FUDiabetes

Medtronic 640g

Hello everyone
I am considering trying a pump but not sure if I really need it.
I am using Tresiba with Actrapid.

My life has changed dramatically since I tried CGM (FreeStyle Libre 1 with miaomiao 2 with xdrip).
My HbA1C now is 6.1-6.3 and this is a dramatic improvement (compared to ~6.8 without CGM).
However I still don’t feel completely free in everydays life.

Nevertheless I am warned about hypo beforehand by notifications and don’t have hypos at all (or may be a soft one once in 3 months), I still need to carefully use carbs. And usually that is not that bad. However when I cycling for a few hours I must switch almost completely to sweet drinks instead of normal water. Also I wanted to start driving a car and because of this I also prefer to be more confident regarding hypos.

I looked forward to 780g initially and they promised that it will be available in my country this autumn. However now Medtronic is saying that it will be available some time next year.

So, is it worth trying 640g?
I never used pumps before, and my current diabetes compensation is not bad at all. I eat small amount of carbs so hoped that with 780g I can forget about counting/bolusing at all (pump will deal with my small spikes, my boluses are usually not more than 4 units, usually I have 1-2 units), but looks like that will not be a case with 640g, only preventing hypos.
People are writing that Medtronics CGM is worse than Libre.

I set up my xdrip so it notifies me when my BG is more than 9.5 mmol so I can perform action. Can I do something like that with a pump? And can it’s CGM somehow be integrated with smartphone?

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If you are looking for a pump that automatically adjusts your insulin, don’t go with Medtronic.

I suggest trying either Tandem, or the next version of OmniPod which will be coming out in 2022.

Most people that use Tandem are happy with what it does. And the people that use OmniPod enjoy the tubeless aspect of it.

Medtronic does not seem to have a lot of positive feedback, and their sensor is not as good as Dexcom.

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Thanks for your answer!
Indead, looked on existing now Omnipods variants - looks interesting
May be I should try it first to feel if pump is for me at all. I still not sure if suspending insulin delivery (manual in Omnipod case) is so big deal.
I have very smal basal amount (11-14 Tresiba depending on season of year)
So everything happenes because of bolus and that fact that I can’t never be 100% perсent sure of carb/insulin ratio (not precise carb calculation, physical exercises, bad mood, I don’t know, phase of the Moon). But probably more rapid acting insuling can be usefull too.
So I see 2 benefits of pump (without any automation)

  1. Mare rapid acting insuling so theoretically it has smaller tails after dealing with meal
  2. Ability to suspend basis delivering for sports activities.

Anything else?

By the way can I simulate behavior of more long acting insuling with pump? Like say “deliver N units in 30 minutes”? Or this depends from pump model?

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As Eric has mentioned, when looking at automated pump systems, the sensor is the critical thing, not the pump. And so any pump that uses Dexcom is going to be superior to the Medtronic offerings. Additionally, the Medtronic pump has a bunch of safety programming that make it a bigger pain to use than the Tandem or the Omnipod. That isn’t to say there aren’t happy campers that use the Medtronic system, but there are many more in our readership that are happy with the other pumps after switching from Medtronic than the other way around.

You can by using an extended bolus, x units over y period of time. So it isn’t exactly like you mention where it will deliver a second bolus at a future time, but it does accomplish the same thing and is very very useful for high fat meals where digestion is slower than normal.

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Another big benefit is the ability to vary the basal throughout the day according to a schedule. Many people need a different amount of basal at night compared with in the daytime. This is noticed first with “the dawn effect” but in my case my basal requirement overnight is about triple what I need around noon, and double what I need in late afternoon-early evening.

And of course, if you are wearing a pump you have insulin available for any correction size or eating at any time.

The pump gives a bolus in multiples of some small amount, such as 0.05u. So giving 3.35u is as easy as giving 3u.

The pump with CGM can calculate the recommended amount to bring the BG from its current value to the goal number you specified, whether you are eating carbs now or not.

With the automated systems such as the t:slim with control-iq, the big advantage is that it is good at maintaining a steady BG at a good level while you sleep soundly all night long. According to rumor, the Medtronic is not as successful at this, in part because of their sensor, and in part because of their control algorithm and embedded policies.

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