Medtronic 780g + Guardian 4

[Prancy]

I have completed a portion of my 780 training. I could set it up myself. I know how to do it. I’m pretty savvy with Medtronic pumps, but I don’t think it’s allowed.

 

[Retty]

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I haven’t started 780 and G4 yet. And, I can’t speak as to what the company approves as proper sensor site, however I wear mine on my upper arms, which I believe is the approved location. It just works well for me there. I tried the thigh area once, but it interfered with pulling my pants down. I never could get passed that. You might get reports from others who wear it that way online. I try to stay active in the global, online, diabetes community. Taking Control Of Your Diabetes site may have some input too.

I shower with my sensor (G3) in and have swam with it before with no issues. With specific questions on water exposure, you can call a rep. Also, they say there are depth limits and time sensor and transmitter can be underwater. They may not transmit to pump during that time…..so, I’d do a lot of research and approach it cautiously. I’ve decided to hold off on swimming right now and do other exercises at the gym.

Thanks for that information. Yes have always showered with g3 sensor. But never dared swim fearing transmitter failure. Have so many questions for rep when it comes to changeover. But sounds good

 

[Prancy]

I had the chance to swim in a lake in July, but declined it.

 

[JohnRos]

Hi Shell. I haven’t posted for a long time but I went from a 640 to a 780 with CGM in June and I’m in the 0.01% which can call it a nightmare! I loved my 640 which was my first pump and couldn’t believe how smooth running it was after 22 years on MDI after getting all my basal patterns set. So when I was due for a new pump I immediately went with the 780 and the CGM smart guard mode I’d been waiting for for so long. Since June, I’ve had: 4 nights where it hasn’t woken me for calibration, 0 times the CGM has lasted for the full 7 days, 6 times it hasn’t even lasted the minimum 5 days and I’ve had to get a warranty replacement, 50 phone calls from Medtronic people trying to piece it together because it works for everyone and not sure why it doesn’t for me…. My endo is about ready to put me back into manual mode because my control was so much better then. Just in that clinic there is two others that Smartguard mode doesn’t work for so it’s not for everyone. To me it is life controlling every waking minute and the 85% less decisions that Medtronic claim Smartguard eliminates is so wrong it’s not funny. You may be better off with G4 as it doesn’t require calibration but don’t expect it to be set and forget, the CGM is way behind libre in my opinion. Sorry, I hope my reply hasn’t burst your bubble too much! But honest is honest….

Hi Justin, I was interested to read your post and I couldn’t agree more. I have been using the 780 with G4 sensor for just short of 2years and it is terrible. Like you I have had numerous sensor failures and many other issues. The worst and most frightening that happened was that in Nov 2022 my pump started to deliver 13 units of insulin without any prompting on my part and for no logical reason, my blood glucose was around 7m moles/litre at the time. The pump was sent back to Medtronic and the binned it without doing any investigation! There is no doubt using the pump with the CGM is better than nothing but in my view Medtronic’s claims about its capabilities are far overstated. To get benefits from it I am constantly having to intervene to keep things under control. Fortunately for me I have a scientific background so much of the stuff around the technology etc isn’t that much of a difficulty for me but for anyone who expect that they can use this as a “plug and play device” are going to be disappointed. Like you I felt Libre was better than G4. Good luck
John Roscoe

 

[Prancy]

Hi Justin, I was interested to read your post and I couldn’t agree more. I have been using the 780 with G4 sensor for just short of 2years and it is terrible. Like you I have had numerous sensor failures and many other issues. The worst and most frightening that happened was that in Nov 2022 my pump started to deliver 13 units of insulin without any prompting on my part and for no logical reason, my blood glucose was around 7m moles/litre at the time. The pump was sent back to Medtronic and the binned it without doing any investigation! There is no doubt using the pump with the CGM is better than nothing but in my view Medtronic’s claims about its capabilities are far overstated. To get benefits from it I am constantly having to intervene to keep things under control. Fortunately for me I have a scientific background so much of the stuff around the technology etc isn’t that much of a difficulty for me but for anyone who expect that they can use this as a “plug and play device” are going to be disappointed. Like you I felt Libre was better than G4. Good luck
John Roscoe

That’s really shocking. I’m trying to fathom how that would happen. Doesn’t Smart mode have a max bolus limit? Were you in a trial or experimental program at the time? Was there any explanation from the company? What did your doctor say about it? Have you continued to wear a 780?

 

[JohnRos]

That’s really shocking. I’m trying to fathom how that would happen. Doesn’t Smart mode have a max bolus limit? Were you in a trial or experimental program at the time? Was there any explanation from the company? What did your doctor say about it? Have you continued to wear a 780?

It was a real shock. Fortunately only about 1.7 of the 13 units it was trying to deliver were delivered as I stopped the it. There is a max bolus limit but 13 units is below the limit I have set. At the time I wasn’t involved in any trials or anything like that.
I spent a few months chasing the company for an answer and finally they admitted they had a problem in their complaints system and binned the pump I returned.
I asked what they proposed to do to stop this happening again but nothing happened so I reported it to the MHRA (the U.K. regulatory authorities) I understand their investigations are on going.
Medtronic aren’t a good company in my view they don’t seem to care about their customers. I think they released this closed loop system too early as there are many issues with it. I still use it but only because I am so reliant on it and by close monitoring and intervening when necessary I manage.
Looking to the future the scary thing is Medtronic are saying they are not far away from using AI in their pumps. That could be another real disaster.

 

[Prancy]

It was a real shock. Fortunately only about 1.7 of the 13 units it was trying to deliver were delivered as I stopped the it. There is a max bolus limit but 13 units is below the limit I have set. At the time I wasn’t involved in any trials or anything like that.
I spent a few months chasing the company for an answer and finally they admitted they had a problem in their complaints system and binned the pump I returned.
I asked what they proposed to do to stop this happening again but nothing happened so I reported it to the MHRA (the U.K. regulatory authorities) I understand their investigations are on going.
Medtronic aren’t a good company in my view they don’t seem to care about their customers. I think they released this closed loop system too early as there are many issues with it. I still use it but only because I am so reliant on it and by close monitoring and intervening when necessary I manage.
Looking to the future the scary thing is Medtronic are saying they are not far away from using AI in their pumps. That could be another real disaster.

Were you able to see what was happening by viewing the upload to carelink?

Also, is it possible the 13 was insulin on board, from previous boluses and not actually 13 in the progress of delivery? I can’t understand why the company would take such a serious report so lightly. That sounds like a very scary situation. I’m not sure how I’d handle it. I can’t imagine I’d be able to wear a pump again.

 

[JohnRos]

I could see everything as it was happening on my pump. The insulin delivery was real, nothing to do with insulin on board. Insulin on board is displayed separately from the insulin being delivered.
Medtronic were very poor in the way they handled this.
I decided to continue with the pump as I am so dependent on it now.

 

[Ginny 2]

Ok. So I am now on Day 10 of my 780 and guardian 4 journey and am also on my third sensor already. First one did five days abscond one did four.
I am liking the pump but the sensor issues are annoying me .

 

[JohnRos]

Ok. So I am now on Day 10 of my 780 and guardian 4 journey and am also on my third sensor already. First one did five days abscond one did four.
I am liking the pump but the sensor issues are annoying me .

Hi Ginny, G4 sensors are a problem, I have been using G4 for nearly 2 years and I have experienced many failures probably at a rate of about 20%.
Last summer I had a period where I had a failure nearly every 36 hours. After speaking with one of the specialist nurses at the hospital I attend, she recommended trying inserting it near the kidney area of my lower back. This certainly improved things but I still get sensor failures.
It is very annoying and I’ve spoken to Medtronic several times about it and their response is that something new is due to come out this year.
They just don’t care.

 

[Ginny 2]

Hi Ginny, G4 sensors are a problem, I have been using G4 for nearly 2 years and I have experienced many failures probably at a rate of about 20%.
Last summer I had a period where I had a failure nearly every 36 hours. After speaking with one of the specialist nurses at the hospital I attend, she recommended trying inserting it near the kidney area of my lower back. This certainly improved things but I still get sensor failures.
It is very annoying and I’ve spoken to Medtronic several times about it and their response is that something new is due to come out this year.
They just don’t care.

They told me that the newest sensors will be released this summer.
I am really hoping this will improve.

 

[JohnRos]

Let’s hope so!

 

[Mance]

Hi - my daughter is currently choosing between two closed loop systems for her Type 1 diabetes - the Medtronic 780G with SmartGuard and the T:SLIMx2 Tandem with Control IQ technology. She has not used a pump before so moving to a hybrid closed loop system will be very new. I've been reading about some of your good and bad experiences with the 780G pump and the Guardian 4 CGM sensor. Has anyone had experience of the Tandem closed loop system with the Dexcom G6 CGMs? Also, any advide on how to choose which system is easiest to use or gets better user friendly marks?

 

[EllieM]

Hi - my daughter is currently choosing between two closed loop systems for her Type 1 diabetes - the Medtronic 780G with SmartGuard and the T:SLIMx2 Tandem with Control IQ technology. She has not used a pump before so moving to a hybrid closed loop system will be very new. I've been reading about some of your good and bad experiences with the 780G pump and the Guardian 4 CGM sensor. Has anyone had experience of the Tandem closed loop system with the Dexcom G6 CGMs? Also, any advide on how to choose which system is easiest to use or gets better user friendly marks?

I haven't used either but just made the decision (I'm in New Zealand where those are the two pumps available).

I've just been notified that the G7 is now available for the tandem in NZ, though I suppose that may not be the case in the UK.

I ended up choosing the tandem mainly because of the sensors...

Both systems have their pros and cons.

 

[Prancy]

I’ve been reading good and bad about all brands of sensors. I don’t have a choice at this point though. I have to get my Medtronic 780 and G4 in action soon and just deal with it. If it gets too bad, I’ll consider returning to MDI and trying just a basic CGM.

 

[Hopeful34]

I've just been notified that the G7 is now available for the tandem in NZ, though I suppose that may not be the case in the UK.

I had an email last week saying that in the next 8 weeks I'd get a code for the Tandem pump update, and the G7 will then work with it.

 

[Mance]

Thanks for your replies - my daughter is in Canada and I don't think the Guardian 4 CGM is available with the 780G medtronic system for her yet and by the sounds of it the Guardian 3 sensors have a number of negatives (calibration needed, poor reliability etc?), and this may well point my daughter towards the Tandem with Dexcom G6 sensor (I don't think the dexcom G7 is available in Canada).
However, I'm in the UK and have been given a steer away from the Tandem by an endocrinology friend, and on reading about it, the system seems to have some downsides such as more fiddly filling of insulin, manual uploads of insulin data, higher baseline target (112.5), none-learning algorithm and autocorrection boluses only given hourly?
But on the flip side - the 780G Medtronic also sounds to have its downsides -what a minefield!!
Any feedback on user experience of both systems would be very welcome as there doesn't appear to be much research evidence out there on user satisfaction with each system.
Thank you

 

[Dexta]

You might find this recent Diabetech Insulin Pumps Comparison helpful:

 

[eventhorizon]

Thanks for your replies - my daughter is in Canada and I don't think the Guardian 4 CGM is available with the 780G medtronic system for her yet and by the sounds of it the Guardian 3 sensors have a number of negatives (calibration needed, poor reliability etc?), and this may well point my daughter towards the Tandem with Dexcom G6 sensor (I don't think the dexcom G7 is available in Canada).
However, I'm in the UK and have been given a steer away from the Tandem by an endocrinology friend, and on reading about it, the system seems to have some downsides such as more fiddly filling of insulin, manual uploads of insulin data, higher baseline target (112.5), none-learning algorithm and autocorrection boluses only given hourly?
But on the flip side - the 780G Medtronic also sounds to have its downsides -what a minefield!!
Any feedback on user experience of both systems would be very welcome as there doesn't appear to be much research evidence out there on user satisfaction with each system.
Thank you

The cartridge filling is a bit of a faff but you soon get used to it. Takes me less than 5 minutes to do a set change. Dexcom sensors is the main reason I went for the Tandem and I haven't been disappointed. 85% TIR with relative ease.

 

[Mance]

You might find this recent Diabetech Insulin Pumps Comparison helpful:

This was very helpful thank you dexa . The other podacsts he's done are also really informative.