# Pump start 780G



## SB2015

I have finally got a new phone that is compatible with the app for my new phone.
It has taken two days to get it all sorted.

I cried and sweared when the new phone told me it was incompatible when I tried to download the pump app initially, even though it was on the Medtronic list.  However I spoke to a very helpful Medtronic person (in USA) who sorted things out, and I am now ready for the pump to arrive.  

I also had no sound on any of the notifications even though I had set up all the in app settings and phone settings.  Coffee with a youngster this morning sorted that out.  How was I to know that there was a nice little switch on the side of my phone which very easily switches off the sound!!!

I tend to assume that if something goes wrong with tech it is down to me.  I know that in a few months this will all be as familiar as my current pump and old phone.

Pump start is next week, and not face to face so it is all online.  I will let you know how it goes.


----------



## Paulbreen

Hey congratulations @SB2015 looks like your making progress, do you mind if I ask what is the name of the app you will be using ?


----------



## Flower

Good progress @SB2015   At least the keyboard and numbers stay in the same order!


----------



## everydayupsanddowns

Phew! And hurrah for new tech (eventually!) cooperating. 

Looking forward to hearing how you get on next week for the big switchover - hope it all goes smoothly and there aren’t too many frustrations.

Have you decided which infusion sets you will use?


----------



## SB2015

everydayupsanddowns said:


> Phew! And hurrah for new tech (eventually!) cooperating.
> 
> Looking forward to hearing how you get on next week for the big switchover - hope it all goes smoothly and there aren’t too many frustrations.
> 
> Have you decided which infusion sets you will use?


They have bought out new ones, which work much more like the Accu Chek ones.  The tubing is now provided separately from the cannulas, so you can change a cannula if needed without having to change the whole set.  The putter inner is very similar to my current one, but unfortunately disposable.  Pros and cons for everything.

I have just had a message to say the pump arrives tomorrow, so it gives me a chance to familiarise myself with it before the training day, which will be very helpful.  I can do that at my own pace, and I have found The Medtronic support line brilliant however silly my questions may seem.

All progress and feeling much less nervous about it.


----------



## SB2015

Flower said:


> Good progress @SB2015   At least the keyboard and numbers stay in the same order!


Thanks @Flower .

It is good that some things are straightforward, although it took 
me a while to find where some of the symbols were hiding.


----------



## SB2015

Paulbreen said:


> Hey congratulations @SB2015 looks like your making progress, do you mind if I ask what is the name of the app you will be using ?


The app is Minimed Medtronic which will work with these new pumps.
I know I can down load my data but this app will enable me to view the data from the pump and sensor on my phone and also share it with my clinic.   I will know more once I have something for it to link with next Monday.  I have also downloaded Carelink.


----------



## Paulbreen

Thank you sir, I’ll look out for the link


----------



## Sally71

Good luck with the changeover, let us know how you get on!  We had very brief moments during the first few weeks when we missed the familiarity of the Combo, never wanted to actually change back though, integrated sensors are a complete game changer!


----------



## everydayupsanddowns

Everythig crossed for you for next week @SB2015


----------



## SB2015

Thanks.  It feels like a big step at present, but I suspect that in a few months 
I will wonder why I was so worried, and we do have a full month of using the pump in manual before giong over to the automated system.


----------



## SB2015

Sally71 said:


> Good luck with the changeover, let us know how you get on!  We had very brief moments during the first few weeks when we missed the familiarity of the Combo, never wanted to actually change back though, integrated sensors are a complete game changer!


Does the t-slim autocorrect in response to the sensor readings?


----------



## everydayupsanddowns

SB2015 said:


> Does the t-slim autocorrect in response to the sensor readings?



Yes. Either Basal IQ (predictive low glucose suspend only) or control IQ (helps protect against both high BG and low BG)

Hypos are attempted to be avoided by reducing or stopping basal. 

For high corrections with Control IQ, it begins by increasing the basal profile you have set for that time of day by a percentage, an dif that doesn't work It can add small correction boluses.


----------



## SB2015

Thanks Mike

It is good to know that there are a variety of systems which operate in similar ways.
As you have said the language around the pump is slightly different from my previous one, 
but it will become familiar with time.

I think the step of letting the sensors and the auto correct might be the more difficult change
but well worth trying.  Someone (quite likely you) suggested that I definitely give it at least six months using the sensors.  

Happy not to be trying with sensors over Christmas with those extra carbs, and a lot of unknowns, although it is all those things that I suspect the automation will address for me in the future.

Thanks for all the help from you and others.


----------



## trophywench

Well, you want it to, certainly! 

Be interesting to find out, albeit 2nd hand, whether it does what it says on the tin at the end of the day, of course.

(Still a bit disgusted with myself admitting it was too different to attract me sufficiently TBH)


----------



## everydayupsanddowns

Hope you get on well with it @SB2015 

I remember my first 28 days with a sensor augmented pump and having a piece of diabetes tech actively independently helping me out. It was amazing, and slightly addictive!


----------



## Sally71

It can make you a bit lazy though, if we get any low alerts from the sensor and it isn’t dropping rapidly into the 2s we tend to just sit there saying “Marvin will sort that out!”


----------



## trophywench

Like it, Marvin.  I ventured into the stratosphere around lunchtime, having changed my cannula this morning.  Had to get my Novo pen and a needle and have a manual jab.  Goodness knows why I hadn't waved the libre over my arm but there you go... still high. Ooops.

Had pump correction cos of course I ripped the failed one out earlier.

How the heck do you keep track of your lousy absorption sites?


----------



## SB2015

Mine has been given the name of Humphrey.

The pump start on Monday was very good.  The first day was a bit wobbly as my cannula failed.
Good to have the chance to do another set change soon after the training.
Just needing to tweak basal rates and ratios.  

I am taking it step by step.  In Manual mode at the moment without sensors.
Next it will be sensors and manual mode, before then going over to full auto mode.

I shall post a few questions as I go along.


----------



## trophywench

Remember discussing this with a lady on the same Uni committee as me, one day, re our  first set change.  Took her 20 minutes so I was pleased it only took me 10-ish.

10 years later, it's still a ruddy faff.  Just gets quicker is all.


----------



## SB2015

Week 1
Very confusing having had a Combo for eight years.  Soooooo tempted to switch back at present but I need to keep going to using the pump in it’s intended mode with autocorrections.  But 

2 cannulas have fallen out
I can’t find a way of adjusting the Bolus if I use the Bolus wizard and can’t remember how I managed to modify the Bolus on a couple of occasions
If things go wrong in the night at present I have to think to do stuff, rather it being something that I can deal with from habit.
If you have to access the pump for any Bolus how do you manage when wearing a dress?  Not a problem at present as we are not eating out  but I am not sure I want to be fishing around in a restaurant, and I have some nice dresses that I like wearing. * Any solutions*?
I will stick at it, and it will get easier (so long as Humphrey, the pump, doesn’t get chucked out of the window!!-  But then I do still have my Combo.)


----------



## everydayupsanddowns

SB2015 said:


> I can’t find a way of adjusting the Bolus if I use the Bolus wizard and can’t remember how I managed to modify the Bolus on a couple of occasions



You can definitely do this... i think you ‘up/down‘ to highlight the dose in yellow, then press the centre button to allow you to ‘up/down’ the dose. 

Sorry that my memory of the menus has disappeared.


----------



## everydayupsanddowns

SB2015 said:


> If you have to access the pump for any Bolus how do you manage when wearing a dress? Not a problem at present as we are not eating out but I am not sure I want to be fishing around in a restaurant, and I have some nice dresses that I like wearing. * Any solutions*?


I guess it depends on how often you wear dresses?

Does the MM780 have the simplified bolus options from the BG meter? those might be workable in a number of circumstances when out and about?


----------



## MrDaibetes

It gets a lot more complicated in auto mode, just be patient with it until you switch into auto mode and you should notice some changes.


----------



## SB2015

Well after one week and hitting a TIR of 34%, and two nights of no sleep at all I gave in.
Cannulas sites were very sore and swollen, my levels were rarely below 10 and corrections only worked if given by pen.  It Then caused a lot of stress and .... I swapped back to my Combo.  I simply needed some rest, and recovery time.

Whilst I am back on my Combo, I am using the time to : 
- do a full fasting basal rate test.  That always takes a few days!
- then check sensitivity and carb ratios for each time slot
- try a Medtronic cannula without insulin to see if it is an issue with the cannula or glue 
- keep a record of the things I automatically do in the Combo, identify these and check 
   that I know how to do these in the 780, and be prepared with questions if in doubt.

In some cases the Medtronic pump support have not known answers to issues I have raised, as this is all so new to them too, but have found out answers where they can.  I think I want to be better prepared before trying again and I am happy to wait, and then try a restart.   I want to have some success with the 780 in manual mode before I order any sensors, so my progress might be slow. 

I still very much want to get through to the auto mode if I can as in the long run it will save me thinking so much about Diabetes.  I think the info itemised above that I will gather over the next few weeks will enable me to make a better start second time round.  Hopefully by then the pump help line will also be more familiar.


----------



## SB2015

everydayupsanddowns said:


> I guess it depends on how often you wear dresses?
> 
> Does the MM780 have the simplified bolus options from the BG meter? those might be workable in a number of circumstances when out and about?


That is a feature that is no longer available.  The handsets are very basic as they are only intended to measure BG and send this to the pump.  Job done, as in automode many of the others facilities in their earlier pumps will not be needed.  It is intended to be in automode.  I will just take some time to get there, if I do.


----------



## SB2015

everydayupsanddowns said:


> You can definitely do this... i think you ‘up/down‘ to highlight the dose in yellow, then press the centre button to allow you to ‘up/down’ the dose.
> 
> Sorry that my memory of the menus has disappeared.


Thanks Mike
I finally worked out how to get back to be able to adjust a Bolus which helped a bit.  However by then sites were so skanky I don’t think the bonuses were getting through.


----------



## Paulbreen

SB2015 said:


> Well after one week and hitting a TIR of 34%, and two nights of no sleep at all I gave in.
> Cannulas sites were very sore and swollen, my levels were rarely below 10 and corrections only worked if given by pen.  It Then caused a lot of stress and .... I swapped back to my Combo.  I simply needed some rest, and recovery time.
> 
> Whilst I am back on my Combo, I am using the time to :
> - do a full fasting basal rate test.  That always takes a few days!
> - then check sensitivity and carb ratios for each time slot
> - try a Medtronic cannula without insulin to see if it is an issue with the cannula or glue
> - keep a record of the things I automatically do in the Combo, identify these and check
> that I know how to do these in the 780, and be prepared with questions if in doubt.
> 
> In some cases the Medtronic pump support have not known answers to issues I have raised, as this is all so new to them too, but have found out answers where they can.  I think I want to be better prepared before trying again and I am happy to wait, and then try a restart.   I want to have some success with the 780 in manual mode before I order any sensors, so my progress might be slow.
> 
> I still very much want to get through to the auto mode if I can as in the long run it will save me thinking so much about Diabetes.  I think the info itemised above that I will gather over the next few weeks will enable me to make a better start second time round.  Hopefully by then the pump help line will also be more familiar.


Don’t worry SB I did the exact same after 2 weeks, went on holiday to Italy and left the pump at home, if you stick at it it will come right, I have 93% TIR, now. Changing the sensor is my big bug bear and I would advise you do it on a Saturday or Sunday morning so you have plenty of time to attend to the calibrations, normally it asks me a couple of times.
I had many probs with the infusion sites and eventually found on my rib cage under my arm works really well and even stays in when I’m thrashing around when I’m sleeping 
I tried to be as discrete as possible but the photo might give you an idea,


----------



## SB2015

Thanks @Paulbreen. It is good to know that others have had similar issues.
I haven’t given up yet.


----------



## Paulbreen

It is a pain in the a*$ to begin with but it is worth the hassle when you get it into auto mode


----------



## Maco

SB2015 said:


> Thanks @Paulbreen. It is good to know that others have had similar issues.
> I haven’t given up yet.



Hi SB, Just wondering if you've had anymore luck with the 780G? I haven't been on a pump since I was 14 & I'm 26 now so won't have issues changing from pump to pump. My 780G was dispatched just before xmas & my online training is on the 7th of January. Ive also been funded the guardian 3 CGM to run alongside.. 

I wasn't given any other options in regards to different pump brands. Your concerns aren't the first I've seen unfortunately.


----------



## SB2015

Hi @Maco

I plan to start on the 780 again in the New Year.  The issues were basically around operator error (Me).  I had not checked my basal rates, my other ratios were hiding this.  The switch highlighted the issue and I was not sure about how to make some of the adjustments I needed to do on the new pump.  As a consequence I was as doing loads of corrections, and bouncing all over the place with levels.  Then my sites got pretty annoyed at having all the extra insulin being chucked at them, ...  Operator errror as I said.

My advice would be to check that your basal insulin is correct before your start date.  Do a fasting test (although perhaps not this week what with Christmas Cake, chocolates, ...). The only other thing I would do is put in a cannula to check that your body has no issues with the glue, although there are ways round it if you do, and the pump carline are excellent.

The various systems with automated insulin delivery seem to keep people in range for a very high proportion of time, and you then have a lot less to think about which is appealing.  The 780 is reported to be a big improvement the 670.  It is great that you have been given funding for the sensors.

I look forward to hearing how you get on, and I shall no doubt be a few days behind you.


----------



## SB2015

Having done some basal rate testing, checked cannulas without insulin running, ... i felt ready to have another go with the 780.  It was definitely operator error the first time round, with the bonus of a UTI to add into the mix.

I had a full hour of a virtual appointment with my DSN and we checked out all my settings, checked basal rates and I committed to a restart on Monday, with a follow up appointment with DSN on Tuesday.  As I had to change my set yesterday I decided to just take the plunge, still in manual mode but if all goes well this time I will order the starter kit.

Had a nice flat line overnight but a hypo first thing.  Easy to sort out ready for tonight (although I won’t shout too loud in case the DF is nearby).  I feel a lot better prepared this time and have found out how to do some of things I was uncertain of before.  I shall see how this goes.


----------



## everydayupsanddowns

Hope it goes really well this time @SB2015 - and you can run in manual long enough to try automode.


----------



## SB2015

Thanks Mike

After a couple of tweaks to basal rates overnight I am now getting nice flat lines throughout the night.  Some other basal rates to check during the day, although I know that once in automode wobbles will be sorted out by the pump. I shall still use the next few weeks to develop an understanding of how the manual mode works before switching over.  I am already getting to know the various screens and routes to TBRs, basal rate profile changes, ...

Talking of TBRs I am used to an alarm going off when a TBR finishes, which gave me the chance to check levels and decide whether to reset it.  Either I did not notice the alarm or this ones doesn’t do that.  Any Medtronic users know?

The Medtronic sensors are dropping in price now which is good news.  I suspect this is due to the competition from Dexcom as well as the availability of Libres.

I have abandoned the linked BG test kit, as I struggled to get the test strips out of their no spill pot. They are a lot smaller than my old ones and I did like the light on the test strip port.  However I can continue with my old one and the bigger strips, which I find easier to manage and just enter the BG manually.

I find it strange that Medtronic have set up with a bluetoothed test kit, but then you have to access the pump to confirm it within 12 minutes.  So if you have to get out the pump I am not sure what advantage the Bluetoothness is.  It feels like they are then able to advertise that their handset is bluetoothed to the pump, which drew me in, and as a Combo user I assumed that that meant I could do everything from the handset.  As I am at home it is not a problem needing access to the pump for a Bolus and I have time to try out different options for adaptations to clothes.

Good brain exercise doing a switch.


----------



## Pumper_Sue

SB2015 said:


> Talking of TBRs I am used to an alarm going off when a TBR finishes, which gave me the chance to check levels and decide whether to reset it. Either I did not notice the alarm or this ones doesn’t do that. Any Medtronic users know?


Mine beeps when the temp rate ends, only one beep though.


----------



## SB2015

Pumper_Sue said:


> Mine beeps when the temp rate ends, only one beep though.


Thanks Sue
I think I just missed it.  My Combo demanded some attention.


----------



## helli

@SB2015 when I had my old tubey pump and wore a dress, I would put it in a pump belt wrapped twice around my upper thigh. I was pretty good at surreptitiously getting the pump out under the table in a restaurant without exposing too much thigh. 
I never tried it with a maxi-dress so didn't have to lift too much dress to access the pump. 

I have read some women storing their pump in their bra. No idea how they discretely access it in public.


----------



## SB2015

helli said:


> @SB2015 when I had my old tubey pump and wore a dress, I would put it in a pump belt wrapped twice around my upper thigh. I was pretty good at surreptitiously getting the pump out under the table in a restaurant without exposing too much thigh.
> I never tried it with a maxi-dress so didn't have to lift too much dress to access the pump.
> 
> I have read some women storing their pump in their bra. No idea how they discretely access it in public.


Thanks Helli

I think your idea of a thigh belt is likely to be a lot more discreet than getting the pump out of my bra.  I have seen the hidin belts and fancy weaving some stretchy fabric to make my own.
That will work better for parties and for concerts, where dresses are a bit less floaty.

I was surprised how many normal dresses that I have do have pockets.  So a small buttonhole behind each pocket will work well.


----------



## Maco

@SB2015 How are you getting on since restarting?


----------



## trophywench

helli said:


> @SB2015 when I had my old tubey pump and wore a dress, I would put it in a pump belt wrapped twice around my upper thigh. I was pretty good at surreptitiously getting the pump out under the table in a restaurant without exposing too much thigh.
> I never tried it with a maxi-dress so didn't have to lift too much dress to access the pump.
> 
> I have read some women storing their pump in their bra. No idea how they discretely access it in public.


I'd need a bra with 3 cups to do that!


----------



## trophywench

Oooh - and make the button hole IN the pockets and pass the tubing through that to attach pump to cannula.


----------



## helli

trophywench said:


> I'd need a bra with 3 cups to do that!


Is the idea that everyone will be so distracted by your three cups that they won't notice you fishing a pump out of one?


----------



## SB2015

Maco said:


> @SB2015 How are you getting on since restarting?


Much happier this time @Maco.  Still some wobbles with basal rates but I feel in enough control to sort these, and no longer have an infection to deal with.

I am glad that I put the time in when back on my old pump, to note what I was doing automatically on that and make sure that I knew how to do it on the 780.  There are some things I will miss, but hopefully some of the things I am used to will become unnecessary once I am in auto mode.  I am happy enough to keep going.

I shan’t bother with the Guide Link Meter.  I find that their pots of strips, which now avoid spills of strips by having a grip on them, are too fiddly for me to get strips out.  Also whilst it is paired with the pump and sends your BG over to the pump, you then have to access the pump and confirm it within 12 minutes.  Not a difficulty but I plan to just use my old test kit with bigger strips.

I shall give it another week before I order my starter kit of sensors.


----------



## SB2015

trophywench said:


> Oooh - and make the button hole IN the pockets and pass the tubing through that to attach pump to cannula.


Exactly my plan.  The hole will be hidden and only needs to be big enough for the end of the tubing.  Some pockets cover part of the seam so that will be even easier, just a slit and reinforce around, again in the pocket.


----------



## Maco

SB2015 said:


> Much happier this time @Maco.  Still some wobbles with basal rates but I feel in enough control to sort these, and no longer have an infection to deal with.
> 
> I am glad that I put the time in when back on my old pump, to note what I was doing automatically on that and make sure that I knew how to do it on the 780.  There are some things I will miss, but hopefully some of the things I am used to will become unnecessary once I am in auto mode.  I am happy enough to keep going.
> 
> I shan’t bother with the Guide Link Meter.  I find that their pots of strips, which now avoid spills of strips by having a grip on them, are too fiddly for me to get strips out.  Also whilst it is paired with the pump and sends your BG over to the pump, you then have to access the pump and confirm it within 12 minutes.  Not a difficulty but I plan to just use my old test kit with bigger strips.
> 
> I shall give it another week before I order my starter kit of sensors.



Pleased your having better results, I start training at 2pm tomorrow. Can’t wait to get started if I’m honest.

Can’t remember if I asked, but what was the reason your CCG declined funding for the CGM? It seems ridiculous that they would happily fund you a pump but refuse to give you the CGM that is absolutely vital for you to be able to get the most from the 780. Seems utterly pointless from them to be handing out 780G’s.


----------



## SB2015

It is twice the cost of funding for the Libre, which I do get on the NHS.
When I self funded the Libre at the start I never dreamt that I would get those funded.  
Who knows what will happen in the future.  

There is always a difficulty as the CCGs are interested in short term savings.  
The CGM will save long term as it improves our control and can help to avoid complications.
I suspect that funding will take time.


----------



## everydayupsanddowns

Maco said:


> Can’t remember if I asked, but what was the reason your CCG declined funding for the CGM? It seems ridiculous that they would happily fund you a pump but refuse to give you the CGM that is absolutely vital for you to be able to get the most from the 780. Seems utterly pointless from them to be handing out 780G’s.



CGM funding on the NHS is still very rare, and it’s not routinely recommended by NICE. Some clinics seem to have more success than others, but certainly my area’s CCG funds next to no adults for full time CGM, such that I have been told (every time I have asked) that it is not worth making the Individual Funding Request.

Until CGM gets a positive Technology Appraisal from NICE I suspect access will remain patchy.









						Can I get a continuous glucose monitor (CGM) on the NHS? - JDRF, the type 1 diabetes charity
					

Information on clinical guidelines and current NHS funding for advanced glucose monitoring technologies for people with type 1 diabetes.




					jdrf.org.uk


----------



## Maco

everydayupsanddowns said:


> CGM funding on the NHS is still very rare, and it’s not routinely recommended by NICE. Some clinics seem to have more success than others, but certainly my area’s CCG funds next to no adults for full time CGM, such that I have been told (every time I have asked) that it is not worth making the Individual Funding Request.
> 
> Until CGM gets a positive Technology Appraisal from NICE I suspect access will remain patchy.
> 
> 
> 
> 
> 
> 
> 
> 
> 
> Can I get a continuous glucose monitor (CGM) on the NHS? - JDRF, the type 1 diabetes charity
> 
> 
> Information on clinical guidelines and current NHS funding for advanced glucose monitoring technologies for people with type 1 diabetes.
> 
> 
> 
> 
> jdrf.org.uk



Ive been terribly lucky, County Durham & Darlington have always been brilliant when it comes to CGM. From what I can remember they where one of the first areas to have trials on the Libre. When I enquired about going back onto pump therapy I didn’t expect them to fund the guardian alongside the 780G.

Shame all areas don’t sing from the same hymn book.


----------



## everydayupsanddowns

Maco said:


> Ive been terribly lucky, County Durham & Darlington have always been brilliant when it comes to CGM. From what I can remember they where one of the first areas to have trials on the Libre. When I enquired about going back onto pump therapy I didn’t expect them to fund the guardian alongside the 780G.
> 
> Shame all areas don’t sing from the same hymn book.



I think everyone will get there eventually. But some are just dragging their heels!


----------



## Maco

@SB2015, how are you getting on? I’ve just finished my second training session today & ive gone into automode. I’m honestly finding this pump absolutely brilliant, I’m 85% in range at the minute with an averagereading of  7.4mmol.


----------



## SB2015

I have my next training session on Tuesday.  This is just to review how I have settled in after the restart in manual made.  I am in no rush, although having had a couple of hypos today (normal for me) I realise that the auto mode will no doubt deal with thany se a lot better than I do and head them off. On Tuesday we will plan the switch to auto mode, although there is now a delay in getting sensors, as well as cannulas through the ports.  It is ‘likely to be resolved soon’.  Not being someone to worry (Ha ha!!) this has sent me into a bit of a flap.  The government have assured us that Insulin will available but I am not sure that they have though about the cannulas that we need to deliver this. DUK have been great and are following this up.

I am very pleased that it is working well for you.  I am currently on TIR of 90% in manual.  The auto system will need to match that or nearly.  Even if not if it reduces the number of hypos I have that will be great.  (Only three today!!!!)


----------



## Maco

I’ve had quite a few hypos since moving back to the pump, that’s why my in range % is slightly lower than I’d like. What I have noticed is the “suspend before low” works a absolute treat. Usually when I drop to around 5.4mmol it’ll suspend, what I’ve been doing is having a little sip of orange juice when it suspends me & it’s usually enough to edge me back up to 6mmol and the pump will start doing it’s work again.

In regards to supplies, this is something that’s really annoying me. Last Thursday my trainer told me they have distribution centres dotted all around the UK, my nearest being 60/70miles away in Leeds. So we really shouldn’t have any issues with supplies at all.

Also, I’ve had it confirmed the new CGM ‘Zeus’ will be released in around a year. My trainer told me today that when my warranty is up on my transmitter I’ll be receiving the Zeus so hopefully not long to wait for people.


----------



## Maco

@SB2015 How are you doing on the 780G these days? Did you ever go ahead with purchasing the CGM? At first everything went great for me but slowly but surely I’m starting to agree with all the negative comments I saw before starting the pump. I’m seriously thinking about running manual mode 24/7 & knocking the CGM on the head to be honest. 4 days ago I had 6 sensors fail the same day, all while in the warm up period. I just kept getting a ‘change sensor, problem with sensor’ alarm. As I’m writing this I’m now getting ‘sensor updating’ & it looks like this one is going to now fail as well.

I’m just getting the point where I can’t be bothered with the hassle of needing to change sensors every couple of days when they fail + I’m doing a BG test more than ever because I’m losing trust in the SG reading. Seems like it would just be easier to run the pump without the CGM and check my BG reading between and after meals.

I’m also not a fan of the automode auto correction, if you miscalculated carbs it’s brilliant and does bring you back into range after a couple hours. The problem I’m having with it is during gym sessions, luckily I’ve got keys to a gym so I’m still training and my sugars are spiking massively during my session and automode isn’t even attempting to do anything about it. I started my gym session today at 8.0 and 1hr after I finished I was upto 16.6. When I had all the troubles the other day with sensors failing I had to go into manual mode for half the day and my readings where pretty perfect. My basal rate most of been set correctly & my carb ratios are bang on too so I was in range all the time I was in manual mode.

Unfortunately I’m running very thin on trust for Guardian at the minute & the mega spikes during gym sessions is really running me down. With me training 6 days a week I’m having these spikes daily so it’s not fun.


----------



## everydayupsanddowns

Maco said:


> I just kept getting a ‘change sensor, problem with sensor’ alarm. As I’m writing this I’m now getting ‘sensor updating’ & it looks like this one is going to now fail as well.



Wow! that’s really unusual. Have you been speaking to Medtronic about this, because that really can’t be right!

I used Enlites and then G3 sensors for 4-5 years off and on, and restarted each sensor to run for 10-14 days without getting those errors. The only times I had issues like you describe was where the ‘filament’ got pulled back into the body of the sensor during insertion. That was only twice, and Medtronic replaced the sensor both times.

Have you got a different inserter you can try? Have you asked about trying a different transmitter?


----------



## Maco

everydayupsanddowns said:


> Wow! that’s really unusual. Have you been speaking to Medtronic about this, because that really can’t be right!
> 
> I used Enlites and then G3 sensors for 4-5 years off and on, and restarted each sensor to run for 10-14 days without getting those errors. The only times I had issues like you describe was where the ‘filament’ got pulled back into the body of the sensor during insertion. That was only twice, and Medtronic replaced the sensor both times.
> 
> Have you got a different inserter you can try? Have you asked about trying a different transmitter?



Hi bud, since posting this I managed to get a sensor working last Thursday at the 7th attempt. Then on Sunday i got ‘sensor updating’ which eventually corrected itself. I then got the sensor updating message again on Tuesday & 2hrs later the sensor failed. I decided to remove the oval tape, remove the transmitter and I stuck it on charge for 20 minutes. I then refitted the transmitter to the “failed” sensor and would you believe it, it came straight back to life and gave perfectly accurate results with my BG!! So from that little test I’m guessing it’s definitely the transmitter as the so called failed sensor was clearly still working.

I’ve actually been up all night again with “sensor updating” “sensor updating wait upto 3hrs” & then again “change sensor, problem with sensor”.

During all of these problems I’ve spoke to Medtronic all the way through, last Thursday they asked me to charge the transmitter fully & fit a 7th sensor. If it didn’t work they would send a new transmitter, typically that 7th did work until the last few days where I’ve had the same problems. Anyway, rang Medtronic again yesterday and luckily spoke to the same lady who dealt with me last week & she’s sent a new transmitter which supposedly will be here today.


----------



## everydayupsanddowns

That’s good to hear. I really hope the new transmitter works well for you. These systems are amazing when they work, but very quickly tech issues and glitches can make you want to lob them out of the window!

I suspect it will take a while for you to come around to the sensors again after this introduction, but I really hope the new transmitter sorts the problem, and that you can start over with them.


----------



## Maco

It really is an amazing system, that’s why I’m desperate to sort out any issues. Smart guard is incredible when the sensors are working.


----------



## Paulbreen

I got the dreaded sensor updating message yesterday, after 4-5 hours it eventually started, sensor has 2 more days to go but this morning the sensor died, said sensor expired, not sure why but I can say this is the first time I've seen that, my biggest gripe is sensor change over day, normally it is taking more than 6 hours to complete it and get back into auto mode, the biggest bugbear is the "active insulin updating" this has no end even when there is no active insulin.


----------



## Phil65

Paulbreen said:


> I got the dreaded sensor updating message yesterday, after 4-5 hours it eventually started, sensor has 2 more days to go but this morning the sensor died, said sensor expired, not sure why but I can say this is the first time I've seen that, my biggest gripe is sensor change over day, normally it is taking more than 6 hours to complete it and get back into auto mode, the biggest bugbear is the "active insulin updating" this has no end even when there is no active insulin.


I really dislike the sensor updating message, do you ensure your ISIG is in range, no? Nor do I but that is often the reason why this message occurs!
Also, why does your sensor changeover take 6 hours? I don’t understand that, mine always takes a maximum of 2 1/2 hours, 30 mins for the transmitter to charge (I charge it on sensor changeover day every 7 days) and 2 hours for the sensor to be back in Auto mode.


----------



## Maco

Phil, what is ISIG? Also I’d have to agree with Phil there my sensor change over time is no longer than 2.5hrs at the most. Like Phil it’s a quick transmitter charge & then a 2hr warm up. I’ve even heard of people from America fitting a sensor the night before to speed the warm up process up.


----------



## Phil65

Maco said:


> Phil, what is ISIG? Also I’d have to agree with Phil there my sensor change over time is no longer than 2.5hrs at the most. Like Phil it’s a quick transmitter charge & then a 2hr warm up. I’ve even heard of people from America fitting a sensor the night before to speed the warm up process up.


Hi Maco,
ISIG is Interstitial Signal, an electrical reading that is proportional to BG. In other words you should Calibrate when you are in normal range, say, between 4 and 9, anything outside that sort of range could lead to inaccurate readings. Look at calibrating if you have had a reasonably flat profile for the previous 30 mins. Do not cal soon after eating or eat straight after a cal, as the CGM is counting on your BG remaining stable for 15 minutes.


----------



## SB2015

Back on track after a bit of a break!!!

I have finally managed to get all my stuff including sensors, transmitter, as well as cannulas.  For me if something could go wrong it did, whether it was ordering, delivery, ....  However this was unfortunate timing with Brexit, Covid, Christmas, infection, ....  I remembered (too late) how pleased I was that my pump change over was not due until after B....t.  However when the opportunity came for the 780 I forgot and got hit by everything.

I have now been in manual mode for a month, and I have my training for going over to sensors at the end of this week.  I am making a note of the positive things about this pump, such as slower delivery, reminders when I have  forgotten to do the final press for a Bolus.  Apart from those it basically works in manual mode much the same as any other.  I have made adaptations to clothes to enable easy access to the pump, but management from the handset will still be top of my list for next choice of pump

Looking forward to next phase and seeing the impact of the alarms when using a sensor in manual mode,  and then the benefits of transferring to Smart Guard, auto corrections.


----------



## Maco

SB2015 said:


> Back on track after a bit of a break!!!
> 
> I have finally managed to get all my stuff including sensors, transmitter, as well as cannulas.  For me if something could go wrong it did, whether it was ordering, delivery, ....  However this was unfortunate timing with Brexit, Covid, Christmas, infection, ....  I remembered (too late) how pleased I was that my pump change over was not due until after B....t.  However when the opportunity came for the 780 I forgot and got hit by everything.
> 
> I have now been in manual mode for a month, and I have my training for going over to sensors at the end of this week.  I am making a note of the positive things about this pump, such as slower delivery, reminders when I have  forgotten to do the final press for a Bolus.  Apart from those it basically works in manual mode much the same as any other.  I have made adaptations to clothes to enable easy access to the pump, but management from the handset will still be top of my list for next choice of pump
> 
> Looking forward to next phase and seeing the impact of the alarms when using a sensor in manual mode,  and then the benefits of transferring to Smart Guard, auto corrections.



Im sure you'll love automode, I had quite a few sensor issues but in all honesty now I've sorted the problems its the best piece of diabetic tech ive used. Automode is absolutely fantastic, Especially when you have a naughty cheat meal like I do every Saturday. Usually id spike into the high teens and wake up the next morning at 17/18mmol. With automode I still might spike to 14ish but the next morning ill be back into range at around 6-7mmol. Ive never been out of range throughout the night as of yet, automode is that good. 

Before the 780g my a1c was 83, with Carelink my predicted is 48.7.


----------



## everydayupsanddowns

Thanks for the update @SB2015 

Sounds like you are finding your feet with it, and pleased to hear you’ve been able to make some clothing adaptations as I know that was a big change for you. You are coping really well with it this time around, and had the courage to take a break when you needed to, so give yourself a pat on the back.

I really hope the sensors and automode work brilliantly for you - if they work as well for you as Smartguard did for me, I think you’ll find it really hard to go back to a non-hybrid-closed-loop option the next time around - Just hope there’s one with a handset by then!


----------



## SB2015

everydayupsanddowns said:


> Thanks for the update @SB2015
> 
> Sounds like you are finding your feet with it, and pleased to hear you’ve been able to make some clothing adaptations as I know that was a big change for you. You are coping really well with it this time around, and had the courage to take a break when you needed to, so give yourself a pat on the back.
> 
> I really hope the sensors and automode work brilliantly for you - if they work as well for you as Smartguard did for me, I think you’ll find it really hard to go back to a non-hybrid-closed-loop option the next time around - Just hope there’s one with a handset by then!


Thanks Mike

The next steps will be interesting, and with lockdown I have more time and more consistency with both carbintake and levels of activity, which will help me to get used to things. 

One thing I had wondered about was why there is no concern about having the pump orientated with the tubing down so that bubble rise away from the delivery point.  No need.  The fill system is excellent, much easier and I just don’t get any bubbles at all.  I also like the fact that you cannot forget to prime the cannula. 

Another bonus with this pump is the alarm when I forget to do the final stage of a Bolus.  No more spotting a rapid rise after a meal way beyond what I expect, and then spotting that I had not delivered the Bolus.  On this I get an alarm.  It also reminds me to change my cannula if I forget, shows me how much insulin is left, shows the battery life left, ... All things that probably seem normal to Medtronic users.  

Pros and cons for all the different makes of pumps, which you don’t realise until you are actually using a different one.


----------



## SB2015

I started on the CGM on Friday afternoon, still in manual mode for now.

The sensor needed a calibration after 2 hours, 6 hours after that and then another 6 hours after that.  It didn’t take much working out to realise it was going to be a disturbed night. 
*Lesson 1 Put new sensor in in the morning so calibrations are all done before bed.*

I set up a suspend before low.  It seemed good to know if I was heading to a hypo rather than wait for it to arrive.  However my levels are usually around 5 overnight.  This dropped me into the suspend zone, so I had alerts throughout the night and was too sleepy to work out what to change.
*Lesson 2 Stick to suspend on low, and just look at the screen to see what is happening.*
This  will be sorted anyway once I go into auto mode but I shall check about alerts at the next training session.

Once the alerts were sorted, yesterday went smoothly and back to TIR in the 80s.  It is a lot easier having the display on my phone with all the info there including active insulin, etc and not having to swipe to check.

One thing that surprised me was when we were told that the CGM readings were not valid for pre driving checks.  This seems to contradict the statements from 2019 when Libre became a valid check.  What I have read seems to suggest that any flash and CGM is okay for driving.  
*Has anyone else’s been told this? Can anyone clarify?*


----------



## Maco

SB2015 said:


> I started on the CGM on Friday afternoon, still in manual mode for now.
> 
> The sensor needed a calibration after 2 hours, 6 hours after that and then another 6 hours after that.  It didn’t take much working out to realise it was going to be a disturbed night.
> *Lesson 1 Put new sensor in in the morning so calibrations are all done before bed.*
> 
> I set up a suspend before low.  It seemed good to know if I was heading to a hypo rather than wait for it to arrive.  However my levels are usually around 5 overnight.  This dropped me into the suspend zone, so I had alerts throughout the night and was too sleepy to work out what to change.
> *Lesson 2 Stick to suspend on low, and just look at the screen to see what is happening.*
> This  will be sorted anyway once I go into auto mode but I shall check about alerts at the next training session.
> 
> Once the alerts were sorted, yesterday went smoothly and back to TIR in the 80s.  It is a lot easier having the display on my phone with all the info there including active insulin, etc and not having to swipe to check.
> 
> One thing that surprised me was when we were told that the CGM readings were not valid for pre driving checks.  This seems to contradict the statements from 2019 when Libre became a valid check.  What I have read seems to suggest that any flash and CGM is okay for driving.
> *Has anyone else’s been told this? Can anyone clarify?*




On lesson 1, Your first two calibrations are always 6hrs apart so yeah its always a good idea to start a sensor on a morning. You dont need to stick to the calibration times though, if say your 5hrs away from the pump asking for a calibration but your heading to bed then just do a calibration. Thats what I've done a few times & it always works fine. After the 6hr period I calibrate first thing on a morning, with my lunch & then before bed. 

On lesson 2, Personally I didn't like the suspend before low setting or alarms. If I remember correctly Medtronic told me it usually kicks in between 5.4-6.3mmol or something along them lines. I didn't see the point in having tight control & getting my reading down to the 5mmol mark for the pump to suspend. Fortunately like you've already said once your in automode the suspend before low feature is turned off & the pump will just shut off insulin as & when needed. 

On the driving, I just presumed you could use the CGM to drive like you could with libre. Wasn't told otherwise from Medtronic's training team or the hospital so personally ive never done a blood test to drive in over a month unless I felt high/low. 



What I will say is don't always rely on automode to fix a big high. Yesterday for example me and my partner decided to try out a new very traditional Chinese restaurant that was doing take-aways. I knew the sauce was doing to be stacked with sugars & it was impossible to count the carbs so I just did a bolus for a large amount of carbs. My though was id rather start to go low & I would easily correct it instead of being sky high. The complete opposite happened & within 30minutes of eating I rocketed to over 16Mmol. I tried to ride it out for a few hours but from what I could see on my graph automode wasn't giving me any auto corrections so eventually I went & grabbed my pen and injected. Checked my readings around 2am & I was back in range, from there I thought the pumps automode would take back over but unfortunately an hour later I started to rise sharply again so once again had to grab my pen.  

Not completely blaming the pump because I know the food was absolutely stacked with carbs, but its definitely not as easy as Medtronic make it out to be. I remember the trainer saying, if you miscalculate for a takeaway auto mode will happily correct for you. No chance was this happening last night


----------



## SB2015

I am now on Day 2 of the automode Smart Guard. 

It coped well with a meal that I would normally have done a multiwave Bolus, eaten later than usual (It was another Big1 gathering last night) as well as a short walk afterwards.  I slept through with just one loo visit and staid level all night.  I woke on my target value of 5.5 and was already on 85% time in range.  A good start.

Today I tried a longer walk using the temporary target.  I made it home just before I went hypo, so that will need a bit of adjustment perhaps around the timing of setting up the temp target. 
I then hypoed again this evening during a Pilates class before dinner.  Another puzzle.

At present the basal pattern is using is based on the two weeks before I starter Smart Guard.  During that time I had has kidney stones and my vaccination to which I reacted a bit.  I think it is a bit confused at present so need to allow it time to settle into my normal patterns.

I look forward to my settling into this, and apartment from exercise I have been very happy with the levels.  So often I look and I am 5.5! With no effort on my part.  Any ideas welcome @Maco and any others using this pump.


----------



## Maco

Hi @SB2015, pleased to hear your settling into automode. I’m currently 94% in target range over the last 7 days, this pump really does work wonders. Where I use to struggle to be in range, I now struggle to be out of range!

As for exercise, set your temp target 2hrs before you start then take into account the time you’ll be exercising then add another 2hrs post exercise. So if your going to exercise for say 1hr then set your temp target for 5hrs and start it 2hrs before you plan to exercise. Starting it 2hrs early let’s the pump adjust & start to back off your basal.

All that being said I still regularly run very close to hypo territory when I go walking/running/crosstrainer etc etc. Think the main problem is the pump keeps you in such a tight range that you might be starting exercise at 5/6mmol so you haven’t got much to play with. I usually keep some glucose tablets or fresh orange with me & soon as I see a drop off I’ll eat or drink.


----------



## SB2015

Thanks @Maco .  

I am off for another walk this afternoon so will try setting the temp target before lunch.  It is a case of finding tweaks for this pump as I did with my previous one.  Lovely overnight flat lines, and 94% TIR so as you say it does work hard for us.

I got woken up early (for me) this morning asking for a BG, in spite of a calibration at 23:00.  There was a bit of a break in the SG values, and I wondered whether it could have been that I had been lying on the sensor.  Have you had this?    I had planned a lie in, but the sun was out so decided I might as well get going now that Humphrey had woken me up.


----------



## JohnWhi

Joining in here as I started with 780G and sensor this morning. Guided by Medtronic rep and the nurse who set me up with the 640G just over four years ago. Struggling as three calibration attempts were "not accepted" and the "change sensor" alert came up. Telephoned Medtronic and a first person told me that I should only attempt calibration if I knew that BS was stable. (The Freestyle Libre suggested a sharp rise after a meal, though I did not know this at the time of calibration.) At that point the line dropped and I had to phone back. The second person suggested I needed to check that the sensor had not come adrift. It had come unstuck. She expressed astonishment that I had not been told to use an alcohol swab to clean the site beforehand, and to avoid anywhere that might have come into contact with soap. (!!!) Also to ensure that any body hair had been shaved away. (I certainly do that when applying infusion sets, but the Diabetes Centre seminar room didn't have facilities at hand!) Both under the instructions of the Medtronic rep and having watched the videos on applying the sensor, I am less than confident on the exact positioning of the oval tapes, and exactly how the pieces of paper are supposed to move as one pulls them away. Somebody here may be able to offer suggestions ...


----------



## SB2015

Welcome to the forum @JohnWhi  sorry to hear that you had problems with your first sensor, especially if you are self funding!! 

To address the issue of alcohol wipes, I was advised at my training that that was included for the USA training but not recommended over here.  They do clean the site but they also harden the skin and we don’t need that to happen.  Just shower before applying the sensor.

Having had your sensor go adrift I was told to contact the Product Support team (but stick to between 9:00 am and 5:00 pm to get the UK team (unless it is an emergency) and if there is a problem they will replace the sensor if you have done as instructed around the site of insertion.  I have found all the team to be absolutely brilliant on the phone.

For applying the sensor, I used the videos and on the advice of another user, stopped and started it as necessary as I did each stage.  That was a brilliant bit of advice.  I did my second one with the video again, and realised that the tapes exact position is not so critical but understanding what each of the tapes is trying to do has helped.  On my first one I mucked it up totally and just stuck a tegaderm over the whole thing which worked.  I unfortunately had to abandon my first one after three days as I ended up needing a CT scan!!  A costly scan as a self funder. 

In an ideal world we would calibrate when our BG is stable, BUt the world doesn’t behave like that does it.  On the 780, unlike the earlier ones every BG you give it is used as a calibration.  I don’t use the Guide Link meter (too fiddly for me with arthritic hands)  but I manually enter BG before each meal.   Only once I was on a steep decline but it seemed to cope.

I am only on the third day of SG and I am amazed at how I just sit around 5.4 or 5.5 most of the day and throughout the night without any effort from me.  I just do my beat before meals, applying the same timings for my pre Bolus as before, and the pump sorts out the rest.  

The only bit I am still working on is exercise.  I gardened in the spring sunshine this morning and managed to hypo, and did my walk this afternoon in manual mode so that I could use Temporary basal rates and top ups of glucose without getting the pump out.  

Keep in touch and let us know how you get on and we can all help each other.  It is such a new pump so great to be in touch with others using it.


----------



## SB2015

Ps
I contacted Product Support about the interruption.  Again impressed by their ability to look at my data, suggest explanations but also their wanting to check out other things and get back to me which they will do tomorrow.  They have been amazing.


----------



## JohnWhi

Many thanks for that @SB2015 . I started a new sensor this morning, pausing the video at each stage and reading the written instructions. Looked a bit different from the first attempt with the Medtronic trainer. It accepted calibration, and is now giving readings. Pulling the backing paper from underneath the oval rings is difficult. I am told everything may be easier when we have the new-style sensors in a few months.


----------



## Maco

JohnWhi said:


> Many thanks for that @SB2015 . I started a new sensor this morning, pausing the video at each stage and reading the written instructions. Looked a bit different from the first attempt with the Medtronic trainer. It accepted calibration, and is now giving readings. Pulling the backing paper from underneath the oval rings is difficult. I am told everything may be easier when we have the new-style sensors in a few months.



Hi John, where are you inserting the sensor? I know this may sound daft, but try to pick a very fatty area. I used the back of my arm when I first started & had 7 sensors do what yours has done in the same day. I also couldn’t get away with the from of my stomach, these days the only place I have success is on my love handle area towards my back. Anywhere else my sensor fails before the 2hr start up has even completed.

As SB has also said, try to Calibrate when you are stable. Don’t calibrate just before or after a meal either just incase your bloods rapidly raise or fall because it may lead to a sensor failure. Once you get the hand of things you’ll absolutely love it!


----------



## Maco

Hi @SB2015, my sensors have usually been pretty good with keeping to the 12hr calibration. Think I’ve been woken up once since I started. As for lying on the sensor, I place mine on my love handle area & usually sleep on my right side so I try to place it on my left as much as possible. Not always available because of sensor rotation but I try to do that as much as possible. But to answer your question No I’ve never had an issue with lying on a sensor as of yet.


----------



## JohnWhi

Maco said:


> Hi John, where are you inserting the sensor? I know this may sound daft, but try to pick a very fatty area. I used the back of my arm when I first started & had 7 sensors do what yours has done in the same day. I also couldn’t get away with the from of my stomach, these days the only place I have success is on my love handle area towards my back. Anywhere else my sensor fails before the 2hr start up has even completed.
> 
> As SB has also said, try to Calibrate when you are stable. Don’t calibrate just before or after a meal either just incase your bloods rapidly raise or fall because it may lead to a sensor failure. Once you get the hand of things you’ll absolutely love it!


Thanks Maco. Left of abdomen, similar to the picture in the instructions. I gather from Medtronic that I should have simply ignored the calibration alert, but the BS test for initial calibration was the first indication that things were not stable. (Nothing of the kind  shown on Freestyle Libre.) Useful advice to avoid automatic entry of a BS test before a meal as all entries serve for calibration.


----------



## Maco

JohnWhi said:


> Thanks Maco. Left of abdomen, similar to the picture in the instructions. I gather from Medtronic that I should have simply ignored the calibration alert, but the BS test for initial calibration was the first indication that things were not stable. (Nothing of the kind  shown on Freestyle Libre.) Useful advice to avoid automatic entry of a BS test before a meal as all entries serve for calibration.



Once your in automode you won’t need to accept every BS as a calibration, it’ll give you a “YES/NO” option. Comes in handy if there’s a big difference between SG & BG results


----------



## SB2015

Thanks @Maco 

Check in the night
When I checked with Product Support about my interruption whilst my line was absolutely flat, they suggested that it could have just been that the line was so flat it needed confirmation that this was okay!  It hasn’t happened again.

Exercise
I have opted for switching back into manual mode for now.  My walks are more spontaneous rather than planned a few hours ahead.  It is so easy to switch into manual and it means I can trickle in carbs as necessary without accessing the pump to keep it informed.  It is as I did before but with the bonus of the alerts when going low and ease of viewing my graph on the phone.  
I had initially thought that I ‘ought to be able to do this in auto mode’. But my pump is just my tool to manage levels in the way that best suits me.

Still lots to learn and try out.


----------



## SB2015

Sensor accuracy

Have either of you noticed increased gaps between SG and BG as the sensor comes to its end. 
My current one (which is only my second, so not exactly a pattern!!) was very stable at the start, but yesterday it was reading about 2 below BG when I was low.  It is changeover day tomorrow.

I know it is measuring different things so expect a time lag, which would be more evident if my BG was on the move.  This happened overnight, so it switched off basal for a bit.  Last night was gentle hills rather than flat.


----------



## Maco

SB2015 said:


> Sensor accuracy
> 
> Have either of you noticed increased gaps between SG and BG as the sensor comes to its end.
> My current one (which is only my second, so not exactly a pattern!!) was very stable at the start, but yesterday it was reading about 2 below BG when I was low.  It is changeover day tomorrow.
> 
> I know it is measuring different things so expect a time lag, which would be more evident if my BG was on the move.  This happened overnight, so it switched off basal for a bit.  Last night was gentle hills rather than flat.



Haven’t found much difference between SG & BG as of yet, normally within 1-2mmol which is pretty good given they are reading different things & the SG is around 15 minutes behind I think. I quite regularly get matching SG & BG readings which would never happen with Libre.. 

If I’m honest I just leave the pump to it’s own devices, I never come out of automode for exercise or if I think there’s something going on that isn’t perfectly right. My Medtronic trainer advised that the Medtronic geniuses believe coming in and out of automode, giving fake carb boluses etc etc can mess with the algorithm. The only time I ever go against the pump these days is if I go really high then I just disconnect for half an hour, take a bolus injection and normally go for a quick walk.


----------



## Maco

@SB2015 Little bit in interesting information I’ve just found it & something i definitely wasn’t told by Medtronic Uk. In the Netherlands the Medtronic trainers are telling new users that any high carb foods that starts with ‘P’ such as pizza & pasta to only bolus for 70% of the carbs. You then autocorrect give correction bolus for the remaining 30%.

I’m going to give it a go this weekend, when I eat high carbs for a cheat meal on a Saturday evening I usually always go hypo then gradually go high through the night because of the way the fats and carbs are released from things like pizza. Giving the 70% upfront should stop the hypo but not sure I trust automode for the other 30% but ill try it.


----------



## everydayupsanddowns

That wasnt my experience over my years of using Enlites, and later G3s @SB2015 

I restarted all of mine, and as long as I kept them well calibrated, they mostly gave me solid data for 10-14 days.

G3s were a little more twitchy on the calibration front for me unfortunately, and on reflection I think Enlites probably suited my body chemistry better.

 But I didn’t notice any fall-off in accuracy at 6-7 days


----------



## SB2015

I have had another sensor that is going bonkers.  
This afternoon after lunch, with known carbs which I bolused for, it just rose and rose.
I didn’t notice until I did a peek at it after a bit of a busy afternoon by which time I was up in the 14s.  The Medtronic tech wizards had a look at my readings and could see that the pump was cutting out after any blous and they didn’t know why.  Possibly sensor or could be transmitter.  Another replacement sensor on its  way and if necessary a new transmitter.

I am not enjoying this.  It is certainly not leaving me thinking less about my Diabetes.  It is causing more stress and I am spending so much time asking for help.  I am very very close to giving up on this.  I have spent this evening in tears as I just don’t know what to do!!!  My TIR is no better than when I managed it myself.  I am thinking that the Libre 2 with a Combo is looking like a very good option, although I know I have not kept up to date with any experience with that.  I am not sure how long to stick with this system.


----------



## SB2015

Ps I am doing regular calibrations, wearing the sensor correctly, ....
I have gone through this so many times on calls to Medtronic.


----------



## Maco

SB2015 said:


> Ps I am doing regular calibrations, wearing the sensor correctly, ....
> I have gone through this so many times on calls to Medtronic.



Where abouts are you fitting the sensor? The day I had 7 fail the same day I was on the phone constantly. Just like you fitting/wearing the sensor correctly, by the end of the day Medtronic didn’t have a clue what the problem was. Eventually they just ended up giving me a new transmitter. I switched from the back of the arm to the love handle area towards my back & since then I haven’t had any issues (touch wood).

I feel for you because it’s soo frustrating, especially when you feel you’ve done everything correctly. I still have days where I eat exactly the same food & take exactly the same amount of insulin but I spike massively. Straight away I second guess the pump, change infusion sets etc & grab my Pen. To be honest I’m having a couple crappy days, TIR is still in the 90’s but for some reason I’m fighting against hypos then random raises to around 10-11.


----------



## Maco

@SB2015 Out of curiosity, did your BG match your SG? If so, why have Medtronic replaced the sensor?


----------



## Paulbreen

Hey @SB2015 I’m sorry to hear of your struggles after so much effort. I got to the same point as you and gave up on the 680G, what it did was great but it was just needing too much attention to keep it working, I’m back on the libre2 and injections again TIR is down to 65% but I’m treating myself on my own terms now


----------



## SB2015

Thank you both for your support.

I have put Humphrey on a final warning!!!
@Paulbreen were you still mid contract with the sensor package.
What happened about that when you stopped it.


----------



## SB2015

Maco said:


> @SB2015 Out of curiosity, did your BG match your SG? If so, why have Medtronic replaced the sensor?


BG and SG matched within a reasonable variation.  There were interruptions throughout yesterday.
I have put yet another sensor in and we will see what happens.  If this doesn’t work they will try replacing the transmitter.  I guess it is cheaper than replacing the transmitter.

My sensor is in the ‘spare’ bits at the bottom of the top of my arm, where I used to put my Libre without any issues.  My pump is on the same side of my body, and they should have no issues talking to each other. However if it continues to need me to sort out any arguments they are having, I shall send them both away with a flea in their ears, and plead for a Combo.  A good reliable workhorse that ‘does what it say in the tin’. (That probably shows my age - Ronseal advert)


----------



## Paulbreen

Hi @SB2015 
I had funded the 680G pump and CGM through my health insurer, I think it works a little differently here in Germany than the UK. I just told them it wasn't working out for me and I sent it back to Meditronic. 
I'm going to see what come into the market in the next 12 months or so before i dip my toes into the pump world, I had 2 great meetings with YPSO mylife and Tandem Tslim reps in the last month and both were telling me about the new features coming online this year from both of them so I'm waiting to see what arises, I've had diabetes long enough to have heard too many "the next big thing" promises to be taken in but both were promising almost closed loop systems and they are both working with Dexcom G6 which I like because of the lack of calibrations required for those sensors.


SB2015 said:


> Thank you both for your support.
> 
> I have put Humphrey on a final warning!!!
> @Paulbreen were you still mid contract with the sensor package.
> What happened about that when you stopped it.


----------



## Maco

So SG & BG where within good enough range, so quite possibly not a sensor issue & im guessing the sensor didn’t fail? Did Medtronic run through all of the transmitter tests with you?

What was your main issue, that your bloods where raising & the pump didn’t jump in with auto corrections? Sorry if I sound daft I’m just struggling to find out what the main issue was/is.

Personally I don’t think the auto correction features works very well at all & it’s actually something that I don’t rely on. If I see arrows shooting up especially if I see 2/3 arrows and I’m already above around 10 then I’ll just bolus with fake carbs. The most I’ve ever seen auto correction bolus is for half a unit, when your raising rapidly I don’t really see the point that small of a correction. Half a unit would only be expected to bring my readings down at the very most 1mmol.

Like you said earlier, it’s fantastic when your asleep and it keeps you in range all night but you’ve probably done all the hard work yourself to make sure your going to bed with a reasonable BG. Making the pumps life a lot easier just maintaining it with micro basal throughout the night.

It’s a cracking system that works well, but you certainly need to put just as much effort in as any other pump. I weigh out every meal so I can count the carbs exactly, I make sure I bolus at least 10-20 minutes before a meal. I eat a relatively low amount of carbs all week so that I’m not taking large amounts of insulin. I certainly haven’t gone onto the 780G and forgot about being diabetic, roughly guessing at carbs or eating a low carb snack without even a bolus. It’s still hard work!


----------



## JohnWhi

Just had a Zoom session to move on to SmartGuard a week after getting the 780G, so must be winning on points. The Medtronic rep told me they had a new sensor awaiting approval, likely to be released in a few months, that will avoid the need for calibration. Will have to wait and see whether that is true.


----------



## Maco

JohnWhi said:


> Just had a Zoom session to move on to SmartGuard a week after getting the 780G, so must be winning on points. The Medtronic rep told me they had a new sensor awaiting approval, likely to be released in a few months, that will avoid the need for calibration. Will have to wait and see whether that is true.



That would be the Zeus sensor, still awaiting approval I believe. Keeps getting pushed back because of COVID. Last I heard from Medtronic was early 2022 but hopefully it’s before!


----------



## SB2015

After five replacement sensors I have finally had a chance to see how this pump behaves.  The past three days have been very stable, ranging from 98% to 100% TIR, and including a walk using the temporary target.  I finally feel like it will reduce my worry levels.  

Like you @Maco I stick a lower carb target for meals, carefully measure carbs for meals, and expect to do this all the time.  What I wanted was a chance to think less in between meals.  I am definitely a perfectionist who has had to learn to accept that that is impossible with Diabetes, and to set myself more realistic targets. 

I have stuck to the advice to tell the pump whatever carbs you eat, and it now seems to have settled into my bodies patterns.  I used the temporary target for a walk yesterday but topped up with JBs, telling the pump, when things started to go a bit lower.  Today I trusted it to sort things out, and I ended a three hour walk spot on.  I am finally beginning to feel that Humphrey and I could get on with each other.


----------

