Medtronic 780G shortfalls

[Alistair Wood]

I've had this pump for 3 or 4 years and its ok, but I have recently found that it takes ages for the pump to reduce my high blood sugars. (15+) When I look at the active insulin it says zero units. Smartguard is ON. All my ratios are in order. Looking at the graph it is just not giving me any auto-correct even though the b/s is running level at roughly 14.
I appreciate that if the insulin absorption was poor, it could be giving me the basal thinking that that was enough, but to have no auto-boluses (and me not resorting to giving a manual bolus) I wonder what's going on.
Eventually the only way for me to continue is to pretend that I'm eating carbs, but I don't like doing that because they say it mucks up the algorithm.
Changing my infusion set is possible, but what does that prove? The bloody thing is not giving me enough insulin!

 

[Dexta]

This occasionally happens to me towards the end of a cannula’s time or a poor cannula site.

My understanding is that the pump is prevented from giving an ‘appropriate’ bolus to avoid a potential hypo if the glucose readings are incorrect.

This is what I do in these situations and it isn’t medical advice, but it works for me.

Firstly, on the pump I would press the down arrow button which will show any outstanding recommended bolus, which I would then deliver.

If there’s no bolus recommended I would probably give myself a 15g manual bolus and monitor closely with a glucometer.

My priority is always to reduce the high level quickly and not be driven by the algorithm. It’s also important to consider my activity level when doing this.

If there’s little or no reaction then this suggests I need a replacement cannula after which the target results soon return.

 

[Alistair Wood]

I agree that replacing the cannular is often the best fallback measure, but if the blood sugar has remained high for a few hours, you would think that the algorithm must realise that the insulin is not getting through effectively, and at least give an automatic 15mg bolus.
What is absolutely infuriating is that to give oneself a 15mg bolus one has to enter calories! This is absurd. It is "lying" to the pump and surely upsets the algorithm for the future, by giving the impression that the insulin has been added to cover the calories. I have reported this more than once, to no effect, and I believe others have.
Thankyou for your intelligent and informative reply. I hope others will respond.