FUDiabetes

Soon to be 1st time Pump/CGM User

I am having some serious fears about going on the 770g and Guardian cgm. I have been a multiple shot and finger poker for just shy of 20 years. I am also a mother to a 19 month old. I feel silly for all the fears and anxieties I have around changing my treatment, even knowing it will be better in the long run. My a1c is typically 6-7. However, after having my son, my body has done some strange things regarding my diabetes and I am trying to find a bit more balance again.

Have any of you experienced fears or anxiety around your pump and cgm use? Do you have an tips or tricks to pass along?

Thank you for your time,
Lyndsi

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Someone else will be a better resource for you about pre-pump trepidations. I am an oddball. My first pump was a MiniMed 507. Fedex dropped it off in December of 1996. The package included the pump, pump supplies, and a book of reprints of articles about using an insulin pump.

I looked over the book and the pump documentation. Then I used the suggestions in the pump book to pick some initial basal settings, inserted an infusion set, and started using the pump. Some days later when I showed up for an appointment with my “educator” I found out they expected to train me before I started using the pump.

I expect you’ve already been told to expect to be trained and probably already have your training session scheduled? (Out of curiosity, will it be in person or virtual?)

In my case, after switching to the pump I immediately felt much better than I had on MDI. But I was using NPH for basal. From what I’ve read, the basal insulins have gotten much better since then so you may not feel that way.

Heck, you may not feel that way because things are just different for you. The pump is not guaranteed to be a better experience for everyone. One of the things I would suggest you do is get information now about what your options are for returning the pump. If you find out that it’s not working out for you, you should already know what your options are.

On the other hand, I strongly recommend getting a handle on using CGM. It can make a big difference over just results from a Blood Glucose meter. CGM gives you a much clearer picture on how your BG changes over time.

I used Medtronic’s CGM for about 6 years. While many folks in this forum may tell you it’s terrible, that was not my experience. I had some problems now and then, but mostly it worked for me. It does tend to be finicky to set up though. My advice is to be careful with the insertion and taping and then it should be OK for you. The taping is the biggest hassle. If you get that part correct then the rest should fall into place.

But if you do have problems with Medtronic’s CGM then what I’d suggest is …

  1. Try to get help from your educator and/or trainer.
  2. Realize that Medtronic is supposed to release a “new & improved” CGM sensor in the (hopefully) near future. Sometime in 2021? Ask your trainer about that, maybe?
  3. Try Dexcom. Dexcom has always been the Apple Computer of CGM. Maybe it’ll work for you too. Of course, you won’t be able to use Dexcom CGM with a Medtronic pump. But if I had to choose between a pump and CGM, I’d pick CGM. I find that it is that helpful to me.
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Thank you for all the information you provided!!!

I do not have an Endocrinologist, I have a PCP, who has been in charge of my care for the last 6 years. I will be meeting with him in-person on the 14th of this month. I see him every 3 months, and it just lined up that my pump arrived the other day.

I am reading all the information that came with both the pump and cgm. I am trying to educate myself as much as possible before the appointment. I have mostly gotten advice to give my Medtronic equipment back and go with Dexcom. That is also causing a bit of added stress and anxiety.

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Are you interested in an integrated system ? Meaning the cgms gets bg, sends to pump, and pump makes adjustments automatically, if that is turned on. But if you go with Dexcom cgms, it won’t talk to Medtronic pump (but in future will).

I recently switched to Tandem X2 pump, after 25 years using Medtronic pumps. Tandem is integrated with Dexcom.

However, I don’t rule out a future Medtronic pump integrated with Dexcom, expected within year or so, along with other integrated system choices.

Have you read this post?

https://forum.fudiabetes.org/t/medtronic-780g-first-4-weeks/

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Yes? So how much experience does your PCP or his/her staff have with helping people to start with a Medtronic pump? It sound like you may have a lot of questions and would do better if you had a knowledgeable support team backing you up. Does that describe your relationship with your PCP?

Seriously, find out about what your options are for returning the pump. No, I’m not encouraging you to return it, I just think having a better grasp of what your options are will help you make better decisions. The timeline can might be important. I vaguely remember people talking about having 30 days to potentially return the pump. That may or not apply in your case, but I’d encourage you to find out.

Hasn’t anyone talked to you about getting trained by a Medtronic customer rep yet? :astonished: You should definitely expect to be trained on how to switch to using a pump and CGM. If you PCP hasn’t already arranged this then call your PCP’s office ASAP this coming week and find out about this. You can also call Medtronic’s help number and ask someone there about it.

Not a surprise at all. Dexcom is the considered the gold standard for CGM. I just recently switched to a Tandem pump using the Dexcom G6 CGM and, frankly, I expected to more impressed. My reaction is more along the lines of a “meh”. :man_shrugging: True, the insertion is easier and sensors (typically) last 10 days vs 7 for Medtronic. But in my particular case the actual CGM accuracy isn’t noticeably better over what I was experiencing with Medtronic Guardian 3.

But perhaps making the application of the sensor easier is what makes all the difference. I’ve always suspected that the main reason people were having horrible experiences with Medtronic CGM was because it was too finicky to insert and tape. In my experience, if you get the CGM sensor attached to your body successfully then the rest usually just falls into place.

The one aspect of CGM where Dexcom clearly is better than Medtronic at this time is calibration. With Dexcom you can enter a 4 digit sensor code when you start the sensor and it won’t require you to enter periodic BG meter results for calibration.

The Medtronic Guardian is extremely tedious by comparison. During the first 24 hours after you start a Guardian 3 sensor you need to enter a calibration BG reading every 6 hours. After that calibration needs to be done every 12 hours. It can be annoyingly tedious and really irritates a lot of people. (Apparently)

The upcoming new Medtronic CGM sensor is not supposed to required calibration. I see it as Medtronic’s attempt to respond to Dexcom “no calibration” CGM. I’m not sure how many days it is supposed to work. Or whether it will be less finicky to apply. Hopefully it will, but I just don’t know anything about that yet.

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Neither company has said anything which truly supports the hope of Dexcom sensors working on Medtronic pumps. My personal opinion is that this is very unlikely to happen.

I certainly would not expect it to be considered unless Medtronic’s next generation of CGM sensors completely flops after it is introduced. So we’ll just have to wait and see how that goes. But definitely the wait would be longer than “within a year”.

Medtronic has been working on their version of integrated CGM for decades. I don’t see them throwing in the towel and being dependent on Dexcom without trying a bit longer. What I think is more likely is that Medtronic would attempt to take over Dexcom. Remember, Medtronic started it’s line of pump technology by buying MiniMed.

The fact that at this time none of Dexcom’s management would support an acquisition is the biggest barrier to that. Well, that and the fact that Dexcom’s current stock price would make a hostile takeover very expensive! :wink:

Back story on why I’m on this new journey:

My son was born 19 months ago and both he and I barely made it through delivery. I was in the hospital for a couple of weeks and he was in the NICU for a couple of months. The day after I was released, I ended up passing out in my kitchen from my first ever extreme low. I was taken by ambulance back to the hospital over night. Since then, I have had severe anxiety regarding low blood sugars. My a1c has risen and I am on this rollercoaster of blood sugars that has become too much for me to be good living with. I contacted Medtronic and Omnipod regarding pump and cgm options. Omnipod never got back to me. Medtronic walked me through my options and my insurance covers all the costs at 100%. They sent me the pump, cgm, and new meter 5 days later. I texted my PCP and let him know. He told me to bring everything to my appointment that I already had scheduled. Medtronic never set me up with anyone but a representative for ordering supplies through. Is that the person who would also be walking me through the pump and cgm education? My PCP sent orders in for vials of insulin, since I’m on pens, and for test strips for my new meter. I have read all the manuals that came with the pump/cgm, I’ve watched some YouTube videos, and am piecing things together on my own so far.

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Just because you have a CGM doesn’t mean you have to give up finger sticks — you could keep doing them until you gain some confidence in the CGM.

Similarly, you could keep some pens around just in case the pump isn’t working out or just if you want a break.

One thing that I find nice about a CGM is that it will make a lot of noise if your BG is low. Mine (a Dexcom) also has the option of alerting if it sees your BG dropping quickly. Mine is connected to both my phone and my pump, both of which make the alarm sounds, so it’s pretty hard to sleep through, which is good. It also comes with a standalone receiver if you don’t have both a phone and a pump that you want to connect it to. I’ve read about people who put their receiver in a glass on their nightstand to make the alarms even louder.

One other nice thing about CGMs+pumps is that the Dexcom+Tandem combo will stop pumping basal insulin if it predicts that your BG will go low, which is really handy while sleeping and I’m now never worried about nighttime lows. It will also increase your basal insulin if it thinks your BG will go high. This change has dramatically reduced my alarms at night. Presumably Medtronic has the same feature set (or will soon).

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Once you get started on the pump I think you will see the benefits. i.e. ability to dose in smaller increments, ability to eat a little more like gluco-normals, ability to turn down your insulin before or during activity, and the ability to tailor your basal. Whether or not you keep the CGM going will depend greatly on whether you develop an ability to trust the information it provides.

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This says otherwise…

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Update:

Just got off the phone with Medtronic. They set me up with an education appointment next week before I see my PCP. I asked what felt like a million questions, the guy on the phone took time and answered them all. He was kind and made the conversation easy. I feel less stress and anxiety after that initial call and am hoping after my Zoom education course, I’ll feel even better.

Thank you all for giving me additional support and care!! :blue_heart:

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Glad things are looking up for you and getting your pump situation sorted! A good lesson we have learned. Always keep some long acting insulin onhand for pump failures, or shipment delays with the infusion sets, etc. My son takes a one week long pump break every year just to keep his MDI skills up to par. Enjoy the learning.

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That’s super good advice. I will keep pens on hand, both long and quick acting, just in case. Always better to be over prepared! Thank you!!

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So it sounds like they are going to do your training virtually rather than 1 on 1. Not surprising at all, of course. Hope it helps.

I’m still worried that you (apparently) had to personally intervene to get this to happen. For most folks this is something their health care folks just automagically set up as part of switching to a pump. Are you the first T1 on a pump your PCP has ever worked with? :fearful:

Has anyone pointed you towards the online Medtronic’s online pump & CGM courses? They should be accessible via your online Medtronic account.

You should also be aware of how Medtronic usually shares the CGM and insulin dosing information of their pumps with your medical team. Medtronic calls their site for this “Carelink”.
https://carelink.minimed.com/app/login

I’m not sure how you are supposed to upload data from your pump to the Carelink site. Maybe @Paul can comment on how this works with his 770G? True, he is in Switzerland, but it could still be relevant to us in the US.

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Hello Juniormints,

I didn´t have any fears on starting my pump, but just wanted to say good luck and that you will be fine-the education course with the medtronic rep when I did it was very helpful and covered so much. I am so happy using medtronic-but I don´t have experience with Dexcom or any other system. I use ine with Libre 2 sensors and it is friggin awesome.

Good luck, gurl.

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I know the older Medtronic pumps did uploads using the Contour Next Link meter.

https://www.medtronicdiabetes.com/products/contour-glucose-meter
CONVENIENCE AND SIMPLICITY

  • Wireless Connection - Sends results proven to be highly accurate2 to the MiniMed™ 670G and MiniMed™ 630G pump for easy insulin dosing and CGM calibration.*
  • USB Connector - Allows for easy downloading to CareLink® software and battery recharging.
  • Remote Bolusing - NEW easy-to-use and discreet remote manual and preset bolusing feature from the CONTOUR®NEXT LINK 2.4 Meter.*
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Yes, that meter is what I used to upload data from my 630G to my computer where it was uploaded to the CareLink site. However, it appears Medtronic no longer uses that meter.

Instead the 770G comes with the “Accu-Chek Guide Link Blood Glucose Meter”. This meter will still send the BG meter reading to the pump, but I don’t think it is used to upload data from the pump.

Perhaps the phone app is used to upload data from the pump? If so I wonder how Medtronic supports people who can’t use their phone app for one reason or another?

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Did a bit of googling in hindsight and was led to the YouTube vid below. The (typically tedious) vid walks through using a computer (not phone) to upload the pump to CareLink. It refers to a “Blue Adapter”, a USB dongle you plug in to your computer and connect the pump to wirelessly, probably over BlueTooth. :thinking:

That’s apparently one way you can upload your 770G pump data. I don’t know if the phone app will also support this or not.

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