My New Boyfriend, the Medtronic 670G

I have been a bit quiet lately, and that is mostly because I have wanted to give the 670G a chance with out diving in with posts. That, and I simply haven’t had time. I am happily busy with work and raising a family, which is what currently occupies most of my attention.

So, I started on the 670G on August 1st, and stayed in manual mode for 2 weeks. I believe that helped me a lot, especially since the 670G works differently than even the 630G. However, even from starting on the 670G, things were getting better. This is because the pump suspends insulin before I hit my low limit, AND it stays off only as long as I need it to. SO, If I only needed it paused for 30 minutes, that’s all it would suspend for, and my basal would be automatically resumed. (Unlike the 530G and 630G where it would stay on for the full 2 hours and stay that way). So right away, my rebounds were so much smoother, and I could treat with less carbs.

I have to admit — I was super scared going into auto mode. I seriously didn’t think I wanted to even use it. But, I went in and went through with it, and I’m so glad I did.

Now — here is where the title reference comes in. While I was at AADE, I talked with a Medtronic rep for a long time about auto mode. She told me the best advice she has been able to give her patients is to look at the system like starting a brand new relationship. ( I mean, what first date doesn’t try to “sell” you and exaggerate their features a bit teensy when you meet them?) You have to give it time and patience. With that in mind, and comments from others to say that it takes about a month to three months to get the system adjusted to you, I didn’t go into it with expectations that flipping me over to auto mode would be a cruise-control switch, because it’s not.

Here is my assessment: The 670G in auto mode is an automatic basal control pump. There is no worry over increasing or decreasing basals or suspending if needed. It does most all of the background work for you. The key to making this system work it’s best is to be sure your insulin-to-carb ratio and correction factor is as close to accurate as possible. The only problem there is that a lot of times, our basal rates, even just a tiny bit, may be masking part of what you need as a bolus. So that is the part that takes the most time to adjust. I just made abig adjustment to my breakfast IC ratio and it helped a LOT.

Now, this may not seem like much, but honestly, this system has helped me so much, I don’t know that I could go back to a standard pump. I mean, I would if I had to, but this system has helped to ease SO much of the mental burden that is there on a daily basis. I don’t have those glorious flat pattern days just yet, but not going from the 40’s to the 400’s day after day is a HUGE help.

I uploaded my pump last night and ran a comparison between the last two weeks and the two weeks prior. There are still bumps and things, but my stats have improved a lot, without much change in how I do things at all:

You can see, I’m slowly getting more green on that graph 🙂 That is an 11% increase of time-in-range in just 2 weeks. I’m sure I could get it even higher if I really buckle down on things like pre-bolusing. I have also been so busy some days that I forget to bolus, and I won’t remember until I get my high alarm. So cracking down on that will help too I’m sure.

My estimated A1c has also dropped 0.5%.

I’m not the OCD PWD that I used to be. I don’t have the time to sit down, upload, and analyze like I used to. My A1c has been hovering much higher than I feel comfortable with. So, if you are someone coming from using the pump with already great control, there will be an adjustment period where your numbers will be higher because the system will try to be conservative while it learns you. This is where a lot of new users are getting frustrated because they expect it to be great for them right off the bat, when in reality, there is the same learning curve for the in-control crowd as there is the not-so-in-control crowd (like myself) Since I was already staying high all too much of the time, I didn’t notice the curve as much.

Now, I’m staying in-range roughly 80% of the time, and my lows and highs have been reduced for sure. I’m gaining my ability to feel lows slowly again. And, as a matter of fact, most of the time, I don’t even know I’ve had a low unless I look at my pump. By the time I do, the system has taken care of it for me. Only the big ones that come from really miscalculating carbs are the ones I know about.

What about the sensor? The accuracy?

So, a lot of what I am loving is that I’m not having to “give up” anything by coming over from Dexcom to their Guardian 3 sensor. Even the improved Enlite wasn’t as good as the Guardian! I do change out my sensor every 7 days just because I feel better to not extend a sensor that my pump is relying on readings from. It’s my own personal quirk, I guess.

I’m still uploading photos to my @sugarandsites Instagram photo feed though if you’d like to see them in comparison to my meter, and a brilliant lady also created a hashtag #medtronicaccuracy if you’d like to take a peek at those.

But in short, I’m getting the same accuracy from the Guardian 3 as I did with Dexcom, and I follow the same “rules” as I did with Dexcom. I wear the sensor on my thigh or my arm, never my belly (they just do NOT work there for me). I calibrate in the morning, in the afternoon, and before bed, and with no arrows. It’s really not that big of a deal. While at AADE, I wore my Dexcom so that my family at home could see my numbers (I hadn’t gotten my Nightscout set up yet), and there were times when the Guardian 3 was even closer to my BG meter than Dexcom. So, in my view, there is no longer a question about accuracy comparison.

Of course, I’m sure you all may have more questions for me, and if you do, please let me know! I’m more than happy to reply and give my experiences with the system so far.