Medtronic 780g + Guardian 4

[Mance]

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.

Thank you - it's really helpful to have specific user feedback on these aspects

 

[Lukah]

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….

I am in the US and switched from the 670 and the Dexcom G7 to the 780 and the Guardian 4 and just wanted to let you know that I am having the same issues as Justin. I wish I hadn't switched to this system!

 

[smc4761]

I moved from 640 to 780 about 18 months ago. However my health board will not fund me for guardian 4 Smartguard and i still have to use the 780 in conjunction with Freestyle Libre.

Reading the comments above it seems that I may be better off not getting the Smartguard function.

Also I find the features of the 640 and 780 very similar apart from Smartguard, but the 640 is slightly smaller and lighter

 

[Prancy]

I moved from 640 to 780 about 18 months ago. However my health board will not fund me for guardian 4 Smartguard and i still have to use the 780 in conjunction with Freestyle Libre.

Reading the comments above it seems that I may be better off not getting the Smartguard function.

Also I find the features of the 640 and 780 very similar apart from Smartguard, but the 640 is slightly smaller and lighter

I highly recommend G4 with 780 with Smartguard. For me, it’s considerably better than G3. I haven’t used Libre.

 

[Justin04]

Sorry @JohnRos I didn’t ever follow this post, from way back then the G4 never really improved. Even now here at 1am I’m getting a sensor updating warning, the fifth one in 12 hours on a 4 day old sensor. I guess I gave up looking for answers and am patiently counting down the next 18 months where I get a new pump. Which will absolutely be a Tandem T slim!!! Mainly for the dexcom sensor, but also as a shift worker I think the choice to not have it learning the last 7 days (which is my roster, so it has always learnt the wrong time of day), as well as being able to have different basal rates for nights and days. Nothing is perfect and the cons that have me worried are the pump itself, not sure if the Tandem can cop a beating like my 780g, looks a bit softer, also the fact the Tandem will only correct once an hour, not every 5 minutes. If you’re having a rough day, it happens, and it will take far too long to bring you down at once per hour without phantom dosing yourself.

 

[Justin04]

And yes it must’ve heard me talking bad of it because the sensor just failed

 

[CazJaAk]

Hi

Ive been approved funding to have the 780g with the Guardian 4. All the gear is actually sitting in my spare room waiting for an appointment with the Rep to set me all up... It's like tangling a carrot!!

I've been looking for some genuine/honest experiences and advice when first going onto this set up (I'm already a Medtronic pump user with the 640g) but can't seem to find anything but Medtronics advertising and people who are clearly affiliated with them.

Can anyone offer anything? I worried I've bigged it's capabilities up and really, experience should tell me that with diabetes technology there is always a catch or something that's not quite good enough.

TiA
Shell x

Hi Shell I have been on the Medtronic 780 CGM with Guardian 4 for 7 months. I have posted a thread about the fact that it has become very dominating in my life. If algorithms don’t calculate properly it wakes me in the night, i was in Norfolk recently with no coverage and even my pump and sensor did not communicate till I got home! That was very stressful. It bleeps at me a lot which I don’t like as it might not be a place where I want say I have a pump! On a positive note I have had better Time in Range for longish periods than before, but this is informed over a 24hr hr period so changes regularly if you get a high b/s or low b/s and when all is working well it’s quiet and does its job! Also another thing I stress out every week when I have to change the sensor! Sometimes this does not work straight away and if you get timings wrong in doing this that can be a problem as you have to wait 2 hrs for it to warm up as you may have to calibrate! You need to always take your blood. Testing kit as it regularly ask you to che k BG and if you don’t have it it goes out of smartguard and your stuck. All in all I do feel like a guinea pig and I feel it had dominated my life with diabetes which never happened before! I’m not sure whether to return to old system with Libre2 until it can be worked to be more discreet!

 

[Prancy]

Hi Shell I have been on the Medtronic 780 CGM with Guardian 4 for 7 months. I have posted a thread about the fact that it has become very dominating in my life. If algorithms don’t calculate properly it wakes me in the night, i was in Norfolk recently with no coverage and even my pump and sensor did not communicate till I got home! That was very stressful. It bleeps at me a lot which I don’t like as it might not be a place where I want say I have a pump! On a positive note I have had better Time in Range for longish periods than before, but this is informed over a 24hr hr period so changes regularly if you get a high b/s or low b/s and when all is working well it’s quiet and does its job! Also another thing I stress out every week when I have to change the sensor! Sometimes this does not work straight away and if you get timings wrong in doing this that can be a problem as you have to wait 2 hrs for it to warm up as you may have to calibrate! You need to always take your blood. Testing kit as it regularly ask you to che k BG and if you don’t have it it goes out of smartguard and your stuck. All in all I do feel like a guinea pig and I feel it had dominated my life with diabetes which never happened before! I’m not sure whether to return to old system with Libre2 until it can be worked to be more discreet!

What did you decide to do? It’s 2:40 a.m. and I’m awake because of my pump. It’s the second consecutive night that my 780 has kept me awake with low alerts. There were more last week. Either, it’s a false low reading (I have finger sticked to ensure accuracy and it‘s actually 82 not 62) or it is low while being in smart guard for no apparent reason. There have no boluses that could be responsible. Carb counting is the same. Just the pump putting it below 70. Why? Makes no sense. This is a recent thing and I have no idea why it’s happening, but it must stop.

For the first time in a while, I’m considering switching to a different system. I can’t believe I’m saying that. I’m having to sleep in Temp Target.

 

[twotimes]

Using the Medtronic 780G with the Guardian 4 sensor can be a double-edged sword. While many users, including yourself, appreciate the improved Time in Range and the automatic insulin adjustments, the frequent alerts and reliance on cellular coverage can be stressful, especially during travel or at night. The process of changing sensors can also be anxiety-inducing, particularly if the new sensor doesn’t work immediately and requires calibration. This can make you feel overwhelmed and as if diabetes management has become overly dominant in your life. If discretion is a priority for you, considering a switch back to the Libre2 system might be worthwhile, as it generally offers a quieter experience and simpler sensor changes, albeit with some trade-offs in monitoring capabilities. Ultimately, it’s about finding the balance that best fits your lifestyle and comfort level with diabetes management technology.

 

[Prancy]

I haven’t tried Libre, but have heard good things about it. With the way my BG is, I must have an integrated system with automatic delivery. I thought Dexcom worked that way with Tandem.

 

[Hopeful34]

Dexcom does work with Tandem t slim as a HCL.

 

[Christian_DT1]

Hello everyone, I use the Medtronic 780G in SmartGuard. I am very precise when entering carbohydrates. However, I have the problem that I repeatedly get hypos at night and cannot explain why the auto mode gives me so much insulin. I have already increased the Smartguard target to 120 mg/dl and set the active insulin time to 3.5 hours. So far without effect.

My question: there are the settings "Carb Ratio", "Insulin Sensitivity Factor" and "BG Target" under "Bolus Wizard Setup". Are these settings under "Bolus Wizard Setup" considered by the auto mode? Does anyone else have any tips for me on how I can prevent these nighttime hypos?

 

[Prancy]

Hello everyone, I use the Medtronic 780G in SmartGuard. I am very precise when entering carbohydrates. However, I have the problem that I repeatedly get hypos at night and cannot explain why the auto mode gives me so much insulin. I have already increased the Smartguard target to 120 mg/dl and set the active insulin time to 3.5 hours. So far without effect.

My question: there are the settings "Carb Ratio", "Insulin Sensitivity Factor" and "BG Target" under "Bolus Wizard Setup". Are these settings under "Bolus Wizard Setup" considered by the auto mode? Does anyone else have any tips for me on how I can prevent these nighttime hypos?

I was having the same problems! Last night, I didn’t though…. i stayed around 100, even though I didn’t sleep in Temp Target. I was staying around 70 and dipping lower for some unknown reason. But, with good results last night, I may just watch and see if it’s corrected itself. The theory is, the pump brain learns what works and then adjust. So….I’m a year in on this pump, so….it should know me by now.

I’m going to send a PM to my Endo about this to see if she thinks I should change my Sensitivity factor. I did change my Insulin to Carb ratio a couple of months ago with doctor’s advice, which increased the amount of insulin i get with each carb, but it worked fine and helped me then. So…idk. I don’t think mine is related to my boluses.

It’s recommended to not adjust settings without medical advice, so I’m trying to stick with that, even though I know how to do it.

Please post what you discover. I’ll do the same. I find this so bizarre.

 

[Hopeful34]

It’s recommended to not adjust settings without medical advice, so I’m trying to stick with that, even though I know how to do it.

Have your medical team told you that, or is it something you've read somewhere @Prancy

 

[Prancy]

Have your medical team told you that, or is it something you've read somewhere @Prancy

It’s in pump manuals, policy on all diabetes websites I’ve been a member and been advised by endo office.

 

[Hopeful34]

If you've been advised of that by your endo office, that's fine. Many Type1's adjust their own settings, once they've been on a pump for a while, and their team are happy for them to do that.

 

[Alistair Wood]

Does anybody know if the 780 with g4 and smart guard always asks for collaboration after a sensor change?
We changed sensor tonight only after one day as the placing was uncomfortable for my 10year old son (too skinny so transmitter was poking him in the ribs) and it never asked for collaboration prick test!
Has anyone else had this?

Yes, a couple of times

 

[Alistair Wood]

Using the Medtronic 780G with the Guardian 4 sensor can be a double-edged sword. While many users, including yourself, appreciate the improved Time in Range and the automatic insulin adjustments, the frequent alerts and reliance on cellular coverage can be stressful, especially during travel or at night. The process of changing sensors can also be anxiety-inducing, particularly if the new sensor doesn’t work immediately and requires calibration. This can make you feel overwhelmed and as if diabetes management has become overly dominant in your life. If discretion is a priority for you, considering a switch back to the Libre2 system might be worthwhile, as it generally offers a quieter experience and simpler sensor changes, albeit with some trade-offs in monitoring capabilities. Ultimately, it’s about finding the balance that best fits your lifestyle and comfort level with diabetes management technology.

Changing the sensors is totally, unnecessarily, complicated. What a naff system. I still use the Libre2 for backup and it is wonderful.
The 780G pump itself? Not bad, but I wish so much that it had an increment on the carbs that I could decide eg 5g instead of 1g. When entering say, 30g, I press the button until it goes up to 37, then back down to 28, then up to 30g you know what I mean!