Medtronic 780G Pump & Guardian 4 Sensor (Closed Loop System) Temp Target ?

Henry_Sugar said:

Hi all,
Have been on this closed loop system since Nov 2022, and all in all am very impressed!! For the last 30 days I'm 83% in range (+3.9 / -10.0mmol/L) and my average blood sugar reading is 4.5mmol/L. That's assuming I'm reading the tech correctly.......
Yes, the 2 bits of tape you need to attach to the sensor is virtually impossible, if doing by yourself (I find the Patchinga coverings to be great) but that's a minor gripe. So I've finally started walking 10,000 / 12,000 steps a day with no blood level issues, but now I want to start doing some proper exercise, nothing extreme just 30 minutes on my cross trainer. In the past I'd take extra carbs "to cover" the exercise, but if I do that now the SmartGuard software will give me extra insulin to take my blood sugar levels back down. Therefore I will need to use the "Temp Target" on the pump. For those who don't know, it attempts to keep you blood sugar level at 8.3 mmol/L instead of 5.5 / 6.1 / 6.7 depending on your pump settings.
So I'm just looking for anybodies experience using the Temp Target feature? Set it and do nothing else ? Nothing but issues ? Needed tweaking somehow ?

Many thanks in advance, to anybody taking the time to reply......

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I just saw your post about using 780G. I’m very interested in your experience with it. I’m on 670G and I use auto mode over 95% of the time. I struggle with it running me low during the night, even though I haven’t bolused. I’m hoping the 780 might be better and improved. I’d love to see more about how things are going with you.

Henry_Sugar said:

Hi all,
Have been on this closed loop system since Nov 2022, and all in all am very impressed!! For the last 30 days I'm 83% in range (+3.9 / -10.0mmol/L) and my average blood sugar reading is 4.5mmol/L. That's assuming I'm reading the tech correctly.......
Yes, the 2 bits of tape you need to attach to the sensor is virtually impossible, if doing by yourself (I find the Patchinga coverings to be great) but that's a minor gripe. So I've finally started walking 10,000 / 12,000 steps a day with no blood level issues, but now I want to start doing some proper exercise, nothing extreme just 30 minutes on my cross trainer. In the past I'd take extra carbs "to cover" the exercise, but if I do that now the SmartGuard software will give me extra insulin to take my blood sugar levels back down. Therefore I will need to use the "Temp Target" on the pump. For those who don't know, it attempts to keep you blood sugar level at 8.3 mmol/L instead of 5.5 / 6.1 / 6.7 depending on your pump settings.
So I'm just looking for anybodies experience using the Temp Target feature? Set it and do nothing else ? Nothing but issues ? Needed tweaking somehow ?

Many thanks in advance, to anybody taking the time to reply......

Click to expand...

Hi. I’ve started with the M780 just over a week ago after 3 good years with the M670 (replaced early with reservoir issue).
The Temp Target on the 670 never really worked for me. Particularly if you have IOB and I think it’s fair to say that’s a general view. I remember In my early 670 days Medtronic advised me to select Temp Target at least 2 hours before taking exercise (not very practical). Probably when IOB is low or zero.

As you say the M780’s Smartguard will bolus you if it detects additional carb intake takes you over your target level, but these would only be micro bolusses and couldn’t address substantial carb intakes. If that was the case we wouldn’t still need to bolus before meals.
I would still try the Temp Target, but I would also be prepared to to take plenty of carbs. I think the correct balance will be based on experiences.

Along with the new M780 I was lucky to be also allocated the G4 sensors and the new Extended Wear Mio 7 day Infusion sets.
It’s very early days for me, but I’m very impressed so far. It seems so strange not needing to BG check for every meal and not having to change sets every 3 days.
I’m now beginning to feel less like a pincushion.
Good luck with your exercise.

Dexta said:

Hi. I’ve started with the M780 just over a week ago after 3 good years with the M670 (replaced early with reservoir issue).
The Temp Target on the 670 never really worked for me. Particularly if you have IOB and I think it’s fair to say that’s a general view. I remember In my early 670 days Medtronic advised me to select Temp Target at least 2 hours before taking exercise (not very practical). Probably when IOB is low or zero.

As you say the M780’s Smartguard will bolus you if it detects additional carb intake takes you over your target level, but these would only be micro bolusses and couldn’t address substantial carb intakes. If that was the case we wouldn’t still need to bolus before meals.
I would still try the Temp Target, but I would also be prepared to to take plenty of carbs. I think the correct balance will be based on experiences.

Along with the new M780 I was lucky to be also allocated the G4 sensors and the new Extended Wear Mio 7 day Infusion sets.
It’s very early days for me, but I’m very impressed so far. It seems so strange not needing to BG check for every meal and not having to change sets every 3 days.
I’m now beginning to feel less like a pincushion.
Good luck with your exercise.

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Am I correct in my belief that the M670, in Auto mode is supposed to increase basal, when you need it, AND slow or stop basal if that is needed, based on your numbers? So, the M780 would not only do that, but also do micro boluses? Is that right?

Your initial reports sound good.

Henry_Sugar said:

@Dextra,
Re ordered my supplies, but still on 3 day infusion sets, because I need to talk with the hospital to get it changed to 7 days.....

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In fairness to Medtronic I don’t think they can just automatically upgrade our pump equipment.
Hopefully, if your hospital is able to email them you should then be able to place your order. I would like to think there will be some cost savings owing to the ‘extended wear’.

Does anyone have the cost for this system? I just sticker shock on Tandem. I have insurance, but it’s not as much as when I got my 670G years ago. I had only a small out of pocket cost.

Henry_Sugar said:

I'm in the Uk Prancy so NHS funded, so I cannot help you, but I did find a couple of links that you may assist you, good luck...

Medtronic MiniMed 780G Hybrid Closed-Loop System to Launch in United States - DSM

The company’s latest insulin pump features new meal detection technology and can correct blood glucose levels every five minutes.

www.diabetesselfmanagement.com

MiniMed™ 780G Insulin Pump System | Medtronic

Learn more about the MiniMed 780G insulin pump system with real-time insulin adjustments and corrections all day and night.

www.medtronicdiabetes.com

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Thank you! One link says that regardless of which Medtronic model I have and if out of warranty, they’ll arrange to get me a 780G. Does that mean no money up front? Hmmmm….I’ll have to explore that. No up front out of pocket costs might entice me. I’ve just resolved that no matter which system I get, I’ll like feel I made the wrong decision. Lol

Dexta said:

In fairness to Medtronic I don’t think they can just automatically upgrade our pump equipment.
Hopefully, if your hospital is able to email them you should then be able to place your order. I would like to think there will be some cost savings owing to the ‘extended wear’.

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I'm thinking the same thing with the extended infusion sets. I'm in Canada though, where we don't get full funding for many diabetic products we need to stay alive - so at least I'm able to work still and able to afford CGM and Pharmacare (pump is covered by province). We're allocated $2,400 Cdn (about 1,400 Pound Sterling) for the year - so better than nothing - but if I can get 7 days out of an infusion set - instead of 3-4 - then more money for the juice of life, aka insulin that fills up the reservoir.

Hi please can anyone advise, so I’m on the 780g with guardian 4 sensor- it’s great. I’m a bit unsure what I may need to alter, seeing as my target is 5.6 quite often I’m hovering around 8/9 with insulin on board but unable to do a correction. Can anyone advise as I’d rather be no higher than 7 ideally. Should I consider changing my basal rates slightly (upping)

Jess1D said:

Hi please can anyone advise, so I’m on the 780g with guardian 4 sensor- it’s great. I’m a bit unsure what I may need to alter, seeing as my target is 5.6 quite often I’m hovering around 8/9 with insulin on board but unable to do a correction. Can anyone advise as I’d rather be no higher than 7 ideally. Should I consider changing my basal rates slightly (upping)

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I'm new to the 780G (using G3 - it only got approved this month in Canada) - but changing out your basal settings will NOT make any difference to your readings - according to the Medtronic Support when I'd asked the same question. Depending on how long you've been in SmartMode - be patient (I've only been on the 780G now for almost 2 months - and it's been a struggle with maintaining normal preMedtronic / closed looping BG's).

One thing - your Insulin on Board - aka IOB - I learned through another website meant for CDE's - that it should be set to 2 HOURS.

Are you lucky enough to have a good team that understands the "workings" of the 780G as well? I sadly don't, so am self taught with forums like this - along with finally hearing back from Medtronic Canada when I had some serious almost ER situations during a holiday I was on (glad I wasn't solo travelling this time - it was scary with going too low and then way high - like 18!!!).

My insulin on board is set to 3 hours by my team.
Just a bit frustrating be up at like 9 for a few hours or so when I want to be lower

I reduced mine from 3 to 2 hours during my initial Medtronic Smartmode training session. I know my DSN would say it’s my choice.
Judging by the number of micro boluses the M780 is capable of generating, it just maybe that the shorter time setting will guide you nearer to your target quicker.
I must admit that I’ve no idea how the IOB is able to react to the different time settings, but I don’t think it can do any harm.

Dexta said:

I reduced mine from 3 to 2 hours during my initial Medtronic Smartmode training session. I know my DSN would say it’s my choice.
Judging by the number of micro boluses the M780 is capable of generating, it just maybe that the shorter time setting will guide you nearer to your target quicker.
I must admit that I’ve no idea how the IOB is able to react to the different time settings, but I don’t think it can do any harm.

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Thank you
Will give this a try

Jess1D said:

Thank you
Will give this a try

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Last night I attended a Medtronic virtual event for those new to the 780G (still on G3) here in Canada. Overall, it went really well with learning some tips - and how my "phantom carbs" (I had called them ghost carbs when I wrote in the Chat box for the discussion afterwards) - and that's a big no no for helping the algorithm to learn the individual. So last night, I went to bed at 9 (I like to be between 5-7 at night when doing manual mode in pumps / MDI) - and woke up to 6.9. So that's not to bad.

And yes, the IOB being set at 2 hours with the closed looping system I've seen mentioned in many forums (I'm self taught on pumps through places like this) - and also CDE verified it in discussion last night. From what my nontechnical brain can fathom (and anyone who is more brill in that area - pop in and correct/explain) - the algorithm is set for the time. The CDE had given a case story of someone who was on 3 for their IOB - and when comparing the before and after - just with that change - it really made a difference (they were having lows overnight).

Also, learned that the correction factor that the algorithm uses when say you're calculating your carbs/AutoCorrect - it doesn't use the 5.5 setting but the 6.7 (I like to be tightly controlled - and maybe reason for little complications from 57 years of the D ??). So that does explain why I never quite get close to the lower numbers I like, and why my phantom carbs I'd take (when the AutoCorrect would give .1 unit ... I'd add a few more based on bolus calculator I use on my mobile that's set up with same settings as the pump).

Also, I had my bolus increment set at .1 units - the CDE at this virtual event - said it's best to keep it at .025 - since it allows better increments of insulin rather than the .1. I have had to set my I:C ratios to a point I never thought would be what they are - but I guess with age - I'm the opposite of what the CDE said last night - that as we age we need less insulin. Ha! Ha! I always seem to go against the norm - but all good - since someone reading this - maybe you - we don't all fit into that cookie cutter mold - so what works for one - may not work for the other. I never used to think so much about diabetes until starting on technology - and seeing it constantly telling you if you're up/down/all around - can be right mind boggling depending on how you view it all. The joys of being OCD and having discovered after a stint in a mental ward - I've got quite a few mental quirks from having been a diabetic for so long. Hopefully, pumps like this, and well informed / up to date CDE's, etc. will be able to help those who can get it. I live in a small town, full of a lot of retirees, and of course, sadly many are Type 2 diabetics.

Hoping this makes sense @Jess1D - and sorry for babbling on (having a late lunch break) - this is all new to me - having a pump do all the work - instead of me. I'll see how it goes with my first CDE appointment at my local hospital here in Cornwall (Ontario - not the UK) - and see if there's some more tweaks they can offer to me - as I tend to run high after the same breakfast every day - which I don't get when in Manual mode or MDI.

Cheerio for now. Lunch break ... is over!