Upgrading the 640g to 670g

[aphex2k]

Aus based, so might be different for UK peeps.

Anyway - had the 640g since October last year. Just before Christmas I lost it (put on roof of car after a run, then drove off and lost it!). So Medtronic allowed me to "rent" a 640g for the duration of the warranty period (at $180 per month on top of my CGM subscription, insulin costs and consumables). Less than ideal but serves me right for losing one.

Anyway, since the 670g came out, Medtronic have been working on their rental scheme and have just called me to say this has been given the go ahead and did I want to upgrade? Going to work out around the same cost, maybe $30/40 cheaper. Was the first person on their books as technically the scheme is for those outside the warranty period. They're making an exception for me.

So just reaching out to all you 670g users. What do you think of it? In your experience, is it worth the upgrade? Have you had any issues? Do any of you feel upgrading was a mistake and miss the old 640g? Will be using the 640g with the Guardian 3 sensors (the new model). Quite excited but just putting the feelers out.

Cheers

 

[aphex2k]

So good news. 670g has been ordered and just waiting for my DSN to give me me a shout. It's costing me $149 a month to "rent" the new pump, until my warranty period expires on the pump I lost (3 years = $5000 ish AUD$).

I'm assuming that the consumables I already have (cannula / reservoirs) for the 640g will be transferable?

 

[dancer]

The pump consumables are just the same.

 

[Chas C]

Great your sorted on the new pump, would insurance have helped you if you had it on the original loss ?

 

[aphex2k]

Great your sorted on the new pump, would insurance have helped you if you had it on the original loss ?

Possibly. TBH I never thought I'd lose one and I'd have needed to add it as an extra on my home insurance. I still haven't done this, but not planning on being quite so stupid again!

It actually works out better to start a new loan on the 670g as it's cheaper than loaning the 640g. That doesn't make much sense to me, but not complaining. Just have to suck up 36 months of $150 until I can get a proper replacement through my health fund.

It's ordered, and on way to my nurse. Will report back once I've got it and used it for a few days. Hoping this auto mode is all it's cracked up to be.

 

[aphex2k]

So I've just picked up the 670g. Told to use it for a week as I used the 640g while it keatns my habits and then in a week I can go onto auto mode. My educator is going to test me before we switch on auto mode and said there will be questions she expects me to ask, and if I don't she'll know I've not read up on smart guard. Crafty huh? I thought I read somewhere that most take a couple of weeks before switching to auto mode but maybe as I'm only relatively new to the 640g that most things will be already known to me?

New menu / layout will take a bit to get used to.

Oh... The clip on the new pump is waaaaaaay better!

Screen looks lovely. Can't say much else as it's still in the warm up phase. Got no case or screen protector so I'll get myself sorted. And I'll give the insurance a call and get it covered this time!

 

[aphex2k]

Woo! Recent blood work shows my A1c has dropped from 8% to 7.7%. Cholesterol a tiny bit high and offered a statins which were politely declined. Funny as she was really hesitant when she asked... "Err would you like to try a statin...?"

The sun's shining and it's Friday afternoon. Have a great weekend everyone.

 

[aphex2k]

Monday here in sunny Western Australia. I'm "officially" switching on AM on Weds evening. I know it's not going to be perfect from the get-go but it seems I've got the basics set up. Just need to be sharp with my carb counting. New G3 sensors seem to be lasting well.

Wondering what will be on the market in 4 years when I'm next able to upgrade. Will have the 670g for 3 years.

 

[DunePlodder]

Probably the 780G:
https://diatribe.org/news-medtronic...-and-timing-next-gen-minimed-780g-closed-loop

It will be interesting to see how Auto mode goes for you.

 

[aphex2k]

Well I'm fully expecting some teething issues when I switch over, as most have had. But will be a patient patient and I'm sure it will all work itself out in a few weeks.

 

[aphex2k]

Into my first day on AM.

Dinner last night - veggie curry and basmati rice. totally forgot to bolus with my meal. I know, right? What a way to start. So after [some time] and what looked like a long pink line of micro bolus, it dawned on my I hadn't had insulin for my meal. Corrected accordingly.

Anyway, overnight all seemed good. Levels were stable up until I woke at 645. Was at 2.9 confirmed by BSL but had no signs of being hypo - no sweats, wobblyness etc. Felt fine. Hope I don't lose my hypo awareness!? Odd as the pump didn't even beep to say I was low / approaching low.

 

[aphex2k]

Having a few teething issues. Namely the accuracy of taking a BG and then calibrating, and the sensor seeminly wanders off and does it's own thing and loses accuracy.

Now, I'm calibrating when I wake, before bed, and some point late afternoon. I'm only taking readings when my BSL is stable (ie not rapidly rising or dropping, and now after I've eaten). In the space of 2 hours my BSL was 8 and my pump showed 11. I don't think I'm over doing it calibration wise.

On one of the Medtronic 670g user groups (with 20k members) I was told to divide my BSL by the ISIG but this seems to give me REALLY low figures this way ( 9.2 / 43.61 = 0.21 but If I do it the other way (ISIG / BSL I get 4.7). I was never shwn this way and to be honest, I'm still confused by this as I assumed calibrating something like BSL to the pump it should remain quite close? But Im probably over analysing?

 

[DunePlodder]

I saw an explanation of this here:
http://sugabetic.me/the-isig-equation/
But I would agree that calibrating should be much simpler.

 

[aphex2k]

Yeah it would be. Advice given to me was that there's no point even trying to calibrate if your BG / ISIG calculation shows you being below 3 or above 8. You'll generally get a Cal Error.

What I'm finding is that even after I've calibrated, the sensor seems to be 3 or 4mmol/L off. Have been doing my BG and comparing over the last few hours.

BG SG
1345 9.2 10.2
1415 13.4 10.4
1445 9.4 10.2
1515 13.3 10.4
1545 11.4 9.4
1615 10.0 8.7

I don't recall the sensors being this iffy when I used the 640g with the G2 sensor. Oh and they don't last 7 days (last one was 5).

Have tweaked my settings a little - dropped my carbs down to 8.0g and my active insulin time to 3 hours.

My graph shows fairly flat, albeit towards the top end of the range.

I just don't understand how calibrating (in ideal conditions) doesn't lock in a bit better than it currently is. Also conscious not to make toooooooo many alterations to the settings as the algorithm must still be learning. I also heard that the algorithm updates at midnight each day?

 

[DunePlodder]

Yes, I understand that the algorithm is based on the last 6 days, so would presumably change at midnight.
I've read plenty about the 670G but never used it. Obviously good CGM results are essential.
I'd say keep talking to/pestering Medtronic they should know how to sort this out by now - the 670G has been out a long time in Europe & the USA.

 

[aphex2k]

I was never particularly impressed with their support staff tbh (calling from australia I think goes through to Philipines or somewhere). I've had far more relevant and accurate info from the 670g groups on Facebook (the US one has 21,000 members!) and from the lovely crew here.

I'll give it a good blast for 6 months and request a consultant review and he/she can upload my data and make a few tweaks I guess.

Apparently 38% of 670g users either stop using auto mode and revert back to manual mode, or simply return the pump and go back to their old system.

 

[aphex2k]

Each day makes a little more sense and my TIR creeps up. Yay.

 

[aphex2k]

Day 5 on the sensor. Calibrated this morning. Just got asked (6 hours later) to calibrate again, so I'm gonna hazard a guess that the sensor is about to die. (1 day 10 hours left out of the magical 7 day life)

This morning I had what some people call a "unicorn"..... Where my morning BG and calibration showed 7.7 on the glucometer, and 7.7 on the pump too.

Expecting my TIR to be a little off today as some idiot at work brought in cake and tiramisu and I was powerless to refuse a slice but ate it just before my lunch (ham salad... so that negates cake, right?)

**** you tiramisu!!!

 

[DunePlodder]

Bet it tasted good though!

 

[aphex2k]

Hell yeah, it was lovely!!!