# Guardian 4 sensors



## SB2015 (Feb 2, 2022)

Has anyone got experience of using the Guardian 4 sensors? Do they really eliminate all fingerpricks?


----------



## everydayupsanddowns (Feb 3, 2022)

Not heard of anyone yet. When did it launch?


----------



## SB2015 (Feb 4, 2022)

Thanks Mike
I shall have to wait and see.


----------



## mikeyB (Feb 8, 2022)

There were supply delays late last year. The sensors integrate with the Medtronic 780G to provide a closed loop system, as they are a Medtronic product. I guess they are like any CGM sensor system subject to their usual problems, but in a closed loop system they should be minimal. I have no idea whether they will have to be self funded or will be available on prescription, but I can tell you that they are far more expensive than either the Libre or Dexcom. The transmitter is over 700 dollars, or around £500 or so,  but works for a year apparently.

So not one for the self funders, and if I’m startled by the price they must be beyond most people.


----------



## SB2015 (Feb 8, 2022)

The pricing of the Guardian 4s will be the same as Guardian 3, as with the transmitter.
On a contract the weekly sensors work out at under £34 each.  I think this is similar to a dexcom. The transmitter is guaranteed for a year and is currently lasting longer than that. I do have to self fund these.

I shall wait to see whether the Guardian 4 sensors truly replace all finger pricks and calibrations.
There have been delays with all the Medtronic sensors but these seem to be settling now.


----------



## peedee76 (Feb 8, 2022)

There's a number of people who've received emails this week inviting them to move to the G4 from the G3 (including me). They don't quite remove all fingerprick tests - they need one when you first insert them but (hopefully) that's it. Anecdotal reports suggest they're very accurate, but time will tell. I'll try and remember to report back.


----------



## SB2015 (Feb 8, 2022)

Thanks @peedee76 
That sounds like they have overcome their supply issues.
I suspected that you would need at least one calibration at the start.
I shall be interested to hear how you get on once you switch.
Are you using your sensors in a closed loop?


----------



## peedee76 (Feb 8, 2022)

SB2015 said:


> Thanks @peedee76
> That sounds like they have overcome their supply issues.
> I suspected that you would need at least one calibration at the start.
> I shall be interested to hear how you get on once you switch.
> Are you using your sensors in a closed loop?


Hello @SB2015 - yes been closed loop with 780G and G3 since last summer so similar to you're situation I think. It's not perfect, but it does help a lot especially overnight and in having far fewer hypos. The supply issues look like they're resolving - was a bit dicy in December, but last couple of boxes have shipped on time so hopefully it'll be OK. Hopefully they'll move onto the 7-day sets once they get the sensors out


----------



## SB2015 (Feb 8, 2022)

peedee76 said:


> Hello @SB2015 - yes been closed loop with 780G and G3 since last summer so similar to you're situation I think. It's not perfect, but it does help a lot especially overnight and in having far fewer hypos. The supply issues look like they're resolving - was a bit dicy in December, but last couple of boxes have shipped on time so hopefully it'll be OK. Hopefully they'll move onto the 7-day sets once they get the sensors out


Yup, the same as you, but I started in Jan 2021 so now I have done a full year.  Overnight is so much batter, and if I snack later than usual the closed loop settles things down while I sleep.  I also have far fewer hypos.  less than one a week now rather than the one per day I was having before.
I finally received my December sensors late January.  

What are the 7-day sets?  Is this insulin cartridge only replaced once per week?  I heard a rumour of that, and more closely matches what I did on my Combo,  although I still replaced cannulas every three days.


----------



## peedee76 (Feb 9, 2022)

https://www.healthline.com/diabetesmine/medtronic-extended-wear-infusion-set I think they're available in Europe and there's a US launch planned this year. No idea about the UK though.


----------



## SB2015 (Feb 9, 2022)

peedee76 said:


> https://www.healthline.com/diabetesmine/medtronic-extended-wear-infusion-set I think they're available in Europe and there's a US launch planned this year. No idea about the UK though.


Thanks @peedee76 .
I shall be interested to see how these perform.
If they can then get the sensors lasting as long as the Libre at the same price I feel we may be in with a chance of funding!!!  (But I just saw a pig flying by in the corner of my eye)


----------



## peedee76 (Mar 3, 2022)

@SB2015 3 days in to first sensor - so far so good, only calibrated once. Have checked BMs a few times and it seems pretty accurate. Got funded too


----------



## Lindaburner (Mar 3, 2022)

I wouldn't recommend the 7 day infusion sets as I developed basal cell carcinoma in 2 sites where my cannula went into my stomach. I've ended up getting the scabs that formed scraped off. One healed OK, but the dermatologist wants to cut out the unhealed one. I'm not happy about it, but it appears trauma can cause basal cell carcinoma. They never warned me about this when I got my first pump, and no one in my hospital has encountered it before!!


----------



## SB2015 (Mar 4, 2022)

peedee76 said:


> @SB2015 3 days in to first sensor - so far so good, only calibrated once. Have checked BMs a few times and it seems pretty accurate. Got funded too


Well done on getting funded. All sounding very promising.

I am about to start my new contract, and they have promised to switch me to Guardian 4 once they are reliably available.  Sounds like that is not too far off.

Apologies if you have told us this before, but are you in the UK?


----------



## everydayupsanddowns (Mar 4, 2022)

Glad the Guardian G4s are working well so far @peedee76 

Sorry to hear about the difficulties you experienced @Lindaburner - I’d not heard of it either, but a quick search on Pubmed suggests it may be connected with a variety of trauma sites, scars, or injuries. So I guess theoretically any infusion site or CGM insertion might be involved. 









						Previous injuries or scars as risk factors for the development of basal cell carcinoma - PubMed
					

Basal cell carcinoma (BCC) is the most common malignant tumour in humans and most occur in elderly people. The pathogenesis of BCC is directly related to exposure to ultraviolet radiation in sunlight, but trauma is also mentioned occasionally. As well as one published series, several single...




					pubmed.ncbi.nlm.nih.gov
				




Considering the number of pump users worldwide, and the frequency of infusion set insertions, I guess this must be pretty rare? Very unfortunate for you to have experienced it twice


----------



## peedee76 (Mar 15, 2022)

SB2015 said:


> Well done on getting funded. All sounding very promising.
> 
> I am about to start my new contract, and they have promised to switch me to Guardian 4 once they are reliably available.  Sounds like that is not too far off.
> 
> Apologies if you have told us this before, but are you in the UK?


Yes UK, @SB2015 - west central Scotland. In general the funding situation here is pretty decent compared to what I hear in other areas. Still a few hoops to jump through for CGM, but certainly much better than a few years ago for pumps.


----------



## SB2015 (Mar 31, 2022)

Thanks for the heads up on G4s @peedee76 

It took me some time to get the switch over but after some ‘difficulties’ with the Medtronic ordering systems,  my Guardian 4s have finally arrived.  With the problems in supply I shall use the remaining GuardIan 3 that I have, in order to create a one week buffer.


----------



## peedee76 (Mar 31, 2022)

@SB2015 That’s good news. Yes, Medtronic can be a bit of a challenge at times, though to be fair they’re usually good at sorting things if you phone them. Sensors still seem to be ok still


----------



## trophywench (Mar 31, 2022)

Well I was actually about to say 'surely human skin is truly the 'weakest link' rather than infusion sets?'  Anyone who's known me a while also knows about the numerous poor absorption areas on my body which require me to change infusion sets every 2 days come what may.  It's a PITA cos when I get a 'good' infusion site it's so very, very tempting to not change it.

Having said that of course, as far as I know it's only a DSN who decided to tell me to do that when I first went on a pump cos of the way I got the big hollows in my thighs from basal jabs, but that always sounded sensible to me so I've always followed it.  And now have non absorbing areas on my bum too, areas I'd never ever used for jabs for the previous450 years.

If Medtronic can suddenly invent 7 day infusion sets, how come Roche and other pump manufactures can't use such a plastic, and when Roche's tubing lasts 6 days anyway and has done throughout since I first had a pump whyever can't they use that plastic for infusion sets too, and how can the plungers in insulin pen cartridges and in the 'bungs' at the top of cartridges and vials last practically for ever when nothing else can last that long?  

Not logical Captain said the T1 Vulcanite.


----------



## DKM (May 16, 2022)

SB2015 said:


> Has anyone got experience of using the Guardian 4 sensors? Do they really eliminate all fingerpricks?


Hi, I've just joined the forum, I'm on Guardian 4 and yes just 1 fingerprick when you apply a new sensor and it's warmed up. Then it leaves you in peace! Are you are anyone else on here self-funding Guardian 3?


----------



## SB2015 (May 16, 2022)

Like you @DKM I am now self funding the Gaurdian 4.  I was amazed when all I needed the one finger prick at the start of the sensor.  Far fewer interruptions and generally pretty good at levelling things off for me.  I would certainly recommend the switch from Guardian 3.

I did have a bleeder on my first sensor, and have just come off the phone regarding a 3 week delay in sending the replacement sensor and no idea when they will have more stock.  Sadly their ordering processes and stock control are nowhere as good as the sensors and the pump support team.  You can’t have it all.


----------



## DKM (May 16, 2022)

Hi SB2015 and thanks for getting back to me! I am extremely fortunate and have funding for my Guardian 4 sensors and an amazing support team at the hospital. I was on Guardian 3 from Oct last year until last week, when I was upgraded to the Guardian 4 and yes, it already seems soooo much better for my needs than the G3 which frequently woke me at night to calibrate for no apparent reason. My question regarding self-funding was due to a series of admin errors at Medtronic, I have an stock of the Guardian 3 sensors and was hoping to do someone who is having to pay for these a favour.


----------



## helli (May 16, 2022)

I'm intrigued by this one finger prick at the start and that's it. 
Does that mean Guardian 4s are accurate at all BG levels and don't take any time to bed in like the LIbre?

I have used a number of CGMs (not the Guardian) and I am happy to dose insulin from them because I make sure I check them at least once a day. Some times they drift towards the end of their lives and I always double check if high or low (unless I can feel the hypo).


----------



## DKM (May 16, 2022)

helli said:


> I'm intrigued by this one finger prick at the start and that's it.
> Does that mean Guardian 4s are accurate at all BG levels and don't take any time to bed in like the LIbre?
> 
> I have used a number of CGMs (not the Guardian) and I am happy to dose insulin from them because I make sure I check them at least once a day. Some times they drift towards the end of their lives and I always double check if high or low (unless I can feel the hypo).


Hi helli
Yes the Guardian 4s do seem to be much more accurate, I've done a few little sample checks fingerpricks for my own peace of mind (and knowing how far out the Guardian 3s could be!) and they do really seem to be getting it right.  When you put a new sensor on it does an initial calibration for about 2 hours and then asks for a BG test and that is it. I know the 3s did become less accurate at the end of their lifespan but I don't know yet how the 4s will pan out as I'm quite new to them, but I would also always do a double-check fingerstick if I feel I'm being told a porkie ;-)


----------



## SB2015 (May 16, 2022)

helli said:


> I'm intrigued by this one finger prick at the start and that's it.
> Does that mean Guardian 4s are accurate at all BG levels and don't take any time to bed in like the LIbre?
> 
> I have used a number of CGMs (not the Guardian) and I am happy to dose insulin from them because I make sure I check them at least once a day. Some times they drift towards the end of their lives and I always double check if high or low (unless I can feel the hypo).


Hi Helli

I am still amazed at the accuracy of the closed loop system With the Gaurdian 4.   I think it is the closed loop along with an improved sensor that makes things more reliable.  Even if it is out a bit initially, it is gathering data every five minutes and making adjustments to the basal insulin constantly.  I am finding this to be very accurate and will regularly ‘flat line’ overnight.  My last couple have stayed accurate to the end.

My only issue recently was some ‘electronic interference’ which I think ended up being someone’s hearing aid close by.  Never happened before with lots of people around me using hearing aids.  I still forget to put the pump on the same side as the transmitter so sometimes get a reminder that it is finding it difficult to pick up the signal.

I am confident enough now to only check Bg when I feel odd, and readings don’t appear to match. For the few hypos I have I need to still take account of the time lag between sensor and Bg readings, but for the rest of the time their algorithm seems to work and take account of this.  My TIR is generally in 80s or 90s so happy with that.


----------

