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Medtronic Enlite

Juicyj

Juicyj

Expert
Retired Moderator
Messages
9,267
Location
Worcestershire
Type of diabetes
Type 1
Treatment type
Pump
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Hypos, rude people, ignorance and grey days.
I am hoping to get some feedback from an Enlite user and how they get on with using this cgm, also is it failsafe at avoiding hypos ?
 
I've been using the Enlite along with the 640G since November 2015. I still get a few hypos but that's usually my fault. I sometimes get alerts of going low but continue doing what I'm doing "as it won't take very long", but it usually does and I then get an alert saying that the basal has been stopped. If I don't eat quick acting carbs at that point, I will go hypo.

The Enlites have their pros and cons but on the whole I would say that, used properly, they are failsafe. Occasionally I get a sensor that says my BG is higher than it actually is. I take account of this when checking the pump for my BG (before going dancing etc) and am very careful to check my BG more often (just in case ).
 
dancer said:
I've been using the Enlite along with the 640G since November 2015. I still get a few hypos but that's usually my fault. I sometimes get alerts of going low but continue doing what I'm doing "as it won't take very long", but it usually does and I then get an alert saying that the basal has been stopped. If I don't eat quick acting carbs at that point, I will go hypo.

The Enlites have their pros and cons but on the whole I would say that, used properly, they are failsafe. Occasionally I get a sensor that says my BG is higher than it actually is. I take account of this when checking the pump for my BG (before going dancing etc) and am very careful to check my BG more often (just in case ).
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Thanks for the reply.

How many hypos do you get a week/month now ?

What are the pros and cons ?

My Medtronic rep claimed it was the most accurate CGM available, so not sure if you've tried any others and can give me a low down on if it is or not ? It's quite an investment for me but tempted to try it to reduce hypo events if I can, thanks again :)
 
I haven't tried any other cgms. My hypos vary but I might get one per week. Generally the only ones that aren't my fault are the ones I get while asleep. I have NHS funding but realise how expensive the sensors are. You can restart sensors (as a new sensor) to make them last twice as long. I haven't tried doing this twice but think that some people have. I have only restarted sensors when they have been really accurate (and when my very sensitive skin allows it)

If you can afford it, I would say go for it. I wouldn't be without it.
 
I have used the entire since they came out. Unfortunately my medical insurance changed so I do not use them all the time but do use one every 2-3 weeks. They are great when they work but unfortunately as with anything you sometimes get a dud! The company is great to replace them if they are not functioning or assist in troubleshooting. As for accuracy they are for the most part very close
I have restarted a sensor to extend the life and again sometimes it works and sometimes it is not accurate. I have gotten as much as 15 days on one sensor then it started giving wanky readings. Mostly for the initial six days they are very accurate. All other time is bonus but I check with finger sticks more frequently to ensure accuracy
The good thing is they are tied to the pump and will shut it down if necessary
I wish I could afford to wear them more often as they are very useful tool!
 
Thanks @Squidzy and @dancer I am looking at the Dexcom g6 as well and the only major differences are cost and smart guard but the primary focus is simply reducing hypo events, might try the g6 first and see how that goes.
 
@Juicyj - Enlites with Smartguard do work to reduce Hypos effectively, but it's really dependent on how you use them and how you set up Smartguard. I don't think there's a truly failsafe model while you are bolusing for food and while your sensitivity can vary.

What you'll get with Dexcom G6 is predictive low warnings, while the 640G with Smartguard will suspend insulin as it warns you.

This was the analysis that I did, and some lessons learned: http://www.diabettech.com/artificia...-own-activity-and-a-few-useful-lessons-gbdoc/
 
Hi @tim2000s Thanks for posting your link, that's really useful. Theres a few points to consider, firstly reliability, so which sensor is more robust and less likely to fail, second it's accuracy, I'm not so fussed about smart guard as this would be more useful at night time and as my levels are stable through the night, I don't have a great fear of hypos then, it's getting alerts to my iPhone which would make this useful as I can then take action to correct or treat, so not sure if the enlite is just a glorified way of doing this as its considerably more expensive than the g6.
 
@Juicyj I got the G6 starter kit back in July and managed to get 30 days out of the second sensor using xDrip+, the alarms you can set to your phone which is very handy with the loudness and if you set your low alert to say about 5-5.5 mmol you get time to treat the oncoming hypo before it hits you
 
Juicyj said:
Hi @tim2000s Thanks for posting your link, that's really useful. Theres a few points to consider, firstly reliability, so which sensor is more robust and less likely to fail, second it's accuracy, I'm not so fussed about smart guard as this would be more useful at night time and as my levels are stable through the night, I don't have a great fear of hypos then, it's getting alerts to my iPhone which would make this useful as I can then take action to correct or treat, so not sure if the enlite is just a glorified way of doing this as its considerably more expensive than the g6.
Click to expand...
Taking your points one by one:
  1. Reliability: I've not had issues with either the Dexcom or the Enlite in terms of reliability. Both have been equally unlikely to fail for me, but you'll hear fewer scare stories on the internet about Dexcom.
  2. In terms of accuracy, the G6 wins hands down. I didn't have issues with accuracy on the Enlites as long as I calibrated regularly and consistently. The G6 is a world apart though, and remains accurate without needing to calibrate, which is considerably more user friendly.
  3. The predictive low glucose suspend functionality is kind of like an "artificial pancreas -". I found the algorithm to be pretty aggressive, and as I mentioned in the post, like all AP type systems, you need to tune it to you. Once you do, you really do start to stop the lows getting there and don't need to treat in the same way. It becomes hands off. I found PLGS surprisingly useful once I started using it. You can extend the Enlite sensors, but I never got more than 12 days out of them. This does reduce the cost somewhat.
Ultimately you have to make the choice. There's no doubt that predictive low glucose suspend (PLGS) is remarkably useful with the Medtronic system, however, it is noticeably more expensive to fund the Medtronic sensors than it is to fund the Dexcom sensors, and the Dexcom sensors do last longer anyway, and even longer still if you don't use the official app. Most people make their choice based on the amount they can afford to spend.
 
So far so good. The sensors are not as accurate as blood sugar testing, but it's great to see the graph showing if your levels are stable, or going high/low. It's also fantastic to visually see how foods affect you. You get 1,2 or 3 arrows which dictate how fast your levels are rising and dropping.

I've been sneaky and disconnected the transmitter, recharged it and reconnected it as a "new" one as they're not cheap. However, both times I've done this I've got 2-3 days extra and "sensor error" messages. There doesn't seem to be any accuracy as to how long you can eek out of a sensor past the normal 6 days.... Risky.
 
aphex2k said:
So far so good. The sensors are not as accurate as blood sugar testing, but it's great to see the graph showing if your levels are stable, or going high/low. It's also fantastic to visually see how foods affect you. You get 1,2 or 3 arrows which dictate how fast your levels are rising and dropping.

I've been sneaky and disconnected the transmitter, recharged it and reconnected it as a "new" one as they're not cheap. However, both times I've done this I've got 2-3 days extra and "sensor error" messages. There doesn't seem to be any accuracy as to how long you can eek out of a sensor past the normal 6 days.... Risky.
Click to expand...
You have to be very careful not to move the sensor when removing overtape from the transmitter and disconnecting. The one time I wasn't so careful, the sensor wasn't accurate and didn't last another 6 days.
 
dancer said:
You have to be very careful not to move the sensor when removing overtape from the transmitter and disconnecting. The one time I wasn't so careful, the sensor wasn't accurate and didn't last another 6 days.
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Yeah - it pays to work out how to tape the sensor down solidly and independently of the transmitter.
 
Yup - steep learning curve, but I'm getting there (with great advice from here)

The sensor seems to be about 5-6mm but I can see how a bit of rough adjusting of the transmitter could cause it to fail. I'm using Fixomul over both parts - I'm trying to find a decent local supplier of the clear overtape or a suitable alternative which would hold up to sweat / water and 2 young children who love to rough play with Daddy!
 
aphex2k said:
There doesn't seem to be any accuracy as to how long you can eek out of a sensor past the normal 6 days.... Risky.
Click to expand...

My son used to work at Abbotts (Freestyle Libre). He explained how eevrything worked to me. On the filament that stays in your body there is a film of a certain chemical(can't for the life of me remember the name of it!) which reacts with your interstitial fluid. That coating only last a set amount of times then the sensor becomes useless and hence the "no readings" from the reader
 
An enzyme called glucose oxidase - the same that's in test strips, only a fraction of the amount. This converts glucose to hydrogen peroxide. This then reacts with a tiny amount of platinum in the sensors, which then calculates this into a glucose reading from the interstitial fluid.

So they are meant to last 6 days, but depending on your body chemistry some people can get 6 days more, some less (seems like I'm one of those who get less - but having said that I'd want accuracy over saving a few $$!)

(Found this link which explained the anatomy of a CGM sensor)
http://www.diabetesforecast.org/2014/05-may/anatomy-of-a-cgm-sensor.html
 
aphex2k said:
An enzyme called glucose oxidase - the same that's in test strips, only a fraction of the amount. This converts glucose to hydrogen peroxide. This then reacts with a tiny amount of platinum in the sensors, which then calculates this into a glucose reading from the interstitial fluid.

So they are meant to last 6 days, but depending on your body chemistry some people can get 6 days more, some less (seems like I'm one of those who get less - but having said that I'd want accuracy over saving a few $$!)

(Found this link which explained the anatomy of a CGM sensor)
http://www.diabetesforecast.org/2014/05-may/anatomy-of-a-cgm-sensor.html
Click to expand...
That's what you see in the Enlites that are available on the 640G - I believe that's second generation glucose sensing tech. I'm not sure, but I think the Libre, Dexcom G6 and Enlite 3 on the 670G are a newer generation where there is no longer the hydrogen peroxide conversion and it's a direct electron transfer.
 
Medtronic are launching the 670 here as soon as it's got approval and the sensors have been sorted. Big program in place to move people to the newer model as it' closed loop and they posted on their FB page that there will be a 670g "Access Program". Spoke to the rep today and it could take days, or months for approval, they just don't know. It does look like I will be entitled to an upgrade, which is nice!
 
Last year my consultant said the 670G would be ideal for me. I've only had my 640G for just over 2 years, so will have to wait another few years (my last pump was upgraded after 5 years.)
 
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