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Question Regarding Medtronic Vs Tandem T slim / Remote Bolus?

D

devisha96

Newbie
Messages
4
Type of diabetes
Type 1
Hi Everyone, I'm new to this platform. I have read through a lot of these forums and when I first made my pump choice it was actually this forum that helped me decide!

I am currently on the accu-chek Insight and I am due to switch over and have been given the choice between Medtronic (I think 770g) or Tandem TSlim. I currently use Freestyle libre and think being able to manually enter a BG reading will be fab. There is just one think I am unsure about, I wanted to know if anyone using Medtronic pump knew if this had a facility to remote bolus. I understand that it comes with an Accu-chek Guide link meter but I am unable to see if this pump has any possibility to remote bolus with the meter. I believe the Tandem does not have this facility at all so this feature will probably help me decide between the two. I did try to contact the company however, i have not heard back.

Any answers would be much appreciated!
 
Hi, guessing your from the states if your getting the 770G? I’m using the 780G which is the updated version of the 770G, the accu check guide link meter will send over your BG readings to the pump via Bluetooth but there is no way to remotely bolus with the Medtronic systems.

If I’ve got it wrong & your from the UK, I would inquire about being funded for the Medtronic 780G with the guardian 3 CGM. That’s basically Medtronics version of the Libre, it links up with your pump & constantly tracks your BG sending all the results to your pump. The pump can then adjust your basal insulin & automatically give correction bolus doses if the pump senses your going high. It’s kind of like a artificial pancreas
 
The t:slim allows manual entry of BG reading direct into the pump. Today the t:slim has no remote capability in the UK, in the USA there is an App that allows users to "read" pump data on their phone (not yet released in the UK). There is lots of talk about remote bolus in the next release of the App, rumours are it will be mid this year in the USA and end this year in Europe but these are only rumours. The management capability of the t:slim and 780G are very similar, like a dimmer switch operation on bolus/basal based upon CGM (turning up or down or off as needed).
 
Thank you for the information Maco. I believe it is the 780g (just got the models mixed up). Unfortunately I dont think they will fund the CGM in my ccg at the current time. I will have a look into it, thank you

 

Oh fab! Thank you for the info. I hope they release this feature soon - it would make things so much easier Hope you're getting on well with Tslim.
 
devisha96 said:
Oh fab! Thank you for the info. I hope they release this feature soon - it would make things so much easier Hope you're getting on well with Tslim.
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t:slim is great for me. I would say that until the remote capability is released in USA (followed by Europe) its just a rumour, sadly I've seen over the past decade that there are lots things spoken about that are "in the manufacturers product pipeline" that we never ever see.
 
devisha96 said:
Thank you for the information Maco. I believe it is the 780g (just got the models mixed up). Unfortunately I dont think they will fund the CGM in my ccg at the current time. I will have a look into it, thank you
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I don’t want to put a downer on things, but the 780G without the CGM is completely pointless. It just becomes another pump. You’ll lose all automode features which is basically what the 780G is all about, unless your happy to self fund?
 
Maco said:
I don’t want to put a downer on things, but the 780G without the CGM is completely pointless. It just becomes another pump. You’ll lose all automode features which is basically what the 780G is all about, unless your happy to self fund?
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Same for the t:slim unfortunately, if you have no ability to fund or get CGM funding :-(
 
Chas C said:
Same for the t:slim unfortunately, if you have no ability to fund or get CGM funding :-(
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I would be absolutely gutted if they offered me the T-slim or 780G but said we won’t fund you for the CGM. If you want to self fund the Guardian 3 CGM, Medtronics best deal/offer is a 364 day rolling contract which costs £1820. Works out at £5 a day, doesn’t sound a lot at £5 a day but £35 a week or £140 a month doesn’t sound that cheap.

Just had a quick look on the dexcom website & the offer they have for a 12 month contract is £1908 billed every 30 days at £159. Not sure if you can get it cheaper if you have the T-slim, @Chas C will be able to answer that.

For me, the costs to self fund both CGM’s are more than half the cost of my mortgage so personally not something I’d want to self fund.
 

@Maco yep you have the pricing correct, I self funded for nearly 8 yrs and agree its not cheap. I was pleased when moved to the t:slim and found that my County could fund if I met the conditions, my consultant and his team worked really hard for me and got me funding.
 
Hi both,

Thank you so much for your replies! (I couldnt log onto to the forum for ages and I then didn't check back). I got the Tslim pump in the end. Unfortunately without CGM but I was told about talks with linking it to the libre... and so far its been good.

Thank you so much for the advice and replies guys!
 

I have heard on the grape vine that t:slim might link to the Libre 3 ?, but when I have no idea.
 
Sadly neither the Medtronic or the T:Slim allow remote bolus from a phone, which I think is down to the fact the app needs to be a certified for it by regulators. As others have said, we’re likely to see it on both pumps at some point in the not too distant future, but when is anyones guess knowing the complexity of medical regulations.

From my research, CamAPS FX with Dana (I or RS) pumps allow you to remote bolus, as does the OmniPod (from the omnipod specific handset)
 

Tandem's ability to be remotely controlled by phone has just been passed by the FDA, I believe. I am on the T slim at the minute but it was a big mistake for me - the algorithm and way insulin is delivered just doesn't seem to work for me and I am very allergic to the Dexcom adhesive, which as it stays on for 10 days has to be pretty lethal. I have a massive allergic reaction with each one. And, as mentioned above, there is talk of it being possible to use Libre sensors in the future which would be a game changer for many people. Dexcom continually upgrades and as soon as a problem is found, unlike with Medtronic, they upgrade software and you can get your pump upgraded.

Many people think it's fabulous - but you have to have your basal rates perfect to get the CIQ function to work well. It continuously refers back to that basal rate so it is the basis of your control. The Medtronic learns your patterns and so getting basals perfect before starting is not such a problem. Personally I would fight to get the sensors funded and without the pumps is as said above are just pumps - and these are c ever machines. If you don't have warning symptoms you should stand a chance.

I think control for control they are probably very similar having been in both a 780 group and a tandem group. Some people do not get on with Medtronic sensors and some don't get on wth Dexcom - but Dexcom seem consistently accurate for most people. However I question that you don't need to calibrate at all - if I do a blood test I often find the sensors are not in agreement even with a stable blood sugar. I always got on with Medtronic sensors. They work for me and the G4 has only a couple of calibrations needed if that. I haven't heard with my ear to the ground if it will be possible to use a phone with the Medtronic for bolusing, or if it is in production - also I don't think you can see your BS on an apple watch which you can with a Tandem, and I will miss that, as I'm having to go back to the Medtronic.
 
I use tandem and am fortunate enough to be funded for the Dexcom that it pairs with. It does small dose adjustments for me to prevent hypo or treat a slight hyper i.e. can't deal with a massive overdose nor a bag of doughnuts!
I believe that the cgm/pump loop is the future and so do the manufacturers. I'd go for the pump which is likely to get paired up with the fsl in the near future.
I had the Insight previously and find this one easier to use re insertion sites, less occlusions even though it is cartridge based and love being able to charge it like a mobile phone!
https://abbott.mediaroom.com/2020-0...for-Future-Automated-Insulin-Delivery-Systems
 
NicoleC1971 said:
I use tandem and am fortunate enough to be funded for the Dexcom that it pairs with.
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I'm finding the Dexcom CGM takes a day or so to become accurate after changing the sensor. Is that a problem for you if it's paired to your pump on the first day after you change the sensor? i.e. does it give you the wrong amount of insulin if the CGM is not quite right?
 
Not a problem for me in that I was told not to 'calibrate' the sensor because the differences were so minor between capillary (finger pricks) and intracellular (sensor) . I haven't noticed any issues with new sensors getting it so wrong that I've noticed anyway! I think the pump is adjusting all the time in any case but as I have my basal more or less right and eat low carb, I don't really need to think too much other than remembering to regularly change the cartridge and charge it.
The sensor will talk to the pump and the pump auto corrects in a small and incremental way to nip problems in the bud. You can also set a bolus limit which has to be over ridden to deliver a dose. I find any hypos I have had on it have been down to human error eg. getting frustrated at a high caused by problem with the insertion site and over riding the pump 's suggested correction dose.
 
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