Medtronic 780g + Guardian 4

[Nicola M]

Thank you
Good to have a users feedback. I will ask my nurse about the g3, what would you say is the difference between the g4 & g3-is it just the g3 needs calibration?

Just that the G3 needs calibration, I haven’t been on it for a few months now but if I remember correctly it asks for a calibration every 6 hours for the first 12-18 hours then 12 hourly after that. G4 never really asks for a calibration, very occasionally it will in specific scenarios such as max bolus limit hit for corrections or max time spent without it giving insulin but you don’t have to calibrate much. I personally didn’t mind the calibrations on the G3 though so would happily recommend it

 

[Jess1D]

Just that the G3 needs calibration, I haven’t been on it for a few months now but if I remember correctly it asks for a calibration every 6 hours for the first 12-18 hours then 12 hourly after that. G4 never really asks for a calibration, very occasionally it will in specific scenarios such as max bolus limit hit for corrections or max time spent without it giving insulin but you don’t have to calibrate much. I personally didn’t mind the calibrations on the G3 though so would happily recommend it

Thank you for all this information.
I am really keen to get it though my nurse is kind of like it’s up to you- I would have thought if I can surely it’s worth getting it to get the most out of the pump

 

[Nicola M]

Thank you for all this information.
I am really keen to get it though my nurse is kind of like it’s up to you- I would have thought if I can surely it’s worth getting it to get the most out of the pump

I had a pump before doing hybrid closed looping with the Guardian. I was probably the worst diabetic with a pump I had a hba1c of 78/9%. I was put on the pump and guardian combination as part of an NHS trial. My latest hba1c was 49/6.6%. So really I do think to get the most out of the pump you are correct that having the sensors with it is ideal and can do absolute wonders.

 

[Jess1D]

I had a pump before doing hybrid closed looping with the Guardian. I was probably the worst diabetic with a pump I had a hba1c of 78/9%. I was put on the pump and guardian combination as part of an NHS trial. My latest hba1c was 49/6.6%. So really I do think to get the most out of the pump you are correct that having the sensors with it is ideal and can do absolute wonders.

Yes this what I believe. I’ve got to pick up the new pump & then got zoom meeting with my nurse & Medtronic rep on the 20th February- really hoping k can get the free trial, as the guardian 4 is more than the Dexcom

 

[ElyDave]

I'm starting the 780g and g4 on Tuesday, really looking forward to it.

I'm interested whether anyone has successfully connected to a Garmin Smartwatch?

 

[Jess1D]

So just had an email from the pump rep- she said to start on the pump first then discuss the CGM side of things with my team, I told my nurse I was very interested in the guardian 4. The rep said I will need a lot of support from my team
Is this normal?

 

[Nicola M]

So just had an email from the pump rep- she said to start on the pump first then discuss the CGM side of things with my team, I told my nurse I was very interested in the guardian 4. The rep said I will need a lot of support from my team
Is this normal?

When I swapped from my 640(I think it was 640 ) to my 780g and Guardian 3 I had a training day to swap over to the new pump, learn all of the controls of the pump and how to insert the sensor and set it up which took around 4-5 hours. A week later we then turned smart guard on and had around an hour training to talk about how to turn it on and how it works etc. Aside from that I didn’t really have additional support from my team as such although they were always available to talk if I needed help, my nurse sat in on both training sessions.

 

[Jess1D]

When I swapped from my 640(I think it was 640 ) to my 780g and Guardian 3 I had a training day to swap over to the new pump, learn all of the controls of the pump and how to insert the sensor and set it up which took around 4-5 hours. A week later we then turned smart guard on and had around an hour training to talk about how to turn it on and how it works etc. Aside from that I didn’t really have additional support from my team as such although they were always available to talk if I needed help, my nurse sat in on both training sessions.

Thank you, I will see what happens, keen to try it

 

[smc4761]

Looks like I will be getting a new 780g in the next few weeks to replace my first pump, the 640g. However for some reason my healthboard are not providing the Guardian 4, think they are still waiting for funding

I do use the Libre 2 system at moment

So if I am reading things right, the 780g is really very similar to 640g, if I am not connected to Guardian 4, so there would be no real benefits.
To be honest applying the Guardian 4 seems to be a bit of a faff, is it really worth it, especially as it only lasts 7 days as opposed to 14 with Libre

The new Libre 3 must be due for relaese soon. Is anyone aware if this will work with 780g

 

[Hopeful34]

From what I've read, i think that Libre 3 will work with Tandem pumps, but not Medtronic. Am happy to be corrected, as I can't remember where I read this, sorry.

 

[Dexta]

Most of us still using the M670G or the newer M780G will be using the dedicated Medtronic Guardian 3 sensors which also last 7 days, but needs frequent calibrations. Guardian 4 is relatively new.
Using a Medtronic pump without Guardian sensors will unfortunately restrict its full potential for automatic glucose control.

 

[Nicola M]

In terms of applying the Guardian 4 it doesn’t really take that long, the longest bit is charging the transmitter, the longer you’ve had it the longer it will take as the battery degrades over time but I always put mine on charge and do other things whilst I wait. Applying my sensor and getting set up again probably takes me less than 10 minutes at most after the transmitter has charged.

 

[smc4761]

Most of us still using the M670G or the newer M780G will be using the dedicated Medtronic Guardian 3 sensors which also last 7 days, but needs frequent calibrations. Guardian 4 is relatively new.
Using a Medtronic pump without Guardian sensors will unfortunately restrict its full potential for automatic glucose control.

I thought that was the case, but at the moment our health board is not funding the Guardian sensors which sort of defeats the purpose. I am only getting the new 780g as my existing 640 g is due for replacement.

Its either the 780g or the Tandem. As I am used to Medtronic thought I would stick them

 

[Jess1D]

So would you consider getting the guardian 3/4? I use the Dexcom g6 at the moment but am keen to try the guardian sensors but the price is higher than Dexcom & the MARD is higher.

 

[smc4761]

So would you consider getting the guardian 3/4? I use the Dexcom g6 at the moment but am keen to try the guardian sensors but the price is higher than Dexcom & the MARD is higher.

As I would have to pay for this myself, until such times as my healthboard approve, the answer would be no. I already use Libre 2 on prescription,and overall I find that fairly good, so will continue with that.

I know i cannot use the new Libre 3 with the 780g but that looks to be and excellent sensor, much slimmer and has an even higher MARD. So if the healthboard dont approve Guardian 4 I will eventually just swith to Libre 3 when it becomes more readily available

 

[Jess1D]

As I would have to pay for this myself, until such times as my healthboard approve, the answer would be no. I already use Libre 2 on prescription,and overall I find that fairly good, so will continue with that.

I know i cannot use the new Libre 3 with the 780g but that looks to be and excellent sensor, much slimmer and has an even higher MARD. So if the healthboard dont approve Guardian 4 I will eventually just swith to Libre 3 when it becomes more readily available

That sounds a good plan

 

[DaisyBarberton]

I thought that was the case, but at the moment our health board is not funding the Guardian sensors which sort of defeats the purpose. I am only getting the new 780g as my existing 640 g is due for replacement.

Its either the 780g or the Tandem. As I am used to Medtronic thought I would stick them

 

[DaisyBarberton]

I’d go with Tandem and Dexcom which has a better MARD and you have the freedom of choice in apps on the phone that are compatible with Dexcom. Medtronic doesn’t work with any other apps or devices.
And I wish I had that choice.

 

[Justin04]

After my original post last year things eventually got better with the sensor and pump. Not best but better. So i learned to live with it. Having trouble the last few sensors with it requiring a calibration every 6 hours, 6h 5min to be exact. Has anyone else had this issue and how do I fix it? Medtronic are at a loss as to why. Levels are good high 80’s to 90’s most days. The guardian 4 isn’t available in Aus yet.

 

[Marc J T]

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 / Shell,

After a pump replacement last summer (the front button split on my first 780), I have joined the 0.1%. Since then I have had the pump replaced 3 times, new sensor inserters and the transmitter replaced under warranty. The original 780 worked brilliantly.

The Guardian 4 is the best and worst performing CGM sensor I have experienced (over 10 years of CGM). The basic problem is that I get only around half to 7 days, and only about half of those reliably. About 1/4 fail to deploy properly - for example the needle jams of the plastic cover doesn't come off, plus the odd bleeder. A significant number either don't go the full days or only work mid range - says I'm 5 when I'm 3 and 10 when I'm 18. A number of them just stop working at random. A batch of them didn't stick. Then there's the 1/4 where the accuracy and responsiveness is utterly amazing. No middle ground really.
All of this means Smart Guard is useless. And since the replacement pump change, SG sends me to 15-20 between 10am and 2pm daily. It just stops the basal if sugar is not rising- same at 5 and at 15mmol/l, crazy right. Yet overnight it will keep delivering when below range. And overnight hypos which I sleep through... I've use SG only when sensor is good and mostly overnight. This hybrid mode can average over 80% TIR. But to satisfy Medtronic I've had to persevere so they can get the data. I've also gone full manual for 10 days. Reentering SG with Medtronic optimal set-up made no difference. Near daily BG's of 15-20 (doesn't happen in manual mode, the difference is SG stops the basal).

YMMV, true of CGM too it seems.