Does the 780G+G4 work well when eating low carb?

[Rianne]

I spoke with Medtronic on the phone today. This low carbing problem is not a very common thing they encounter so far. The only tools for adjusting are experimenting with the carb/insulin ratio and if necessary experimenting with entering slightly more carbs than will be eaten in reality. Other parameters are only applicable in manual mode. No real solution either for having the algorithm improving towards the target of f.e. 5,5 mmol/l. Goals of the algorithm simply are staying between 3,9 and 10 as much as possible and minimizing hypo's, with a TIR of 70% or higher. Wether the algorithm learns during periods of temporary increased target or not (8,3 for exercise etc) is not known. Using manual mode during the day and SmartGuard during the night would work fine and would not have negative influences on the algorithm.
Still feels like I just as well flip a coin for my decision ;-).

 

[jmp21551]

I spoke with Medtronic on the phone today. This low carbing problem is not a very common thing they encounter so far. The only tools for adjusting are experimenting with the carb/insulin ratio and if necessary experimenting with entering slightly more carbs than will be eaten in reality. Other parameters are only applicable in manual mode. No real solution either for having the algorithm improving towards the target of f.e. 5,5 mmol/l. Goals of the algorithm simply are staying between 3,9 and 10 as much as possible and minimizing hypo's, with a TIR of 70% or higher. Wether the algorithm learns during periods of temporary increased target or not (8,3 for exercise etc) is not known. Using manual mode during the day and SmartGuard during the night would work fine and would not have negative influences on the algorithm.
Still feels like I just as well flip a coin for my decision ;-).

I have been using the 780G with sensors for two years. It is good most of the time, but does strange things to keep you on your toes. The main issue is it doesn’t like you lying about carb inputs. Be as honest as possible. My TIR have improved drastically over the months. 80-90%.

 

[Rianne]

I have been using the 780G with sensors for two years. It is good most of the time, but does strange things to keep you on your toes. The main issue is it doesn’t like you lying about carb inputs. Be as honest as possible. My TIR have improved drastically over the months. 80-90%.

Thanks for sharing this, jmp21551. I am curious if you eat a low carb or normal diet and what your daily carb intake and your total daily insulin dose is, to learn a bit more in what cases the algorithm works well or better than in my situation. Would you share that info here? Can you give examples of strange things it does to keep you on your toes and how often you experience that? Improved TIR is a plus of this system!

 

[Prancy]

I’m just finding this thread and am very concerned. I am currently using 670 and have my new 780 and G4 in a box while I’m training to start it. I had read so much about how great it performs……one person 100% TIR! So…..to see this issue concerns me. I sometimes have around 50 carbs a day….not trying to be low carb….just ends up that way. I’m losing weight…..working out…not taking injections. I’ll have to do whatever it takes to make the 780 work. I was really looking forward to auto mode.

Right now, I’m 76% TIR on my 670G In auto. I don’t do well in Manual at all.

I look forward to more info on this.

 

[Rianne]

I’m just finding this thread and am very concerned. I am currently using 670 and have my new 780 and G4 in a box while I’m training to start it. I had read so much about how great it performs……one person 100% TIR! So…..to see this issue concerns me. I sometimes have around 50 carbs a day….not trying to be low carb….just ends up that way. I’m losing weight…..working out…not taking injections. I’ll have to do whatever it takes to make the 780 work. I was really looking forward to auto mode.

Right now, I’m 76% TIR on my 670G In auto. I don’t do well in Manual at all.

I look forward to more info on this.

I can imagine that my post concerns you. I hope my experience does not apply to everyone eating low carb and using the 780G and G4. At least I hope that, in case you do encounter similar problems, you have some advance in recognizing and will be able to experiment with adjustments to find the best way for you. I also hope if others read this and have tips, they will keep sharing these! Good luck, Prancy, with starting on the 780G!

 

[Prancy]

I can imagine that my post concerns you. I hope my experience does not apply to everyone eating low carb and using the 780G and G4. At least I hope that, in case you do encounter similar problems, you have some advance in recognizing and will be able to experiment with adjustments to find the best way for you. I also hope if others read this and have tips, they will keep sharing these! Good luck, Prancy, with starting on the 780G!

Yes, I’m glad I have advance warning. I’m also conferring with my US online community to compare notes. Most of them are males and that might make a difference too. Right now, I’m averaging 35 units total of insulin per day. I’m highly motivated to use this device, so I will have to figure it out.

 

[Rianne]

Hi all,
My decision time is over and, after considering all aspects, the 780G + Guardian4 did, despite meaningful plusses, not win the battle. I am happy I did have the chance to try this system for a while though. I will go back to the Ypsopump, this time in combination with FSL3 and CamApsFX, of which I hope that the options to partly personalize the algorithm, will be a better solution for me. Wearing a phone with me all the time will be difficult, and was such a downside for me, that I did not consider this system to be an option. But with the current experience and choices, if the algorithm fits me better, I will find my way with it. There will be parts of days that I do not have my phone nearby and I will have to work manually, but I look forward to starting with it and learning how to get the most out of it. Thanks, all of you, for sharing your experiences and being so supportive in this difficult decision. I very much appreciate it!

 

[Prancy]

Hi all,
My decision time is over and, after considering all aspects, the 780G + Guardian4 did, despite meaningful plusses, not win the battle. I am happy I did have the chance to try this system for a while though. I will go back to the Ypsopump, this time in combination with FSL3 and CamApsFX, of which I hope that the options to partly personalize the algorithm, will be a better solution for me. Wearing a phone with me all the time will be difficult, and was such a downside for me, that I did not consider this system to be an option. But with the current experience and choices, if the algorithm fits me better, I will find my way with it. There will be parts of days that I do not have my phone nearby and I will have to work manually, but I look forward to starting with it and learning how to get the most out of it. Thanks, all of you, for sharing your experiences and being so supportive in this difficult decision. I very much appreciate it!

Good luck with everything! Thanks for sharing.

 

[Gordontoo]

Thanks for sharing your method, Gordontoo! Indeed questionable if we should call it a solution ;-) but happy to read that it works well for you. My diabetes nurse and Medtronic trainers stipulate NOT to enter ghost carbs so I did not do that so far. But I will take your method in consideration anyhow. In my view it is similar to increasing number of carbs with a part of the grams of proteins.
In an older post on FB someone wrote that she had adjusted parameters like insulin sensitivity and max basal. I am told that the only parameters in SmartGuard are carb/insulin ratio and active insulin time. This was what others replied on her post as well. She however said that after adjusting the other parameters her results were much better. Since I think the knowledge of the professionals is not that impressive I am wondering what information you have received on parameters in SmartGuard? I have already (that is a few hours ago after reading the post) adjusted my max basal in hope for easier improvement than entering ghost carbs or protein carbs...

Sorry to be so long in replying Rianne. Sometime life, both the good and the bad takes us to places unexpected.
In Smartguard, if you go to Bolus Wizard Setup you can edit you Carb ratio, which effectively increases, or decreases the amount of insulin delivered with food. The only thing to remember is that it will continue to do that for each and every subsequent carb entry, until another change to the carb ratio is made. My preference would be to have a chat to an Endo familiar with the 780 (if you can find such a beast) before getting too carried away. As always, err on the side of caution. Good luck Rianne.
P.S. I believe that entering ghost carbs teach the pump bad behaviours, but sometimes my frustration levels exceed my levels of civility. My pump and I have this love/ hate relationship thingy.

 

[Rianne]

Sorry to be so long in replying Rianne. Sometime life, both the good and the bad takes us to places unexpected.
In Smartguard, if you go to Bolus Wizard Setup you can edit you Carb ratio, which effectively increases, or decreases the amount of insulin delivered with food. The only thing to remember is that it will continue to do that for each and every subsequent carb entry, until another change to the carb ratio is made. My preference would be to have a chat to an Endo familiar with the 780 (if you can find such a beast) before getting too carried away. As always, err on the side of caution. Good luck Rianne.
P.S. I believe that entering ghost carbs teach the pump bad behaviours, but sometimes my frustration levels exceed my levels of civility. My pump and I have this love/ hate relationship thingy.

Hi Gordontoo, thanks for your reply. Indeed life takes us to unexpected places and circumbstances. Very kind of you to reply anyway. I think, however, you did not see my post from December 15. It was nice though to have a conversation with you and I wish you all the best with the diabetes and all other things in life! Best wishes for 2024!

 

[THH]

Hi all,
I have been testing the 780G + Guardian4 sensor for about 6 weeks now but have not yet felt very much improvement in comparison with my former system (Ypsopump + FSL2). I recently learned from Medtronic that using a low total daily dose might cause the algorithm to have less possibilities in correcting/adjusting optimally. What I see in my graphs is that the algorithm stops basal for 30 or 45 minutes after bolusing for a meal. My bloodsugar rises than, and the system restarts basal and later on gives lots of autocorrection microboluses. It causes spikes after meals which seem not correctable within 2 hours or more. I tried different carb ratio's but keep seeing the same behaviour of the algorithm. I do bolus about 20 minutes before meals. Bolusing more time in advance gives hypo's so that is no solution. My total daily dose is about 27 units of novorapid and my total daily carb intake is about 110 grams. Does anyone recognize this problem and have you any tips or solutions? Anyone eating low carb and have success with the 780G+G4? I only have 1 week left for testing and have to decide than whether to choose the 780G or not.
Thanks for any help!
Rianne

Hi Rianne

i am on an Ypsopump and using FSL 3 and the CamAPSFX/Ypso looping system. Been on it for 12 months now...and also been eating low carbs for over 1.5 years now (eating a bit less carbs than you usually on average days..but around your intake if we go out for dinner or eat at friends). For me the CamAPS algorithm works well and adapts really well to low/no carbs...I rarely have hypo's and no issues with/post meals. My HbA1c has been between 5.4 and 5.9 since I started using the loop and eating low carbs.

I decided against the 780G pump given it size and in my view too many functions...the Ypsopump and the loop provide all I need.

Have you tested Ypsopump & FS3 & their loop ?

Best,
tobias

 

[Rianne]

Hi Rianne

i am on an Ypsopump and using FSL 3 and the CamAPSFX/Ypso looping system. Been on it for 12 months now...and also been eating low carbs for over 1.5 years now (eating a bit less carbs than you usually on average days..but around your intake if we go out for dinner or eat at friends). For me the CamAPS algorithm works well and adapts really well to low/no carbs...I rarely have hypo's and no issues with/post meals. My HbA1c has been between 5.4 and 5.9 since I started using the loop and eating low carbs.

I decided against the 780G pump given it size and in my view too many functions...the Ypsopump and the loop provide all I need.

Have you tested Ypsopump & FS3 & their loop ?

Best,
tobias

Hi Tobias, really good to hear that you have such good experience with the Ypsopump/FSL3/CamAPSFX. I have not tested the system yet. My former pump (before testing the 780G) was a manual Ypsopump and a FSL2. A new loopable version with FSL3 and CamAPSFX will be order for me beginning of January. Although having to carry my smartphone with me all the time will at several days a week be a problem, I look forward to using an Ypsopump again and be helped by the more personally adjustable algorythm most of the time. Great to learn that low/no carbs are not problematic and even hypo's diminish for you. Thanks for sharing!

 

[Gordontoo]

For what it's worth, my own personal experience with the 780G upgrade, seems to show that, at least with me, it tends to struggle a fair bit with high/very high carb loads at meal times, anything over about 70Gms carbs, seems to cause some problems (pasta, rice etc. etc.), but IMO the pump performs way better with lower carb levels say around the 30-50Gms carbs per meal.

 

[eventhorizon]

I really wanted the Ypsopump /camsaps but the as the diabetes team didn't have much experience they weren't keen.

However I've the Tslim / G6 / CIQ and it has exceeded all my expectations. It just works. Best control in 24 years of T1.

 

[Gordontoo]

Hi eventhorizon.. Pleased to hear that you have found what you were looking for. I hope the remainder of 24 continues to be kind to you and yours.

I can and do empathise with your problem re your diabetes team and the sometimes sketchy levels of knowledge about what is available and how best to assist you navigate your way through to the other side..
For what it is worth eventhorizon, IMO your diabetes team, is just that, your team, with you the captain of said team. As all the decisions "the team" makes will have often long term and profound implications for you and your loved ones, here I believe it always pays to be very, very selfish. Sometimes, when my endo is laboring a point, by reminding me that they are an endo, I remind them that I am the one and only Gordonologist on the planet and my opinions need to be front and center of every clinical decision we, the team, makes.
There definitely is no I in team, but there is a me.
Makes for some fairly frosty sessions sometimes, but eventually we all arrive at a mutually agreed point, based on informed consent and respectful consideration of each others points of view.

 

[Bill Wireman]

Your low carbs diet is not something that I have used after starting using the 780G pump, but if you see a spike in your BS after a meal then add a bolus to help compensate for the carbs. The pump will auto correct but over an extended time frame which will not help your average A1c. In my case, if the BS is high and the remaining bolus will not compensate, then I will add 3U per 100mg/dl. I now use whole milk along with regular packaged or non-diet meals because they taste better and can still maintain my weight by limiting the quantity of foods, remember I only eat twice a day. So, after 2 months and 10 days using the G4 sensor and the 780G pump my A1c is averaging 117 mg/dl as shown on the Carelink website where you can also review your settings. It would be helpful for you to figure out the scale of insulin needed when you experience a high BS. Also, take note that in the morning when taking my coffee I noticed my BS would rise quickly and not in relations to the carbs taken, so note any foods that unexpectedly bump your BS thru trial and error. Now, I take a 2 1/2 U bolus before drinking my first cup of coffee, having the G4 is great teaching tool for diabetics.