780g Medtronic - incredibly low basal and hopeless when eating?!

[Dancingsnowdrops]

Hi

I’m wondering if anyone else has had this experience.
I switched to the 780g around two weeks ago (previous A1C of 41 and tightly controlled) and I’m struggling a bit.
Before my basal daily dose was around 16u - which was probably too high as I was eating some ‘free’ carbs in there with that. The 780g cut me to 12u and has gradually fallen since then. Today it has given me 3.6u of basal and it’s nearly 11pm. This is around 0.18u an hour an average.
I have stopped eating because before my carb ratio was around 1u to 15g but I had six French fries earlier and I had to have 4u to keep it level. And by level I mean it went from 5.2 to 11.7 before slowly and painfully inching its way back down. The 780g is happy for me to run around 11 for hours on end - even though my target is 5.5. Even an night! It’s allowing me to be 11 and giving me less than 0.2u an hour of basal. I thought it was meant to increase the basal to reduce the blood sugar.

I’m starving all the time and have currently lost half a stone since I had it (bmi is now 18.2).

I’ve had no follow up since being switched remotely over zoom onto this pump and have spoken to the DSN once after I contacted her to which she advised me to do everything I already had (reduce insulin activity time, lower target, increase carb ratios). She then said it was just time… and it needs to learn.

But I can’t carry on like this! Do I just go back to manual mode and admit defeat?

 

[Nicola M]

Hi

I’m wondering if anyone else has had this experience.
I switched to the 780g around two weeks ago (previous A1C of 41 and tightly controlled) and I’m struggling a bit.
Before my basal daily dose was around 16u - which was probably too high as I was eating some ‘free’ carbs in there with that. The 780g cut me to 12u and has gradually fallen since then. Today it has given me 3.6u of basal and it’s nearly 11pm. This is around 0.18u an hour an average.
I have stopped eating because before my carb ratio was around 1u to 15g but I had six French fries earlier and I had to have 4u to keep it level. And by level I mean it went from 5.2 to 11.7 before slowly and painfully inching its way back down. The 780g is happy for me to run around 11 for hours on end - even though my target is 5.5. Even an night! It’s allowing me to be 11 and giving me less than 0.2u an hour of basal. I thought it was meant to increase the basal to reduce the blood sugar.

I’m starving all the time and have currently lost half a stone since I had it (bmi is now 18.2).

I’ve had no follow up since being switched remotely over zoom onto this pump and have spoken to the DSN once after I contacted her to which she advised me to do everything I already had (reduce insulin activity time, lower target, increase carb ratios). She then said it was just time… and it needs to learn.

But I can’t carry on like this! Do I just go back to manual mode and admit defeat?

There's not a lot you can change once in smartguard, you can change your AIT (most people go by what Medtronic recommends which is 2 hours) and your carb ratios. You may find that your carb ratios do need changing but it does take around a week for the pump to "learn" you. Although your target is set to 5.5 you've got to remember that the pump bases what corrections and basal it gives you on what your TDD has been for the past 6 days. If it hits the maximum amount it won't give you any more regardless of where your blood sugar is at.

I'm no expert on how it works but have you tried calibrating your sensor when you are sitting above target to "force" it to realise you need a bit more insulin so it can then learn from that and your TDD will increase?

There's also a really good support group on Facebook (https://www.facebook.com/groups/119376721997721) which may have better advice that I can give for everything 780g/G4 & Smartguard.