# Living with a Medtronic Minimed 640g and sensors



## pottersusan (Apr 1, 2017)

Day one:
nearly 24 hours in...

Had a phone call from my DSN before she finished work yesterday, to make sure I was managing OK.

Pro:

much faster doing it's calculations than the Roche Insight
doesn't need so much blood on the test strip and it gives you time to extract more blood if necessary
only one bit of kit hanging around,  instead of two
Con:

I'm not quite sure where I'll put it on the odd occasions I wear a dress. You do need to get at it more than the Roche 'cos of entering your carbs on the pump. 
Last night was the first night for ages that I haven't gone low, but I have yet to experience the suspend feature.
So far I am a happy person.


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## grovesy (Apr 1, 2017)

Glad you are liking it so far.


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## Northerner (Apr 1, 2017)

Off to a good start Susan!


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## everydayupsanddowns (Apr 3, 2017)

Pleased you are getting on well with it so far. Without wanting to look like Mr Smug of 123 Smuginton Gardens, Bigheadshire, I recently managed to get a sensor to last for 20 days (I'm trying to spread a handful out over the course of the year as I can only afford a few). Smartguard saved me lots and lots of low level hypos over that time, and I had next to no readings below 3.5mmol/L.


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## everydayupsanddowns (Apr 3, 2017)

If dress wearing is only occasional (eg special event) I guess you *could* use the remote bolus feature via the Contour Next Link meter. Never had much of a call to use it myself, and it would lack the finesse of a bolus wizard, but could be an option?

Alternatively I gather many women nestle pumps in/around bra area with/without hanging devices. Again, not something I can claim any experience of!!


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## KookyCat (Apr 3, 2017)

Glad it's working well for you   Looks like a very complex affair for those of us who point and jab  but I'm really pleased it's doing the trick.  I love the idea of suspending insulin that sounds like a great feature


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## pottersusan (Apr 4, 2017)

Day 3 (yesterday):
First cannula change went ok.

Had the first 'suspend insulin' which was fantastic, as I was totally unaware I was heading hypowards.

Day 4:
the pharmacy hasn't got my script for the new test strips yet, so am being very economical . this means that my bg is a bit higher than I like, but I might get them later today - with a bit of luck


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## Northerner (Apr 4, 2017)

Hope the strips turn up Susan  Great that the system warned you, and reassuring that it is all working!


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## pottersusan (Apr 6, 2017)

Day 6

2 nd cannula change and first sensor change - blimey that sensor was stuck on well. Medtronic seem to use more powerful glue than Dexcom

Just realised that it suspended my insulin a couple of hours ago and restarted it recently. It is really a clever piece of kit.


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## pottersusan (Apr 8, 2017)

Day 8
First cannula change, that I've been trusted to do by myself, achieved successfully.
It decided to suspend my insulin while waiting for my lunch at the Southampton meet. I had some porridge in Wetherspoons - the joint thoughts on amount of carbs overestimated! But I am one of those whose bg goes up significantly with porridge (slowly to start with and then zoom!)

Battery Life compared with the Insight:
Insight pump battery lasted barely 6 days, Medtronic 8 days and still going
Insight glucose tested needs charging every day, Medtronic 8 days and still going


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## everydayupsanddowns (Apr 11, 2017)

I get about 3 weeks from a standard alkanile Energiser battery in the pump. Doesn't seem to notice that much if I am using a sensor or not.

Rechargeable BG meter (Contour Nextlink USB) seems to last at least 3-4 weeks between charges, but to be honest they are infrequent enough that I can't say I'm really counting!


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## m1dnc (Apr 11, 2017)

everydayupsanddowns said:


> I get about 3 weeks from a standard alkanile Energiser battery in the pump. Doesn't seem to notice that much if I am using a sensor or not.
> 
> Rechargeable BG meter (Contour Nextlink USB) seems to last at least 3-4 weeks between charges, but to be honest they are infrequent enough that I can't say I'm really counting!


Me too. I really don't notice how long they last. As for the meter, I tend to leave it on charge after I've downloaded the pump records - which is probably every 6-8 weeks.


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## pottersusan (Apr 11, 2017)

Day 12 (I think!)
Just done the first sensor change without the DSN (watching like a hawk!). It will become easier with practice, I'm sure. Thank goodness for You Tube.

The Medtronic battery life for the pump and handset reinforces my thoughts on the Insight - the battery life is appalling poor and it takes ages to do anything. The Insight is meant to be an improvement on the Combo - not in my opinion  and experience.


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## SB2015 (Apr 12, 2017)

pottersusan said:


> Day 12 (I think!)
> Just done the first sensor change without the DSN (watching like a hawk!). It will become easier with practice, I'm sure. Thank goodness for You Tube.
> 
> The Medtronic battery life for the pump and handset reinforces my thoughts on the Insight - the battery life is appalling poor and it takes ages to do anything. The Insight is meant to be an improvement on the Combo - not in my opinion  and experience.


Glad things are all going so well Susan.


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## pottersusan (Apr 17, 2017)

Lost count of days

Just been talking to Medtronic in the States 'cos my sensor had died early. After a million and one questions (at least that's what it felt like) they are sending me a new one. I think I've got to make sure the NHS gets value for money - it would be easy to just insert another and forget about the one that went wrong. They reassured me it wasn't something I  had done - you cant help wondering when it's still all very new.

So I'm now waiting for the sensor to 'warm up'.

With the Medtronic you are sensorless for about 3 hours when you have to change it:
about an hour to recharge the transmitter
about two hours for it to warm up.


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## Northerner (Apr 17, 2017)

Hope the new sensor works longer, and better  You are right to try and get value for money, I'm sure an awful lot of money would be saved if people gave it a little more consideration


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## grovesy (Apr 17, 2017)

Hope the new one lasts longer.


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## Scrumpyjack65 (Apr 18, 2017)

Hi, so Im interested by this post ... you are using a Roche insight pump or sensor but you're saying you dont need to test as much which I am surprised about?  I have a medtronic 640g and the cgms linked in but I still need to test as much as I did before as whilst the sensors give you a guide (from my experience), the dont give you the here and now situation rather frustratingly .... has anyone else had the same issues or dare I say it, is it me


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## heasandford (Apr 18, 2017)

Thanks for doing this one - fascinating! 

I am a committed Libre user, although I have to say that even though it gives me the info I can't always do anything about it in the way I want, so the suspend sounds good (ie when I am going low I often miss it, and when I am going high it is too late and then takes at least 2 hours to come down)
I was also interested to hear about the Contour Meter, as I feel I would struggle if I had to keep hoiking the pump out from underneath clothes - my favourite thing about the Roche pump is the bluetooth meter (I have a Combo though, hopefully ! can refuse the Insight! Are you at the Bournemouth hospital like me?)

Food for thought about changing if ever given a chance!


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## everydayupsanddowns (Apr 18, 2017)

Are you wearing the sensor/transmitter vertically @pottersusan? And have you been given guidance about when (and when not) to calibrate?

Sounds like the one you had was just a bad 'un though if Medtronic are replacing it. Did it just stop altogether? Or was it after calibration errors?


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## Scrumpyjack65 (Apr 18, 2017)

heasandford said:


> Thanks for doing this one - fascinating!
> 
> I am a committed Libre user, although I have to say that even though it gives me the info I can't always do anything about it in the way I want, so the suspend sounds good (ie when I am going low I often miss it, and when I am going high it is too late and then takes at least 2 hours to come down)
> I was also interested to hear about the Contour Meter, as I feel I would struggle if I had to keep hoiking the pump out from underneath clothes - my favourite thing about the Roche pump is the bluetooth meter (I have a Combo though, hopefully ! can refuse the Insight! Are you at the Bournemouth hospital like me?)
> ...


HI @heasandford - interesting to hear about the Libre, I had thought of it, but as it doesnt link to the pump I didnt think it added much extra value to be honest.  The suspend option is good particularly for me at the moment where I am going low five or six times a day despite basal changes and adjustments, tricky days.  The Contour Meter is linked directly to the Medtronic pump thankfully but you still have to do your bit of keying in and such like, weirdly thats the thing the thing I didnt like about the Roche one. I tried it as I used to be seen at Bournemouth hospital a few years back but I didnt find the wifi / bluetooth reliable enough, hey we're all different ... Bournemouth was a great place for treatment in my brief time there, but we now live in Norfolk, so go to Addenbrookes in Cambridge which is equally as good.   What kind of pump do you have? Sallly


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## pottersusan (Apr 19, 2017)

everydayupsanddowns said:


> Are you wearing the sensor/transmitter vertically @pottersusan? And have you been given guidance about when (and when not) to calibrate?
> 
> Sounds like the one you had was just a bad 'un though if Medtronic are replacing it. Did it just stop altogether? Or was it after calibration errors?


Horizontally (though haven't been told any way is better). Have been told to calibrate twice a day, but no guidance as to when.
It just  stopped in the middle of the night.


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## Scrumpyjack65 (Apr 19, 2017)

@pottersusan - if you're on a 640g it will tell you when to calibrate, you can check when the next time is by looking at the quick menu options, at least that way you know you wont be woken up at 3am asking you to calibrate.  I tend to calibrate 3 or 4 times a day, so you may need to do it a bit more often? BTW, the sensor will stop if you dont calibrate when it wants you to do it unfortunately


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## everydayupsanddowns (Apr 19, 2017)

pottersusan said:


> Horizontally (though haven't been told any way is better). Have been told to calibrate twice a day, but no guidance as to when.
> It just  stopped in the middle of the night.



My understanding is that there is some data that north-south is the better orientation with the transmitter at the bottom (they always used to suggest east-west). The insertion area should be one that does not bend/twist too much in general, so if using abdomen, upper abdomen is better than the really bendy/creasy bit in the middle. Arms seem to get a lot of positive murmurings online, but I've never tried there.

The other thing I've seen recommended is that calibrations are best done at a time when BGs are relatively stable and are likely to remain so for approx 30 minutes. So good to avoid calibrations where the sensor glucose shows lots of arrows. I think you only get a couple of failed calibrations before the sensor will be refused.

Also, users seem to recommend that if a sensor stops you can try to restart it as if it were a new one. You have to detach the transmitter from the sensor so have to be careful that you don't dislodge the whole thing. Can't say I have any experience of them failing and whether you can restart after multiple calibration fails, but I do stretch mine out with restarting at least once when they have run their 6 days and usually seem to get 12-16 days out of them.


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## Scrumpyjack65 (Apr 19, 2017)

@everydayupsanddowns - I never knew that you could get so many days out of the sensors, something worth trying, thanks for the tips


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## heasandford (Apr 19, 2017)

Scrumpyjack65 said:


> HI @heasandford - The Contour Meter is linked directly to the Medtronic pump thankfully but you still have to do your bit of keying in and such like, weirdly thats the thing the thing I didnt like about the Roche one. I tried it as I used to be seen at Bournemouth hospital a few years back but I didnt find the wifi / bluetooth reliable enough, hey we're all different ...  Sallly



Loving this thread, learning loads!
Not wishing to hijack the main theme, but Sally, I'm not sure exactly what you mean about keying in to the pump? I just use the Combo linked meter (very similar to the Expert one) and it reliably messages the pump with everything. I never need to touch my pump except to change the cannula etc. I just like the convenience. But I would like an alarm when I am going too low (or perhaps even too high - I really need to stop it happening at all!)


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## Scrumpyjack65 (Apr 19, 2017)

@heasandford - Hi ... so when I had the combo, just bear in mind it is thankfully a few years ago now, probably about 3 years ... but at the time it was the wireless connectivity between my blood tester and the pump that was just to unreliable so I had to key in the blood test each time and then it would keep error-ring as the remote wasnt working so you had to go through from memory a whole wizard thing about have you tested, etc etc ... it became rather a bind to say the least !  For me the smart guard on the Medtronic one is my saviour, as it just switches off, it does vibrate or whatever but Id rather try and sleep, and then it just keeps going after 2 hours and switches itself back on.  Generally Im having two or three hypos a night so this is as I say my saviour.    You're lucky your linked meter works as well as it does, perhaps I was just unlucky ....


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## pottersusan (Apr 20, 2017)

I'm learning lots too

The Medtronic was very determined to wake me up last night - it had lost connection with the sensor and please would I move away from any likely interference... I turned over and went back to sleep. All seems well this morning.


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## Scrumpyjack65 (Apr 20, 2017)

@pottersusan - absolutely roll over and ignore it .... the alerts and alarms can be a pain but hey its worth it I think to get the data back ....  but what I would say is to keep testing as much as you used to before having the CGM as sometimes what is showing on the sensor is way out from your good old finger prick option .... have a great day


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## trophywench (Apr 20, 2017)

Goodness Jack!  Why on earth didn't Roche replace it?  They did with my Combo meter/handset when it failed  - no prob at all once I got through to someone sensible rather than being diverted to unhelpful people in the States!  And later the pump when the piston motor went base over apex.


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## Scrumpyjack65 (Apr 20, 2017)

@trophywench - they did and the same thing, I was so relieved to be able to give it back, not like Medtronic ....glad I was able to switch back.  For me Medtronic works, but appreciate each to their own.


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## pottersusan (Apr 20, 2017)

Just been to see my DSN (after visiting Draculette earlier - two nurses in one day is a bit much!). She wanted to download the data from my pump, yet bizarrely nothing appeared. She's going to get on to Medtronic when theyre less busy.
it's strange that the pump is seeing the sensor data, but it's not downloading. Any ideas from Medtronic users? I wonder if I've got a dodgy transmitter, given the blips in connection I'm experiencing.


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## grovesy (Apr 20, 2017)

pottersusan said:


> Just been to see my DSN (after visiting Draculette earlier - two nurses in one day is a bit much!). She wanted to download the data from my pump, yet bizarrely nothing appeared. She's going to get on to Medtronic when theyre less busy.
> it's strange that the pump is seeing the sensor data, but it's not downloading. Any ideas from Medtronic users? I wonder if I've got a dodgy transmitter, given the blips in connection I'm experiencing.


Oh , I hope it is something that can easily be solved.


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## everydayupsanddowns (Apr 20, 2017)

Can you see the 'Sensor glucose review' @pottersusan?

Menu > History > Sensor Glucose Review

This should allow you to see sensor data stored in the pump (scroll back through previous days... view pie charts... average data over 7/14/30 days etc).

In any case there would have been bolus and settings info from the pump.

Carelink is notoriously twitchy for uploads though. Usually takes a lot of patience and often several tries. Added to that they have *just* changed Carelink so that patients now get access to what used to be HCP-only 'Pro' reports. 

I suspect a problem with Carelink upload rather than your pump.


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## Ref (Apr 20, 2017)

Am I right in thinking that if I have the 640g from my hospital then I can just buy the CGM sensors and tell them to talk to each other or do I have to buy other equipment to go with it?


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## Scrumpyjack65 (Apr 20, 2017)

@Ref (Andy) - sort of but not quite ... you need a transmitter, usually costs about £400, but this year my DSN gave it to me for free amazingly ... you then turn on the sensor settings on your pump and you have to manually input the transmitter number, shown on the back of the device, and yes they then as you put it, talk to each other.    In case Medtronic have forgotten to tell you which they often do you can sign up to them for a year as long as you agree to buy one box a month £210, then you get a free transmitter at the end of the year but you also yet your sensors dramatically reduced from £275 to £210 .. worth thinking about but its a big financial commitment .. I see you have been or are a libre user, does that you've decided now to tray something new?  BTW, impressive HBA1c results ...


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## Scrumpyjack65 (Apr 20, 2017)

everydayupsanddowns said:


> Can you see the 'Sensor glucose review' @pottersusan?
> 
> Menu > History > Sensor Glucose Review
> 
> ...


Hi, as you say, lots of issues with Carelink upload, shame it only works on certain browsers well from my experience anyway - Firefox seems to be the most reliable.  If the DSN was using Internet Explorer or Chrome then yes lots of issues ... !!


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## Ref (Apr 21, 2017)

Re my HbA1c - thanks @Scrumpyjack65, hard work though.

I've a few reasons for moving away from the libre.
Since i've started on the pump I'm finding the libre less useful.  The pump has already enabled me to reduce the number of highs and lows I'm having but the downside of that is when I do have them then they hit me harder.  When I was on MDI, if I hypo'd then all I needed was a couple of jelly babies and I was good to go in a couple of minutes.  Now it takes much longer and I feel awful for ages which is affecting me at work and is noticeable to others.  I'm thinking the smartguard feature would be able to help me out.


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## pottersusan (Apr 21, 2017)

everydayupsanddowns said:


> Can you see the 'Sensor glucose review' @pottersusan?
> 
> Menu > History > Sensor Glucose Review
> 
> ...



Thanks for that.

I'm the first patient my DSN has had with sensors - so she's learning too! and my brain is still fogged with cold bugs so cant think straight (amend that to 'cant think)


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## pottersusan (Apr 21, 2017)

After much cursing and swearing, finally succumbed to ringing Medtronic for help with registering with Carelink. Half an hour later, I've succeeded!


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## grovesy (Apr 21, 2017)

pottersusan said:


> After much cursing and swearing, finally succumbed to ringing Medtronic for help with registering with Carelink. Half an hour later, I've succeeded!


Glad you have succeeded.


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## HOBIE (Apr 23, 2017)

I like Carelink. Graphs etc & you can print out sheets & see various problems with insulin or too much hard work/patterns.


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## pottersusan (Apr 27, 2017)

Yesterday, it was two cannulas that wouldn't work. It's inevitable that you think it's something you've done wrong, but I really don't think it was.

The helpline (in the States) told me to always push some insulin through the cannula with the syringe plunger - not to rely on the pump.

Despite the problems I still love this bit of kit.


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## Northerner (Apr 28, 2017)

Sorry to hear you've had 'technical' problems Susan, but glad you haven't lost faith in your little friend  Do you have a name for it yet?


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## grovesy (Apr 28, 2017)

Sorry you are still having teething problems.


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## HOBIE (Apr 28, 2017)

I always hold the cannula end up in the air with pump below which proves it is pushing insulin out. Are you still leaving old cannula in ? I have never done that & like a nice clean start.  Good luck.


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## pottersusan (Apr 28, 2017)

HOBIE said:


> I always hold the cannula end up in the air with pump below which proves it is pushing insulin out. Are you still leaving old cannula in ? I have never done that & like a nice clean start.  Good luck.


No, I'm changing the cannula every time.
Why do these things happen when you are very new to things?! In a few months time I'll take it all in my stride.


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## everydayupsanddowns (Apr 28, 2017)

pottersusan said:


> Yesterday, it was two cannulas that wouldn't work. It's inevitable that you think it's something you've done wrong, but I really don't think it was.
> 
> The helpline (in the States) told me to always push some insulin through the cannula with the syringe plunger - not to rely on the pump.
> 
> Despite the problems I still love this bit of kit.



Which infusion sets are you using @pottersusan?

I had all sorts of bother with the Quicksets (though I know others that love them) and ended up getting 3 or 4 of all te varieties and trying them all out in turn to see how they fared. For me angled sets work much *much* more reliably than 90-degree sets and give me a much wider choice of location as I can use areas with a little bit less 'padding'.

I'm currently using Silhouettes, but have tried and likes Mio30s too - they just seem more useful for someone who needs to do set changes when out and about to me, and I do almost all of mine at home base, so the extra cost/packaging/plastic of the self-serter doesn't seem worth it for me.

Hope these are just a temporary blip, or that you swap to an alternative cannula/set that suits you better.


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## pottersusan (Apr 28, 2017)

everydayupsanddowns said:


> Which infusion sets are you using @pottersusan?
> 
> I had all sorts of bother with the Quicksets (though I know others that love them) and ended up getting 3 or 4 of all te varieties and trying them all out in turn to see how they fared. For me angled sets work much *much* more reliably than 90-degree sets and give me a much wider choice of location as I can use areas with a little bit less 'padding'.
> 
> ...


Pink Mio - I  haven't been given any options apart from the various sizes of Mio.

I suspect my problems are just a blip.


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## pottersusan (May 1, 2017)

Changed the cannula, sensor and battery yesterday with no alarms (thank goodness)

I don't want to speak too soon, but I may be getting the hang of this


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