Kate Johnston's Medtronic 670G start blog

I found this very cool blog by Kate Johnston (loffkat), which documents her start on the 670G. I thought it was an interesting take:

She is an adventurer and an experimenter, like us – check out her motorbike trip! I think she would like our place here.

I invited her here but did not get an answer. I may well have gotten lost in her spam.

@drbbennett, what do you think [of her experiences]?


I mostly kinda scanned it but boy, she sure seems to have had a smoother transition than I have. I think a lot comes down to where you’re starting from. She says she’s been struggling just to get down to a 7 A1C, 8s most of the time. I think those are the people who have the most positive experience. For those of us doing 6 or below on a standard pump, those same results are harder to replicate. I think this one is much closer to my experience, though I differ on some of the details:

His analogy of a big cruise ship with a very small rudder is pretty close to my experience so far.


@drbbennett now that you have seen how the pump functions, what would need to change to work better for you? i.e. as other companies come online with their systems, having control over what, in your opinion, would get you the results you are after? Thanks for blazing the trail.


So far it seems to be the key, in these accounts.


I’m coming to a similar conclusion. If already have A1C under 6ish, probably will be challenging letting the 670 take over.


I think the biggest one is the one everyone knows about and that raises the most skepticism from the experienced pumping community: being able to set a lower target. Because the thing is, I’d be really HAPPY to achieve an A1C equivalent to that 120 target. It equates to a 5.8, which is better than I’ve had since DX in 1983. But everyone’s metabolism is different, and the behaviors programmed into the pump to try to get to that target aren’t going to work the same for me with my specific metabolism as they are for someone else of a different age, gender, activity level etc. It’s a more or less notional set point anyway. What it means for a lot of users who are really happy with the system is that they’re getting their A1C down out of the 8s into the lower 7s or upper 6s. There are also people with the opposite problem who find it’s causing them to run lower than they’d like. Essentially It’s just a way of saying “this pump is only going to be so aggressive toward the BG of any physiology it’s hooked into, no more and no less.” If the whole thing is going to be run by a black-box algorithm that cycles around a certain set point, let me pick a lower set point so I can actually get the result of an A1C centered on 120. Call it something else. “Sensitivity range” or something. It doesn’t have to be unlimited, but it needs to be adjustable so people on the outer slopes of the bell curve don’t have to go crazy trying to get it to do what it’s supposed to do while people in the middle are finding it easy.


@drbbennett, this somehow reminds me of something John Dvorak wrote around 1995, which I have always kept in mind since (to make sure I would never let my engineers do it): fascist software as software where the programmer forces the user to use the software exactly in the way the programmer wants him/her to do it and in no other way.

Fascist diabetes pump software :slight_smile:


Just a thought to throw out. It seems that a lot of people were surprised at how quickly this pump got FDA approval. I believe @Michel posted something about that a while ago.

I wonder how much the inflexibility of the 120 or 150 target settings played into that quick approval.

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What you are referring to:

So what is your take? Would it have happened as fast if the pump let users pick targets like 100 instead of 120?

My guess is that it would not have gone as smoothly.

I hate to say that because that’s not what I would like.

At this point, 100 is kind of the breaking point for me letting something else make decisions on my insulin. I don’t the “black box” aspects of this pump. But I might, possibly, perhaps…let a pump make black box decisions for me as long as it was targeting 100. Anything above that is a deal-breaker for me personally. I know there are many others who are comfortable with 110 or 120 or whatever, and like the aspects of not having to deal with the decisions themselves.

So 100 is just a personal number I have in mind. I don’t know if any pump company will get there anytime soon.

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this was an incredible read. i related to her woes and frustrations. i related to the self-flagellation and self-condemnation regarding all the failed trials after working so hard to live in a target range despite whatever she tried. i shared in her jubilation when she went onto auto-mode. i loved her experience with eating pizza…as well as her attitude of “I’ll show you who’s boss, Diabetes!”

wow. its wonderful to have someone to share such sheer joy and excitement and freedom. i am very impressed.

also, i know that FUD is totally devoted to living D-life Unlimited, but that doesn’t mean that we don’t have to work hard to achieve success. i really felt her pain and her frustration, and then i felt her freedom and especially her ease of life.