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Medtronic MiniMed 640G System

Well,

I believe my order has been placed by my DNS for 640g.

More apprehensive than excited to be honest. Interested in accuracy, reliability and cost effectiveness really so starting to think the vibe and the dexcomm might be a better choice.

The pump does have some great features, but they all hinge on the enlite sensors.

Without the sensors, it's a nice looking pump with features that are to be found on all the other pumps.

The sensors at £52.50 for six days, just don't seem good enough from the reviews I've found on line.

Can anybody confirm categorically that the sensors can be restarted and made to last 12 days. I know this was possible with the original enlite sensors, but I've heard nothing on the 640G.

I'll be getting a free transmitter and five free sensors with the 640G, but the dexcomm still works out much cheaper in the long term....
 
ConsultingTimeLordElf said:
Hi @buckley8219 I managed to get long term funding because I don't have any hypo or hyper awareness. I've had a few close calls so.
Click to expand...

I'm keen to make an application for funding, was going to use the starter pack to get 8 weeks of data.

Due to tight control and mostly sitting between 4.2-6.5 my warning signs have faded. I also live alone. My mother also died aged 44 following a protracted night time low and was left in a vegetative state. So I have big fears around night time lows.

The annoying dichotomy with CGM funding is that in order to meet the requirements for funding, you're very likely to sacrifice your driving licence in the process.

E.g regular severe hypos and evidence of hospital admission.
 

Do you actually need hospital admissions? I hope not, because my DSN has suggested I ask my consultant for funding!
 
Well INPUT mention on their page on the subject that funding is more likely to be provided if you can evidence a cost saving, e.g hospital admissions, severe lows requiring third party assistant.

Both of which will get you a review of probably a suspension by the DVLA.
 
Simple solution is to run a bit higher and also set your pump to switch off if not used as in button push within x hours. I know the Cozmo and the Animas pumps have this function.
I live alone have Addison's as an extra bonus and was told as no one else in the county had funding for cgm then I couldn't either as it wasn't fair! I didn't like to ask if it was fair that I had Addison's disease as well.
 


What a horrible thing to say to you! :-/
 
-Artemis- said:
What a horrible thing to say to you! :-/
Click to expand...
That's normal from my commissioning group
I have someone from an ex forces charity coming to visit tomorrow who hopefully will fund my sensors.
 
CarbsRok said:
That's normal from my commissioning group
I have someone from an ex forces charity coming to visit tomorrow who hopefully will fund my sensors.
Click to expand...

Ah -- that's much better! Fingers crossed...! I have temporary funding because of living alone so it's definitely complete rubbish that they said to you no one does... I'll keep my fingers crossed for you for tomorrow
 
Applying for CGM funding is a real minefield I agree and doesn't come without associated problems.

I started to go down the pancreas/islet cell transplant route before being granted funding for CGM due to no hypo awareness and many episodes of going unconscious when and wherever with zero warning, requiring third party/paramedic assistance.I had already had my driving licence revoked due to 80% sight loss from proliferative retinopathy so for me that bridge had already been crossed but I know the other funded people at my pump clinic have had their licences revoked.

I have only managed 6 days with the new Guardian transmitter provided with the 640g but will continue to try and extend the sensor life by disconnecting the transmitter - without hopefully dislodging the sensor- and trying to restart the old sensor.
 
Yes I know of two people who have got funding for cgms.

However, both were following hospital admission for a low and evidence of hypo unawareness and living alone.
 
Imaging restarting a sensor with reduced sight isn't the easiest thing in the world.

I'm fine with self funding, well if I get longer than six days for £52.50 I am...
 
I think I should preface by making it clear that I live in the US ... upstate New York to be more specific.

I use Enlites with a Paradigm Revel (723) pump. The Enlites I use are "first gen" because the "(slightly) Enhanced Enlite" which the rest of the world is currently using has not yet been approved for use in the US. For that matter, the US FDA, which is our gateway governmental agency deciding which medical devices are or are not available in the US, has decided we should not even be aware that Medtronic sells the 640G. US Medtronic reps are not supposed to talk about it. At all.

One can only imagine the shocked & horrified looks on FDA faces on that day when they learn about "the Internet".

My main point here is that whatever I think I may know about the 640G should be read with a skeptical eye. My government's policy is that the world would be a better place if I did not know anything until after they decide to approve the device.
buckley8219 said:
Can anybody confirm categorically that the sensors can be restarted and made to last 12 days.
Click to expand...

Here's my short answer about confirming 12 day Enlite use: "Hell, no! Of course, not!"

Here's the longer version.

In my experience and reading, Enlite's have always been finicky. To my mind that seems to be the greatest difference between the Enlite and Dexcom G4. People seem to claim typically, consistently good results using the Dexcom. However, the reports on the Enlite vary. Some people appear to just slap those suckers on and then get good results. Others appear to view the Enlite more as "Satan's CGM sensor!"

Given that background, how the heck can anyone assure you what sort of results you'll get using the Enlite CGM?

To complicate matters even more, remember that you will be using Enlites with the new 640G and the also new Guardian 2 Link transmitter. There are some known hardware differences as well as a bunch of speculations about firmware differences for these devices. So while the experiences of other people who used Enlite with earlier devices may be relevant, they also may not.

The firmware in the 640G may use new calibration algorithms which would affect the accuracy and utility of the CGM results. There is also speculation that the firmware in the Guardian 2 Link may included "additional diagnostics" which monitor the health of the sensor. This could also affect the results you get using the system.

All I think you can count on is that Medtronic promises that the Enlite should work for 6 days. (At least in the US. Not sure what is promised in the UK.) So if the sensor does not work during that time, then they should replace it for you if you report the failure to them. However after six (?) days, all bets are off since the sensor was never supposed to last longer than that ... officially.

Given the apparent variable results reported by different people, I think the only way to know if you, in particular, could go longer than 6 days would be to try it and see how it works for you. Assuming that the 640G will let you reset & continue to use an inserted Enlite.

In hindsight I am puzzled that I haven't seen any clear reports from anyone using the 640G on what happens if you attempt to remove the transmitter, recharge it, then reconnect it to an existing sensor and start it as a "New Sensor". I hope we will eventually get some feedback on this from folks who had previously successfully done this with the early Medtronic pumps. My opinion is that it would be bone headedly stupid for Medtronic to not allow this to work. But that's not the same thing as saying Medtronic would never do this stupid thing.
 

I'm with you on this one John. I've scoured youtube, various forums and can't get a clear report on this, I should be able to get a 7-10 day trial and when I do I'll endeavour to do a restart and will report back. I've had really good luck with accuracy with the freestyle libre and the dexcom I trialled briefly, so fingers crossed.

I guess rationally the Vibe and the Dexcom is now making the most sense!
 
I'm getting the 640g and new Enlites TODAAAAAAAYYYYYYYYYYYYYYY (ahem, sorry, little excited) so can try and report back on this if that helps...? Although, never had a pump or Cgm before so might not be the best person to be fiddling with them... But I'm happy to try
 
If you could Artemis, that would be fantastic. It would be great to get some proper feedback from someone who is setting out to provide it!
 
Hi @-Artemis- pump start day is very exciting I had mine 4 weeks ago (wow that went quick). I was also getting the CGM but they gave me it a few days later when I went back for a canula change. Just a bit of advice so you're not disappointed if you don't get the sensors today. They just want you to get used to the pump first. Hope this helps.
 
@ConsultingTimeLordElf - What is your experience with the Enlite sensors? How long have you found they can be made to last? Or are you not bothering as you have them funded?
 
Hi @tim2000s my sensors last 6 days, I've tried to get them to last longer by saying it's a new sensor but it doesn't seem to work. Overall the sensors are great especially if you're like me and don't have hypo awareness. I had a few problems with the sensors as some were only lasting 2 days and then telling me to change sensors. However, I was assured that it must have just been a bad batch. But otherwise they're great.
 
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