# Medtronic pump users



## SB2015 (Dec 16, 2020)

I am currently using my new 780G in manual mode, so it is behaving in a similar way to the 640, but I cannot find some of the equivalent functions that I was used to on my Combo.

Active insulin - my Combo showed only any corrections that were still  active, and did not include the Bolus in the calculations of insulin in board.  I am not sure how to interpret the active insulin at bedtime , part of which will still be working on the carbs consumed.
More to come no doubt.


----------



## SB2015 (Dec 16, 2020)

... and

For a high glucose reading >14 I would normally increase my Bolus by a percentage, which in my Combo there were preset increases which I had set up and could apply: 
‘stress’  which I would use if I was  over 10
‘illness’ which I used if I was over 14

Is there anything like this on the Medtronics in manual mode?

I know that once I am on sensors I would have autocorrections dealing with these, and hopefully not get anywhere near these levels.  (Tonight it was a combination of lentils, as well as a beer.  A rare occurrence and I had miscalculated the carbs!!  At least I know why I am now so high.  I really should have gone for that walk after my meal!!)


----------



## SB2015 (Dec 17, 2020)

Are there any Medtronic users who can help me?


----------



## Inka (Dec 17, 2020)

@SB2015 Sorry I’ve never used a Medtronic pump and on my pump I just calculate the ‘extra’ correction in my head and whack it in.

But - have you tried Youtube? I’ve found a number of helpful videos there for my pump so it might be worth a look if you don’t get a reply here.


----------



## Pumper_Sue (Dec 17, 2020)

SB2015 said:


> For a high glucose reading >14 I would normally increase my Bolus by a percentage, which in my Combo there were preset increases which I had set up and could apply:
> ‘stress’ which I would use if I was over 10
> ‘illness’ which I used if I was over 14
> 
> Is there anything like this on the Medtronics in manual mode?


Nope the moronic pump was built in 1066. It's frustrating because my first pump 13 years ago had these features.
All I do is add the extra % the pump then tells me I have modified the bolus.


----------



## SB2015 (Dec 19, 2020)

Pumper_Sue said:


> Nope the moronic pump was built in 1066. It's frustrating because my first pump 13 years ago had these features.
> All I do is add the extra % the pump then tells me I have modified the bolus.


Thanks Sue

I have just found out how to modify the Bolus.
Sorted.


----------



## SB2015 (Dec 19, 2020)

Inka said:


> @SB2015 Sorry I’ve never used a Medtronic pump and on my pump I just calculate the ‘extra’ correction in my head and whack it in.
> 
> But - have you tried Youtube? I’ve found a number of helpful videos there for my pump so it might be worth a look if you don’t get a reply here.


Thanks for that tip.  It is not my automatic thing to do, but I am realising hit w useful you tube and google can be.


----------



## trophywench (Dec 19, 2020)

@SB2015 - Think we're cast in the same mould, you and I.  I think I sort of resent anything 'that serious' being on You Tube.


----------



## SB2015 (Dec 21, 2020)

trophywench said:


> @SB2015 - Think we're cast in the same mould, you and I.  I think I sort of resent anything 'that serious' being on You Tube.


I still look things up in books!!!


----------



## Paulbreen (Dec 21, 2020)

Hey SB I’m using a MM670G so if you need some pointers give me a shout, the menus take a bit of time to get used to. 
i use the carelink software on my PC a lot to help me setting up parameters, you can print a copy of the setup and then you can edit the sheet before adjusting the pump


----------



## everydayupsanddowns (Dec 21, 2020)

Hello @SB2015 

Yes I did wonder how you would get on with the differences in dosplay of iob (I am currently adjusting to TSlim which is different again!). FWIW I found it a more logical and helpful display after I’d got used to it, especially where i had any uncertainty over my carb estimation. 

Yes i missed the Expert’s % dose increases/reductions too. in the end i opted for the more rudimentary ‘add or knock off a unit or two’ and watched the sensor trace for further adjustments after a couple of hours


----------



## SB2015 (Dec 23, 2020)

everydayupsanddowns said:


> Hello @SB2015
> 
> Yes I did wonder how you would get on with the differences in dosplay of iob (I am currently adjusting to TSlim which is different again!). FWIW I found it a more logical and helpful display after I’d got used to it, especially where i had any uncertainty over my carb estimation.
> 
> Yes i missed the Expert’s % dose increases/reductions too. in the end i opted for the more rudimentary ‘add or knock off a unit or two’ and watched the sensor trace for further adjustments after a couple of hours


It was at night and not being sure how much of the active insulin was working on carbs, or was a correction.  We tried to get round this by eati earlier so at least the carb insulin had done its job when I went to bed.  As the week went on it almost became irrelevant as I piled insulin in from my pen.  The weird thing s that there is no way of telling the pump that I have done a pen correction so it does not take any account of those.  I guess again it is not expecting you to have to do that as in automode it should keep you in target.


----------



## SB2015 (Dec 23, 2020)

Paulbreen said:


> Hey SB I’m using a MM670G so if you need some pointers give me a shout, the menus take a bit of time to get used to.
> i use the carelink software on my PC a lot to help me setting up parameters, you can print a copy of the setup and then you can edit the sheet before adjusting the pump


Thanks Paul.
I will come back to you as my list of questions grows.  
I definitely need to be better prepared before I have another go.


----------



## Paulbreen (Dec 23, 2020)

SB2015 said:


> It was at night and not being sure how much of the active insulin was working on carbs, or was a correction.  We tried to get round this by eati earlier so at least the carb insulin had done its job when I went to bed.  As the week went on it almost became irrelevant as I piled insulin in from my pen.  The weird thing s that there is no way of telling the pump that I have done a pen correction so it does not take any account of those.  I guess again it is not expecting you to have to do that as in automode it should keep you in target.


Sounds like more tuning to do in your basal setup, your in manual mode at the minute as I remember, so the pump is delivering what’s in the setup, I’ll take a photo of what mine looks like so you can compare, only change it with your trainer though.
Also Meditronic help line are usually great so just call them with your questions


----------



## SB2015 (Dec 23, 2020)

Paulbreen said:


> Sounds like more tuning to do in your basal setup, your in manual mode at the minute as I remember, so the pump is delivering what’s in the setup, I’ll take a photo of what mine looks like so you can compare, only change it with your trainer though.
> Also Meditronic help line are usually great so just call them with your questions


They have generally been brilliant.  But they are not particularly familiar with this pump so far and it is definitely lacking some facilities in that it really want to be working in auto.

You are right about basically I was not getting enough insulin.  I felt so rough with the elevated levels, and was so tired it’s lack of sleep, that the option of returning to Combo seemed a good option after a week.  With my old pump I will check Basal rates and ratios more carefully, and then transfer these over before restarting on the 780.


----------



## Paulbreen (Dec 23, 2020)

That sounds like a great first step, if you need help with the menu navigation just shout I’ll be more than happy to help, the Meditronic YouTube channel is very good with how to videos for the menus, each a couple of minutes long so you do t get bored or lose your way


----------



## Pumper_Sue (Dec 23, 2020)

SB2015 said:


> I piled insulin in from my pen. The weird thing s that there is no way of telling the pump that I have done a pen correction so it does not take any account of those.


All you need do is disconnect your pump and bolus


----------



## SB2015 (Dec 23, 2020)

Pumper_Sue said:


> All you need do is disconnect your pump and bolus


Thanks Sue
Simple solutions to what seem like complex problems.


----------



## everydayupsanddowns (Dec 24, 2020)

SB2015 said:


> The weird thing s that there is no way of telling the pump that I have done a pen correction so it does not take any account of those.



The only way I can think of would be to disconnect the pump and to air-deliver the same bolus again?

I never really correct with pens, so it’s not something I‘ve needed to  do.

EDIT: Ha! should have read to the end of the thread before replying


----------



## everydayupsanddowns (Dec 24, 2020)

Sorry that you’ve had such a rough start to your MM780 journey Sue.

Hopefully with your old bolus pattern and ratios copied across things will be a little easier - can you see if there was a difference to your TDD between the two pumps?

FWIW I can see some people on the tSlim group needing to make changes to their established settings - so perhaps you will end up with just an upward tweak on things?

Might be worth trying some different infusion sets too? Took me a while to find an infusion site that worked for me - the quicksets they started me on were very patchy and I many many site failures.


----------



## SB2015 (Dec 24, 2020)

everydayupsanddowns said:


> Sorry that you’ve had such a rough start to your MM780 journey Sue.
> 
> Hopefully with your old bolus pattern and ratios copied across things will be a little easier - can you see if there was a difference to your TDD between the two pumps?
> 
> FWIW I can see some people on the tSlim group needing to make changes to their established settings - so perhaps you will end up with just an upward tweak on things?


Thanks Mike 

That is interesting with the t-slim info with the need for some changes.  It is also encouraging to pick up that the automated systems can eliminate the need for pen corrections, but good to be armed with a solution to tell the pump what I have done.

I copied the Basal rates and ratios across, but I think my automated responses to things with the Combo were masking some things that needed changing.  I also got into a bit of a loop and didn’t just change rates, as I would have done on the Combo, and didn’t know what questions to ask.

Using this quiet time to be a lot more systematic in checking things whilst in the Combo, try out cannula when not using with the pump, ....  Being logical and recording again.  I had become a bit complacent possibly.

A new start planned in the new year armed with lots more (accurate) info gleaned from the Combo, and then no doubt a bit more tweaking once I try the switch again.


----------



## Pumper_Sue (Dec 24, 2020)

everydayupsanddowns said:


> the quicksets they started me on were very patchy and I many many site failures.


Have the same problem after I changed over to them from the angled sets.


----------



## Pumper_Sue (Dec 24, 2020)

SB2015 said:


> That is interesting with the t-slim info with the need for some changes. It is also encouraging to pick up that the automated systems can eliminate the need for pen corrections, but good to be armed with a solution to tell the pump what I have done.


Personally I think you are over thinking things  Take a nice big deep breath and relax. Just put your old pump setting into the new one and tweak from there. Yes I had to tweak a bit but nothing horrendous.


----------



## Paulbreen (Dec 24, 2020)

Quick question Sue what infusion set are you using, I have Mini Med Mio Advance and they seem to work fine, I don’t remember the name of the ones I started with but I remember they were a pain


----------



## Paulbreen (Dec 24, 2020)

Paulbreen said:


> Quick question Sue what infusion set are you using, I have Mini Med Mio Advance and they seem to work fine, I don’t remember the name of the ones I started with but I remember they were a pain


Back of the packet might be more useful


----------



## Paulbreen (Dec 24, 2020)

SB2015 said:


> Are there any Medtronic users who can help me?


Hey SB the 670G doesn’t have any comparable features, I have adjusted the “Active insulin time” to 2.5 hours after some experiments and everything thing is fine, this could be something for you to experiment with, I think the default is 4 hours, verify the active insulin time from the info sheet of insulin you are using and pop that figure into the parameter
*Options > Delivery Settings > Bolus Estimate setup > Active Insulin Time* 

In manual mode i would always just bolus from the pump bolus wizard if I needed a bit extra insulin, the wizard will calculate what insulin you have active and just use a small carb number something like 10g that way the pump knows what insulin you are taking, it will show you the units it will deliver so you can confirm it first, you can go back and adjust the carb amount if it going to deliver too much or too little units.

the pump needs as much info about your habits while in manual mode so it can work correctly in Auto mode, it uses the last Six days of data to improve your current BG levels so I would avoid “topping up” from a pen if you can


----------



## SB2015 (Dec 24, 2020)

Thanks @Paulbreen and @Pumper_Sue 

I always overthink things and want to have things clear in my head.  I doubt I will change that much now Sue.  I was disconcerted as I did exactly what you suggested transferring my rates and ratios straight over, and things went bonkers.  Still not sure why, although today a UTI has shown itself so that may have been brewing or it could be as a result of having such high Bgs for so long. . 

I (briefly) used the Minimed mio advanced @Paulbreen but have also got a few that go with the reusable serter , as I would  like to avoid the amount of waste.  I shall stick one of each in over the next few days and just check I am not reacting to the glue or the ‘needle’ .

The linked BG test kit finally arrived today so that is another piece of the jigsaw sorted.   I am happy on my old pump for a while and will start again in the new year, having checked basal rates etc.  

Thanks for all the ideas and support.


----------



## SB2015 (Dec 24, 2020)

everydayupsanddowns said:


> Might be worth trying some different infusion sets too? Took me a while to find an infusion site that worked for me - the quicksets they started me on were very patchy and I many many site failures


That’s useful to know Mike.

I now have a couple of different sets to try and they are happy to send me others if I want to try them, but need to go through the DSN, who is not back until January.  I think I had a variety of things that didn’t quite work for me in that first week and I just lost confidence.  It was good to step away from it, and I am happy to return to it when DSN is around.


----------



## Pumper_Sue (Dec 24, 2020)

@Paulbreen please have a read of this article Why DIA values are wrong | Diabettech - Diabetes and Technology it will help you understand IOB/DIA or what ever you want to call it.

There is no insulin on the market with such a short DIA value so you are potentially overdosing on your bolus insulin and could come a cropper one day big time. If I were you I would be doing some very basic basal testing.

I use Fiasp in my pump and duration is set to 5 hours which works very well.


----------



## Paulbreen (Dec 24, 2020)

Pumper_Sue said:


> @Paulbreen please have a read of this article Why DIA values are wrong | Diabettech - Diabetes and Technology it will help you understand IOB/DIA or what ever you want to call it.
> 
> There is no insulin on the market with such a short DIA value so you are potentially overdosing on your bolus insulin and could come a cropper one day big time. If I were you I would be doing some very basic basal testing.
> 
> I use Fiasp in my pump and duration is set to 5 hours which works very well.


Thanks Sue for pointing that out and I looked at the article you attached. Makes interesting reading but I would have a concern that there is no author listed apart from “admin” I wonder who is admin and how they are qualified to create such an article.
Also I have not had an hypo of less than 3.8 in the last 2 years since I started using this pump.
In Germany when you start using a “ loop type system” you go to a specialist diabetic hospital for 10 days so they can train you in the use of the pump and you spend 7-8 days in manual mode then 2 more days with the pump in auto mode verifying the pump is working with you as expected. Also they monitor your BG every 2 hours day and night for the duration of your stay so they are able to provide a very clear picture of how your body is reacting to your insulin.
all insulin’s react differently with different individuals and I can guarantee that novarapid or Fisap is not present in my body after 5 hours. Maybe that may change in the future and I would pick up on it with my team but as it stands 2.5 hrs suits me very well at the moment. I was also not making any recommendations to SB2015 to change anything without input from here trainers and support team only giving pointers from my experiences with the Meditronic 670G+CGM


----------



## Pumper_Sue (Dec 25, 2020)

Paulbreen said:


> Thanks Sue for pointing that out and I looked at the article you attached. Makes interesting reading but I would have a concern that there is no author listed apart from “admin” I wonder who is admin and how they are qualified to create such an article.


About | Diabettech - Diabetes and Technology info for you and the author is called Tim  Have a read of pumping insulin as well. People tend to confuse peak of insulin and duration which I think is what you are doing.


----------



## SB2015 (Dec 25, 2020)

Thanks both.

I am happy to be directed to any info, and also hear of other people’s experiences, to draw on.
This can all feed in to the decisions I will make, and then work with DSN if necessary.  
The loop start in Germany sounds very well supported.


----------



## Paulbreen (Dec 25, 2020)

Pumper_Sue said:


> About | Diabettech - Diabetes and Technology info for you and the author is called Tim  Have a read of pumping insulin as well. People tend to confuse peak of insulin and duration which I think is what you are doing.


Hi Sue I took another look at the Diabettec site as you suggested and there is some interesting reading but it’s just a forum type site with no medical foundation to the contributions.
I do enjoy reading this kind of thing but I wouldn’t base my own treatment on it, to arrive at my figure of 2.5 hours it was done with the specialist nurses who trained me to use the pump and Meditronic Nurse. I sort of have to disagree with your diagnosis as I don’t have any hypo issues, in fact I am around 93-95% TIR and the out of range seems to happen when I change a sensor or when I over indulge with dinner sometimes


----------



## SB2015 (Dec 25, 2020)

It is always interesting to read how different the advice is, and as with al things Diabetic, we each have to find our way through and find out what works for us.


----------



## Paulbreen (Dec 25, 2020)

SB2015 said:


> It is always interesting to read how different the advice is, and as with al things Diabetic, we each have to find our way through and find out what works for us.


Very wise words Sue, sharing experiences is a great pathway for everyone


----------



## everydayupsanddowns (Dec 26, 2020)

Paulbreen said:


> Makes interesting reading but I would have a concern that there is no author listed apart from “admin” I wonder who is admin and how they are qualified to create such an article.



It’s Tim Street. Well known on Twitter and a really nice guy (I’ve met him a few times). Quite well thought of in the Loop/APS community and as far as I can tell he finances most of his kit himself rather than being offered it as a freebie by the manufacturer.


----------



## Paulbreen (Dec 26, 2020)

Thanks Mike, the articles are interesting and I do love a good techie as it’s my world for work, I do have a big interest in the loop world myself but I prefer to dabble in it quietly mainly for my own amusement


----------

