That one thing about your pump?

[Swesent]

There's one thing about the MedTronic 780G I can share. A certain "feature" of its "SmartGuard" algorithm that no-one ever mentioned to me - something that forced me to change pump to a T:Slim X2 instead. When I got the 780G I was on a very strict diet Monday through Friday, eating extremely small amounts of carbs. And then, during the weekends (Saturday and Sunday) I wanted to eat more freely - with much more carbs for my meals. However, that was impossible to do with the 780G pump since it always cut all my boluses by 70% during the weekends.

After quite a long time, trying to figure out why, asking my pump-representative, asking my diabetes team - I finally turned to the US Medtronic support who provided me with the explanation. And I'm quite shocked how they could even come up with the idea of programming the "SmartGuard" algorithm this way...

You see; whenever you bolus before a meal, the algorithm calculates on all the usual stuff (amount of carbs entered, carb sensitivity factor, projected glucose levels and all that stuff. However - with the 780G they've added one more "feature", breaking it entirely! The algorithm checks the average bolus throughout the last five days and makes corrections based on that - completely overriding all other settings and the carb amount that you've entered! So what happened for me, when wanting to eat a pizza or similar on Saturday. I bolus for like 125g of carbs. But then the "SmartGuard" checks five days back, where I've eaten like 10 - 15g of carbs for each meal - and then it goes: "Well, I can see that you've only bolused for 13g of carbs on average during the past five days - there's no way I will let you get a 125g carb bolus now! Way too dangerous!" and then the algorithm reduces my pizza-bolus by 70% - letting about 3-4 units go through, instead of the 17-18 units of insulin that I should have gotten, that I would have NEEDED! And my blood glucose follows suit - going extremely high during the meal - forcing me to compensate by insulin injections.

So if you intend on eating very differently between workdays and weekends, for example, then I would really advice you to look for some other pump, other than the 780G. I was lucky enough that I got to change my pump to a T:Slim X2 because of this, and this pump works wonders! Couldn't be happier - manages everything with a breeze!

 

[searley]

There's one thing about the MedTronic 780G I can share. A certain "feature" of its "SmartGuard" algorithm that no-one ever mentioned to me - something that forced me to change pump to a T:Slim X2 instead. When I got the 780G I was on a very strict diet Monday through Friday, eating extremely small amounts of carbs. And then, during the weekends (Saturday and Sunday) I wanted to eat more freely - with much more carbs for my meals. However, that was impossible to do with the 780G pump since it always cut all my boluses by 70% during the weekends.

After quite a long time, trying to figure out why, asking my pump-representative, asking my diabetes team - I finally turned to the US Medtronic support who provided me with the explanation. And I'm quite shocked how they could even come up with the idea of programming the "SmartGuard" algorithm this way...

You see; whenever you bolus before a meal, the algorithm calculates on all the usual stuff (amount of carbs entered, carb sensitivity factor, projected glucose levels and all that stuff. However - with the 780G they've added one more "feature", breaking it entirely! The algorithm checks the average bolus throughout the last five days and makes corrections based on that - completely overriding all other settings and the carb amount that you've entered! So what happened for me, when wanting to eat a pizza or similar on Saturday. I bolus for like 125g of carbs. But then the "SmartGuard" checks five days back, where I've eaten like 10 - 15g of carbs for each meal - and then it goes: "Well, I can see that you've only bolused for 13g of carbs on average during the past five days - there's no way I will let you get a 125g carb bolus now! Way too dangerous!" and then the algorithm reduces my pizza-bolus by 70% - letting about 3-4 units go through, instead of the 17-18 units of insulin that I should have gotten, that I would have NEEDED! And my blood glucose follows suit - going extremely high during the meal - forcing me to compensate by insulin injections.

So if you intend on eating very differently between workdays and weekends, for example, then I would really advice you to look for some other pump, other than the 780G. I was lucky enough that I got to change my pump to a T:Slim X2 because of this, and this pump works wonders! Couldn't be happier - manages everything with a breeze!

Certainly wouldn’t be a reason to get rid of the 780.. you could turn off smart guard dose whatever you want, then turn smart guard back on.. I’ve found the 780 to be significantly better than the tslim

The 780 learns from you and adapts the tslim does not

The 780 works to target the tslim to range

The tslim is much slower at correcting highs due to the reduced corrections

On the 780 you can adjust the insulin active time but not on the tslim

In just over a month I’ve had a massive reduction in my hba1c moving to yhev780

 

[Swesent]

Certainly wouldn’t be a reason to get rid of the 780.. you could turn off smart guard dose whatever you want, then turn smart guard back on.. I’ve found the 780 to be significantly better than the tslim

The 780 learns from you and adapts the tslim does not

The 780 works to target the tslim to range

The tslim is much slower at correcting highs due to the reduced corrections

On the 780 you can adjust the insulin active time but not on the tslim

In just over a month I’ve had a massive reduction in my hba1c moving to yhev780

Yeah, it's the "learns and adapts" that it does wrong - when it starts to cut 70% of much needed boluses. And I rather not have to jump in and out of Smartguard with every single meal bolus when Control-IQ let's me not only have all the insulin I need, but also lets me use combined boluses where I can have the pump deliver 20% of my meal bolus right away and have the remaining 80% delivered over a completely optional time frame for up to two hours.

Anyway, I'm not here to argue pump selections. I am well aware of what the 780G can and can not manage. I'm just sharing the experience I had with the 780G - and if that pump works better for you, then I'm happy for you! To me, it was indeed a huge enough reason to change the pump though, as I don't wish to have the pump's algorithm as my main antagonist throughout my next few years to come.

And congrats to your lowered HbA1c - quite the same as my outcome after switching over to the T:Slim.