is a notoriously inaccurate test. 

I'm at about 85% TIR most of the time. Half high, half too low.


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## SB2015

LoLiz said:


> Yes, I'm in Smartguard.
> 
> I have tried the insulin as soon as i get up, but that is too early for me, as I then shower, dress, take the pup into the garden, feed the dogs and only then have breakfast, and by then am often too low. But any later and the same thing happens, i mean the rise. It's a real pain.
> 
> eGFr wise, my urine test came back as normal, and my consultant said then don't worry about it. So now i have no idea what that means - does she mean she thinks it is an anomaly, or in the absence of protein an eGFr of 71 is not a problem (but all my reading tells me it is). I simply do not know now what to do with this info, but am having the repeat on Weds so at least I'll know if it an anomaly or not - it is a notoriously inaccurate test.
> 
> I'm at about 85% TIR most of the time. Half high, half too low.


Hi Liz

if you are in Smartguard you can let the pump learn about your morning routine and the basal will dust, but the it is still difficult if there is not the opportunity to pre bolus for meals. Having said that your TIR is sitting happy so perhaps the blip at breakfast Is just part of your diabetes.

The spike might reduce by trying one of these things:

Eating a small amount or protein (eg nuts) as soon as you wake to tell your body I am fine, so do not to dump the morning glucose.  I used this when on injections for dawn phenomenon.  The closed loop seems to cope with my DP now and I ignore it now.

Reducing the amount of carbs in your breakfast. Smaller carbs smaller rise

If you are using Novorapid you could ask about quicker acting insulins such as FIASP or Lyumjev.

Dont sit down for 15 min after you have eaten.  I suspect you don't sit down much anyway.
I try to do this after each meal.

Let me know how you get on.


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## Tempyyyyy

Just had an email from UPS saying my Medtronic parcel is on route to the hospital! A nice unexpected surprise after a long week on highs and lows! Almost pump time!


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## SB2015

Let us know how you get on. There will be a bit of work for you at the start to get the settings to match what you need, but it can make such a difference, so worth being patient.


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## Tempyyyyy

Tomorrow is pump day! The butterflies are kicking in but I can’t wait!


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## SB2015

Well I hope that today is going well, with the pump set up.
I look forward to hearing how you get on.


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## Tempyyyyy

I’m officially live and pumping! 

The sessions was due to last 3 hours but as I was the only one starting we completed the set up in an hour and a half. Quick easy and painless. 

I was really impressed with the training and I am in love with the pump already, why didn’t I do this sooner?! 

They think funding will be in place for the CGM in the next year, so I will continue with libre for now. 

Just done my first bolus for dinner so expecting a low at some point tonight whilst the long acting gets itself out of my system.


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## mark king

Hello all, this is a very interesting topic for me indeed.

Mid Jan 23 I will be changing over from my L2 sensor to a Dexcom G7, apparently my Diabetic area is looking to drop the Libre and change over to Dexcom?
I'm T1 with quite good control but get very little warning of lows.  I need to be in the high 1's to mid 2's before I feel it, which is where the L2 low alarms are a great help particularly of a night time.  
I run a L2 and a Omnipod Dash pump with me supplying the necessary meal info to the pump for it to do its job.

I have always liked the idea of closed loop and wonder if this Dexcom change over is the start of that procedure for me?  
When you say "closed loop" you are referring to the fact that the sensor is electrically [blue tooth] or similar talking to the pump - no wires.  Also are these systems tubeless like my Omnipod dash is.
One last Q which closed loop system is the preferred one on our forum.

Many thanks


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## Lily123

The 780 is a tubed pump.

I think the Medtrum has its own sensors for closed loop and I believe that is the only one that is tubeless + closed loop


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