Question about Medtronic low suspend

I have read all about the issues people have with the Medtronic 670G. In deciding on my next pump, I have basically narrowed the decision to Tandem or Medtronic. We don’t have the 670G yet, so I would be going for a 630G.

My question regarding the low suspend is whether you can set the level at which the pump suspends, or whether it’s a fixed level? Would I be able to raise it to, say, 5.5 mmol/L (100 mg/dl) if I was exercising or doing something else that tended to cause lows, or is it fixed at a lower number than that?

I think the low suspend would be a hugely valuable feature for me. Much more so than the auto mode, which frankly I haven’t heard much praise for.

Tandem, unfortunately, won’t be coming to Canada with the low suspend feature. And since that only works with the G6, who knows when it will actually come. And, which I was originally set on sticking to Dexcom for cost-saving purposes, it seems like Dexcom and Medtronic may cost about the same at this point (Dexcom ongoing sensor and transmitter costs, Medtronic slightly cheaper sensors and I think one-time transmitter).

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I’ve had my head in the 670G for so long I can’t remember, but it looks like you can from this…

That’s an awful image. Sorry. Now I’m going to make it worse by giving you a big vague, unhelpful link…

It looks like you can adjust your low limit. I don’t know if that helps…??

Yeah - That stinks.
However, I did hear a rumor (??) that the Tandem is approved and just not announced yet.

There is a big conference that Tandem is having on Sept 25. Tandem has already stated they will be specifically discussing the international expansion. It would not be a shocker to hear on Sept 25 that the X2 is approved in Canada.

It would be double nice to hear the approval includes the X2 but I do not think that was even submitted. But who knows. Until it is announced, it is all speculation.

As you undoubtedly are aware, the Tandem receives remote updates to allow the customer to upgrade the pump at home. So if you were to go with the Tandem t:slim X2 without the Basal-IQ feature but then it were to be approved in six months then you would simply download the update and be able to make use of it then.

(Slightly possible that I have a bit of a bias towards the Tandem.)


BTW - The Tandem Basal-IQ/PLGS update was developed and submitted to the FDA to operate with the G5. The FDA actually approved the Basal-IQ/PLGS for both the G5 and any iCGM (which currently is only the G6).

So, if Canada has not yet approved the G6, there is nothing to stop Tandem from submitting the Basal-IQ to Canada Health so as to work with the G5. It would require no extra effort on the part of Tandem.

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Never used the Medtronic CGM, but I can’t see myself ever going there. How many years has Medtronic had to get it right, and it still isn’t there? Heck it still doesn’t communicate with a phone. Really…come on Medtronic step your game up.

I think you would be very disappointed only for the low suspend feature.

This is true, and is really the big question… Pump technology is changing so fast right now compared to in the past. I did not have to worry about any future pump developments when I was deciding on my first pump in 2006. It was just what did I like at that time, because it would be four years before anything new came out, anyway. But I am picky about pumps. I’ve only used two pumps (Deltec Cozmo and Animas Ping) during that entire time. Many people would have gone through three or four pumps during the same period.

This would be amazing and would definitely be put under “pro” column. At the moment the only potential “cons” for Tandem are a) I don’t know if I can see or use the touchscreen easily (see below), and b) the waterproof issue. Oh, and the news about the Basal-IQ and G6 and the G6 being hardwired to die, all of that stuff freaked me out, although it seems it may not be an issue.

I used a Medtronic sensor for a week back in 2009 (iPro) and, aside from the first few hours, it was quite accurate for me. But that’s only a week. Being able to restart Dexcom sensors (and maybe transmitters) is a plus, but it’s a plus moderated by the fact that if I can’t use said reset sensors/transmitters with a pump, it sort of defeats the purpose.

The one huge plus for me (and it is a major plus) is that I’ve seen the Medtronic 630G and navigated its menus and I can actually see the screen and even read some of the text on a good day if the lighting is right. I have heard some sighted people say they have trouble reading the smaller text on the Tandem screen. It is something most people don’t care about, but for me it is a major issue. If I can’t see the pump, in the past I have memorized menus and counted button presses (or watched what I could see of on-screen feedback). I can’t do that with a touchscreen. Currently I use my iPhone’s camera to magnify the screen of my Ping if I’m doing something where I really need to see inputs, but I’ve also wondered how easy it would be to hold and use the touchscreen with one hand, and how easy it would be to keep in focus with the phone shifting and thumb moving across the frame.

So this is why, right now, Tandem is a huge question mark. Until I see and use a pump, I won’t know whether it will work for me. Medtronic, for all its flaws, is a pump I know I’d be able to use without much trouble.

Also, two recent (and major) changes have me considering new things that were not factors before:

  1. My province now covers pumps (OmniPod and Medtronic) for all ages. And I also have my extended health coverage through work. So, unlike in the past, I can get a pump now without using my insurance and get another pump in four or five years. (My dad seems to think that as soon as a new party is voted in the provincial pump coverage will change, but hopefully not.)

  2. My extended health benefits now cover FGM but not CGM. So I’ll be seeing if I can get the Libre covered. Which, if I can (I do not meet criteria currently, though I can argue points there), will make pump-integrated CGM moot, at least partially (if I did get Libre coverage it’s possible I would switch between Libre and CGM depending on my schedule and BG stability).

Lots of moving pieces to consider.

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Also, the only reason OmniPod is left out of my pump considerations is that I have serious concerns that I would react to the cannula. Though I’ve heard it’s made of a different material. Otherwise, I do like the pods (I wore a sample pod, no cannula mind you, and didn’t notice it was there). Our province does cover the OmniPod system by default, so it’s possible that I could apply for that (I’m sure I would get approved) and try it out, and then move on to Medtronic or Tandem through my extended benefits if it didn’t work out… And I know OmniPod is coming out with a new system themselves soon, too. I have heard that eventually the OmniPod will function from a phone that would also have CGM data, and from an accessibility perspective I love that.

We could drive up to Canada and show you the X2 pump. Depending on which province. [Some of them are not exactly driving distance.] But I think my T1 would have fun. And if you have a University nearby so we could take a tour then the whole thing counts as an excused absence for a campus tour. [Loophole !!!]

EDIT: My T1 was quite excited with the idea of a Canada roadtrip.


The Tandem also. It will be a race to see who gets there first. Although who ever submits first to the FDA will have the harder hurdle. Who ever is second to submit will benefit from the work done by the first.

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Ha. Not sure where you are, but I’m in Vancouver, BC. In terms of universities, close to the University of British Columbia, Simon Fraser University, and (a ferry ride away) the University of Victoria. :slight_smile:

However, if Tandem approval comes in September, hopefully I may be able to see one when I see my endocrinologist in November and he can fill out the pump paperwork for coverage whether through the province or through my insurance. My endocrinologist whipped out a Libre, a 630G, and an OmniPod at one appointment when I was lamenting about needing to see the devices before choosing. So he seems to be well-connected in terms of getting this new stuff.

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