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Upgrading the 640g to 670g

Discussion in 'Insulin Pump Forum' started by aphex2k, Aug 26, 2019.

  1. kitedoc

    kitedoc Type 1 · Well-Known Member

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    Automode allows the BSL to reach 10 mmol/l which is well above recommended levels.
    Do you really want to risk it?
     
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  2. aphex2k

    aphex2k Type 1 · Well-Known Member

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    I had BGL's over 10 in manual mode too. And with MDI. With my 640g, and with my Accucheck Spirit.

    Automode strives to keep you in a target range with a fairly stable graph of levels, rather than the peaks and troughs of extreme highs and lows. I can't think of any insulin delivery method that would completely prevent you from reaching levels higher than 10mmol/L?

    I'm probably misunderstanding your point though? Sorry if I'm completely off the mark!

    (Had another naughty day as some fool left chocolate near my desk and I nibbled. Was fine until the chocolate kicked me in the @Rse a couple of hours later and now I'm at 12 but dropping back down to normal with a wee correction bolus and micro bolusing).
     
  3. aphex2k

    aphex2k Type 1 · Well-Known Member

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    Seem to be eating through sensors :(

    Last one lasted just over 3 days. Replaced on Thursday.

    This morning I woke up and my BG was 9.9. I calibrated and bolused. About an hour later suddenly I'm 2.2 but feel fine. I waited until my BG had come up to 4.5 and tried to recalibrate and got the lovely message that the sensor had expired. Great. It seems that overnight my BG was locked at around 9.5 and I got the message that I needed to give a BG due to minimum delivery? What happened to my 6.7 target? Really not loving micro-bolus. The only time it holds is if I don't eat! I"m also finding that if I enter carbs, the pump only gives me a fraction of what I expect it to. I thought that was because the MB would keep it all going, but it doesn't. And because I can't do a wave bolus, I can't split the insulin delivery. I've just had calzone for dinner (folded pizza) and I know I need a bit of insulin now and a portion later once bread has digested. I can't do this. Now I'm looking at a BG of 6.5 with 3.5u of active insulin and fully expecting a hypo (although if this is an actual hypo, or just the pump telling me I'm sub 3 that's anyone's guess.

    This doesn't seem like a huge leap forward from the old pump and sensors. Annoyingly on the ANZ 670g support group I see people who have got 2 weeks plus from sensors. I don't get it. They seem totally inaccurate. I don't understand why it asks for BG all the time, but not for calibration reasons, just because?

    2 weeks into this, it doesn't seem very good. I'm getting through test strips like there's no tomorrow and having to do the tests at random times through the day AND night. At this rate I'm tempted to sack off AM and go back to manual - after all, this method got my a1c down to 7.7

    So will be emailing Medtronic to get 2 sensors replaced. Not a happy bunny.

    (Oh, I'm hydrating well - plenty of water, been mountain biking today which was fun as the sensor was still in warm up mode for the first part of the ride)

    I know people said be patient..... But I was actually happy with the 640g and its way of working.
     
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  4. DunePlodder

    DunePlodder Type 1 · Well-Known Member

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    Sorry to hear this, I've read quite a few reports of similar experiences.
    It seems that the Medtronic CGM is the weak link.
     
  5. aphex2k

    aphex2k Type 1 · Well-Known Member

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    Could well be. I didn't have issues with the Enlite sensor, it's just these bloody Guardian 3 sensors which seem to have a mind of their own. I've seen people restart them and get 21 days which is mental! I can get 4-5 days if I'm lucky. I wonder if the next box will be better, but I don't want to be playing the sensor lottery every time I put a new one in.

    I will persevere. But in the back of my mind I'm thinking sod it, just go back to manual mode as I was in control of this, not the other way round.
     
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  6. dancer

    dancer Type 1 · Well-Known Member

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    @aphex2k have you tried disconnecting transmitter, charging for 10 minutes then reconnecting and starting as a new sensor?
    Also, have you tried leaving a new sensor to "settle" for a few hours, before connecting the charged transmitter? It could help. I certainly can't connect a new sensor straight away, or my BG will be far off what the sensor says, and after 2 or 3 days the pump would tell me the sensor had expired.
     
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  7. aphex2k

    aphex2k Type 1 · Well-Known Member

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    Never had to settle the enlite sensor. What are the benefits of this? Surely the more time you wait = lower TIR? I don't have the time to be waiting for a sensor to settle. Life is busy, kids work etc. I can't half fit a sensor and I don't see how it would settle better without the external transmitter connected? The filament that's inserted starts to warm up as soon as it's in? The only thing this would improve is a reduced warm up time. It's these (new to me) Guardian 3 sensors which are meant to be better, I just haven't experienced this yet.

    I think.....?

    Plus I use 2 tapes, one holds the sensor in, the other goes over the top and holds the transmitter on. That's how I was shown. Makes removing the transmitter difficult and risks dislodging the sensor. Is there a better way of taping?

    Also Im questioning the accuracy and I can't see that making them last longer would improve the accuracy of the readings?
     
  8. dancer

    dancer Type 1 · Well-Known Member

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    I must admit that the Guardian 3 is great in theory but I don't find the actual sensor better than the Enlite. When my first few Guardian 3 sensors didn't last very long, Medtronic suggested I didn't have enough interstitial fluid for a sensor.I pointed out that the Enlite worked fine (but did work better if it settled in for a couple of hours). They had no answer to that.
    I insert the new sensor while the old one is still working, taping it as usual. After 2 or 3 hours, I remove old sensor and charge transmitter, then connect to new sensor to start warm up time. The Guardian 3 started giving me the full 7 days with reasonable blood sugars, when I did this (apart from the first 12 to 18 hours which can be a real pain in the neck.)
     
  9. aphex2k

    aphex2k Type 1 · Well-Known Member

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    I'm upping my game and trying to cal 4x day at times when my sugars are stable and there's no active insulin. Just done my third one today (5.5 vs 5.8) and will do one before I get off to bed.

    On a side note. Anyone use the Contour Glucometer? I've just found out that if you double tap the menu button, a little light comes on where the test strip gets inserted. Bloody handy for night time testing. I did not know this!
     
  10. kitedoc

    kitedoc Type 1 · Well-Known Member

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    Hi @aphex2k,
    Also see if you can join DiabatteriesDownUnder for advice, even though Dexcom is their main emphasis.
    sk posters there about what there are doing about Medtronic, Loping and whether it is possible to use Dexcom in place of your current cgm. Best Wishes, Also for other looping tips The Bionic Wookie.
     
    • Like Like x 1
    #30 kitedoc, Oct 3, 2019 at 3:23 AM
    Last edited: Oct 3, 2019
  11. aphex2k

    aphex2k Type 1 · Well-Known Member

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    Cheers buddy - it's more of a long term plan tbh. Actually things are ticking over really well the last couple of days. Monday I was 94% in range. Yesterday I got the train to the city and cycled back around 40km or so. Nice warm day, blood sugars were rock solid. I'm learning and the pump is learning....
     
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  12. Peter03

    Peter03 Type 1 · Well-Known Member

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    Thanks for all your posts, it's great to have this information, I am hoping the Medtronic 670g will be available next year in France, so please keep posting and educating us
     
  13. masonbason63

    masonbason63 Type 1 · Well-Known Member

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    That’s really interesting there’s obviously a lot to take in, and really being re taught a new way of pumping, I’m already pretty up on keeping an eye on carbs/bolus ratio but need to get it more tighter.
     
  14. aphex2k

    aphex2k Type 1 · Well-Known Member

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    Bad weekend with sugars all over the place. Sore cannula sites, repaced cannulas. Argh...Poor food choices :(

    But.... I restarted a sensor on Friday after a full 8 days. Monday and it's still working OK today (although I'm expecting it to die and I totally forgot to bring replacement kit with me so might have to nip home). Seems to be accurate when my levels are stable. Medtronic are sending out 2 replacement sensors for 2 which died early but they're on back order, again.

    Definitely seems for me, weekends when my meals and snacks are more sporadic, I think manual mode works better for me. During the week when I generally eat at the same times Auto works better. I think I'm also a lot more carb focussed during the week than I am at the weekends, although the mornings start good (omelette, bacon / sausage and spinach) it's too tempting to nibble a biscuit while I'm doing stuff in the garden or running round with the kids.

    Still learning though.
     
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  15. aphex2k

    aphex2k Type 1 · Well-Known Member

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    damnit, spoke too soon "sensor updating" typical..... Will have to nip home and pick up my kit as i dont want to be installing a new sensor at 6pm at night do i.... *sigh*
     
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  16. masonbason63

    masonbason63 Type 1 · Well-Known Member

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    Haven’t been given the sensors yet but 8 days ? I know when I used the LIBRE I started to get a bit itchy around then.

    I was connected on the 670g yesterday using the Contour Next, it all seemed totally confusing push this scroll that but when I got home I was baffled totally.

    So I just tested regular etc and ate normally and so far have been no higher than 6.9 and no hypos, so I think I’m playing it ok.

    It’s quite easy to read the dials and the handbook is very simple to read and is in colour no black and white which is a bug bear of mine. I’m actually using the bolus wizard for the first time ever why oh why have I never used this before??. I’m using a 1unit to 10 grams carbs and that seems to working but I haven’t eaten anything complex yet to yer if that ratio is right, time will tell.

    So far I’m finding it good to use the Contour Next is compact and easy to read and use well illuminated again in colour.

    So today I’ll be spending reading up on things and testing the water so to speak.

    So far it’s going good
     
  17. aphex2k

    aphex2k Type 1 · Well-Known Member

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    Didn't seem to effect the accuracy of the sensor when I extended it's life. But they do seem to die suddenly without much warning.

    I'm finding correcting a high blood sugar is slow and laborious with auto mode. It just doesn't seem to want to give me enough insulin to effectively lower my levels back into range. I find it's quicker for me to go back to manual mode, correction bolus and sick mode 130%. In auto mode it takes ages and correction BG often suggests no correction dose. If I'm sitting at 12 surely it can't be right that automode doesn't see fit to allow a good correction dose? (I'm actually up at 12.4 now - had a tin of tuna for breakfast and a black coffee and I'm wondering if the new cannula I've put in this morning is perhaps a little off - feels comfortable but there's a chance this is the cause of the "creeping ups").

    AM suggested no correction. MM suggested 2.0u. If that's the calculation I wonder how it would have delivered 2u with micro bolus, and over what period of time if I stayed in AM?
     
  18. DunePlodder

    DunePlodder Type 1 · Well-Known Member

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    Does the 670G do "micro boluses"? I thought it only adjusted basal insulin?
     
  19. aphex2k

    aphex2k Type 1 · Well-Known Member

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    Yup, it gives micro boluses to keep you close to target range.

    This system, in automode, is really different than other pumps. There really isn’t a basal rate in the traditional sense. What you have is AM giving you micro boluses of insulin every 5 minutes based on your sensor readings and how you reacted to the previous micro blouses.
     
  20. dancer

    dancer Type 1 · Well-Known Member

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    My 670G suggests correction if my BG is over 8.3, when there's no active insulin, so it looks like there could be something wrong with yours. You should phone Medtronic and tell them about this.
     
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