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Treating hypo’s using Medtronic CGM

S

Straw362

Member
Messages
24
Type of diabetes
Type 1
Treatment type
Insulin
Hi
Can anyone help me . My daughter has just had a Medtronic 780g pump , also using the cgm sensor in smart guard. We are told that the CGM adapts to her body & should stop her dropping low.
The machine caused her to drop to 2.7 hypo.
The issue we have is that when we treat a hypo & she’s comes out of low sugars with jelly babies . When her sugars comes up the machine does a auto correction & pumps insulin back in. So she’s dropping straight back into hypo. Does anyone have the same problem or any suggestions how to stop her dropping back into a hypo
 
Hi Straw,

I have the same issue with the Tandem Slim and Control IQ using the G6 CGM, what the system doesn't have is the ability to prevent hypos in time, particularly if there is too much insulin on board already, the pump system wouldn't cause the 2.7 hypo. So in theory it isn't the pump/CGM causing the hypo but it could be from too much insulin, exercise, heat, stress etc etc. I think it is a mis conception that a pump/CGM system will prevent hypos though. They certainly help with time in range which is vital as an indicator to improving control with t1.

My approach would be to follow up with a carby snack after quick acting glucose treatment and allow the pump to correct then, generally with hypos the liver will also produce some glucose too and at some point later on this will be restocked from glucose in the blood which can cause a second dip, that's why treating the first one with carbs say a digestive biscuit will help to prevent the second dip.
 
 
Hi Juicyj
Thanks very much for the reply ,it’s very helpful we would normally treat my daughter with a carb after her jelly babies when we were pen injecting, but when she went on the pump we were told not to. We will go back to treating a hypo back with a carb
 
It's interesting what we get told, as our realities can be quite different, based on the fact that there is no one size fit's all, I would certainly err on the side of caution when it comes to hypos, as it's best to prevent them if at all possible but correct a high instead. Keep a record though if you can, it's useful to see if there's a pattern to them in regards to time of day, food/carbs eaten and insulin taken, as the more knowledge you have the better prepared you will be.
 
Reactions: ert
Hi
It’s very interesting , daughter has only been on the CGM 2 weeks , & the insulin pump nearly 3 months , after being on pen injections for 2 1/2 years & we can already see the great benefits of my daughter being in range a lot more , when you see a flattish line you think great. But because this is new to us all it’s also very worrying.
 
I think the worry comes from trusting medical devices that control your life so confidence does take time to build, but it's also an incredibly useful piece of kit that can start to take some of the stress out of your hands. When I first started on a pump I got a copy of John Walsh's 'Pumping Insulin' to help me manage it better, with the greatest respect to nurses, it was in my own hands to manage my pump and know more about achieving better control. It's the same with any tech, it's only as good as the user input so getting ratios and settings fine tuned means better control. My focus is now purely on 'time in range' as my guide to control, I don't stress about the daily highs and lows unless they are affecting my TIR, and then when my TIR is dropping I know I have to do some basal fasting checks to make sure my background ratios are right before looking at bolus ratios etc.
 
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