780 Users

Sensor Updating and other bits - Some observations

When starting a new sensor
Issue: When the sensor goes in and then the transmitter it can sometimes take a little while for the pump to pick it up and go into warm up.
Solution: we now put the sensor in and give it a good 15 minutes before inserting the transmitter. The pump then picks it up immediately. I always needed to put the Libre in the day before I activated it so this makes sense, and works for me

Issue: I have had a some sensors that have gone into updating after the initial warmup.
I have worked out that this has been where I have eaten something quick acting soon before the end of the warm up. My glucose levels are therefore changing quite quickly so the BG I put in at the end of warm up gets rejected, and the sensor is not happy. It then sorts itself out and a asks for a BG once it is happy.
Solution: We put the sensor in before breakfast, transmitter in after, then I keep levels steady and avoid eating in the last hour of warm up.

At other times
Issue: The pump goes into updating apparently for no reason
There is generally a reason for this such as :
- Unplanned activities, so Temp target not set early enough
- Forgotten to enter carbs so BG changing rapidly soon after meal and no insulin to deal with it
Solution: having checked tapes are all okay, keeping a record of circumstances when this happens.
A bit of a hassle but I found doing this for a while helped me to spot patterns.

There are still occasions when there is no obvious reason and it does not settle.
I then get a replacement. I am impatient, and as the HCL works well for me I don’t like coming out of Smartguard. In manual I regularly forget to complete the bolus and tuck my pump away and then get the alarm.

I hope these observations help. If not the support team on the phone are just brilliant.
 
AJLang said:
Thank you but at the moment I don’t trust it. It’s going down fast again now, but I only know because of finger pricks. I have these because of hypo unawareness so scary when they put in too much insulin.
I’ve already, in four months had problems with six sensors that have needed replacing for various reasons. I’m still owed three of these and fed up about hearing about their stock problems.
Click to expand...
Have you got a buffer of sensors? I keep a month’s supply in hand to deal with delays. If you are getting single replacements they always take longer than the boxes of five. The singles are not stored in UK so come from abroad, whereas they hold a stock of boxes of five.

As you are waiting for three at present I would phone them, and I have found that they will often switch to a box of five in this circumstance, especially if you stress that you are running out, and even more so as you have hypo unawareness.
 
I phoned them and all they would say about this sensor was that they could tell what I could do about the glucose now but no interest in what caused it. I also asked about the replacements sensors that I requested in April and they’ve no idea when they will be in stock.
 
SB2015 said:
Sensor Updating and other bits - Some observations

When starting a new sensor
Issue: When the sensor goes in and then the transmitter it can sometimes take a little while for the pump to pick it up and go into warm up.
Solution: we now put the sensor in and give it a good 15 minutes before inserting the transmitter. The pump then picks it up immediately. I always needed to put the Libre in the day before I activated it so this makes sense, and works for me

Issue: I have had a some sensors that have gone into updating after the initial warmup.
I have worked out that this has been where I have eaten something quick acting soon before the end of the warm up. My glucose levels are therefore changing quite quickly so the BG I put in at the end of warm up gets rejected, and the sensor is not happy. It then sorts itself out and a asks for a BG once it is happy.
Solution: We put the sensor in before breakfast, transmitter in after, then I keep levels steady and avoid eating in the last hour of warm up.

At other times
Issue: The pump goes into updating apparently for no reason
There is generally a reason for this such as :
- Unplanned activities, so Temp target not set early enough
- Forgotten to enter carbs so BG changing rapidly soon after meal and no insulin to deal with it
Solution: having checked tapes are all okay, keeping a record of circumstances when this happens.
A bit of a hassle but I found doing this for a while helped me to spot patterns.

There are still occasions when there is no obvious reason and it does not settle.
I then get a replacement. I am impatient, and as the HCL works well for me I don’t like coming out of Smartguard. In manual I regularly forget to complete the bolus and tuck my pump away and then get the alarm.

I hope these observations help. If not the support team on the phone are just brilliant.
Click to expand...
Thanks for this. I’ve had the sensor in since Monday. I’m mainly a wheelchair use and hardly walk so there has been no change in activity. I hadn’t had carbs and there was nothing on the pump about updating.
 
SB2015 said:
Have you got a buffer of sensors? I keep a month’s supply in hand to deal with delays. If you are getting single replacements they always take longer than the boxes of five. The singles are not stored in UK so come from abroad, whereas they hold a stock of boxes of five.

As you are waiting for three at present I would phone them, and I have found that they will often switch to a box of five in this circumstance, especially if you stress that you are running out, and even more so as you have hypo unawareness.
Click to expand...
Thank you. I really appreciate all your help. can’t afford to buy extra sensors to create a buffer and in four months I’ve had to order five replacement sensors. The people I spoke to today had no interest in getting replacement sensors to me sooner because and just kept saying that they had no stock for replacements and didn’t know when they would be in.
 
AJLang said:
Thanks for this. I’ve had the sensor in since Monday. I’m mainly a wheelchair use and hardly walk so there has been no change in activity. I hadn’t had carbs and there was nothing on the pump about updating.
Click to expand...
It sounds very like a faulty sensor. I hope that you can get another replacement.
I just spoke to Jon who was extremely helpful. Worth a bother try to get the replacements switched to a box of five.

I have known them to tell me there is a delay and then the sensors arrive within a couple of days, up like you I have had some that have taken ages. I hope things get sorted.
 
AJLang said:
Thank you. I really appreciate all your help. can’t afford to buy extra sensors to create a buffer and in four months I’ve had to order five replacement sensors. The people I spoke to today had no interest in getting replacement sensors to me sooner because and just kept saying that they had no stock for replacements and didn’t know when they would be in.
Click to expand...
With your hypo unawareness I am surprised that you are not getting the sensors on the NHS now.
Have they given you a reason why they will not fund them
 
AJLang said:
Thank you but at the moment I don’t trust it. It’s going down fast again now, but I only know because of finger pricks. I have these because of hypo unawareness so scary when they put in too much insulin.
I’ve already, in four months had problems with six sensors that have needed replacing for various reasons. I’m still owed three of these and fed up about hearing about their stock problems.
Click to expand...
Thank you. I
I’ve lost count of the number of times I’ve had to phone them and I’ve just had enough of them for the moment. I don’t think I will carry on with it until I get NHS funding. Going hypo ie 3.4 because it gave me too much insulin and was still giving me more insulin, combined with having to keep chasing them, has has really knocked my confidence with them.
 
SB2015 said:
With your hypo unawareness I am surprised that you are not getting the sensors on the NHS now.
Have they given you a reason why they will not fund them
Click to expand...
The people at the diabetes department and the Medtronic rep have said that the equivalent of the (I can’t remember what it’s now called) is incredibly tight with funding. They put in a request for my NHS funding for the sensors in January and they still haven’t got a decision about it. I have phoned the pump nurse twice to see if there has been any decision.
 
AJLang said:
The people at the diabetes department and the Medtronic rep have said that the equivalent of the (I can’t remember what it’s now called) is incredibly tight with funding. They put in a request for my NHS funding for the sensors in January and they still haven’t got a decision about it. I have phoned the pump nurse twice to see if there has been any decision.
Click to expand...
Keep at it Amanda. Whether you stick with your 780 or switch to another of the ‘loop able’ systems you definitely meet the criteria. I know that it took a while for them to switch us over to funded. Those of us already using the system were easier to do this for as we didn’t need any training. I think that helped me.
 
What can I do to get rid of a hypo at the same time every day? Apart from eat sweets? In manual mode my basal dropped from 0.5 u/HR to 0.15 from 3-4pm to avoid a hypo from 5-6pm. Smart Guard doesn't seem to have twigged this yet (after 3 weeks). Any suggestions? Not a good time of night to go hypo, with driving home some nights of the week. Any ideas welcome!
 
Hi @Pigeon

Sorry you are getting regular hypos at the same time each day.

I am wondering whether as these are at the same time each day, it could be your lunch time bolus (although this depends on the time you have lunch) Possibly that ratio needs changing, or do a check on the carbs. The other possibility is the nature of that meal. If it is higher in fat it could be that the release of glucose is not matching the action of the insulin (again depending on time of the meal).
 
Thanks for your reply. I eat lunch (a sandwich) at 12 most days, so this should have gone by 5pm. I don't snack in the afternoon and don't bolus or exercise especially. I always had a hypo at this time on manual mode until I reduced the 3-4 pm rate right down to less than a 3rd of the previous hour's rate. I don't know how to get Smart Guard to work this out?
 
My dodgy point is walking home from town, whatever time of day it is. I forget to set a temp target as I don’t think of walking into town (20 min) shopping and walking back as exercise, but it is. I often have a minimal lunch, and have learnt to reduce carbs put into the pump or to use a temp target (this stops any auto corrections).

I think you mentioned that your team had advised you that it could take a month for your pump to settle -still a week to go. I did abandon my HCL in the first month with frustration, but so glad that I stuck with it.
 
I have just had notification of the new sensors with an integrated transmitter that they are rolling out to use with the 780G, which requires an update. They are also requiring us to have additional training, which I am very happy to do as all the training that I have ‘attended’ has been excellent.
A smaller sensor, not tapes to apply on top. Almost looks like a Libre
 
Well that sounds like really great news and we can't wait until they roll it out here. Although the Guardian 4 has been more reliable and less prone to failure for us over the past 1-2 months, we had a few blistering months of lots of failed sensors and readings that were wildly off. I wonder if the new sensors are the Simplera Sync ones?
 
They are the Simplera Sync. They are in clinical trial at present. Looking forward to the roll out.
 
SB2015 said:
Good to hear how well this is working for you, and that the extended infusion sets are working for you.
Click to expand...
Sorry for late reply. I'm not on Extended infusion sets, my 1.8ml reservoirs and infusion sets last 4 days very nearly every time (at least 90%). I keep a close eye on what the Sensor 4 is registering and the insulin effectiveness doesn't alter. Last week it lasted 5 days with no increase in BG, my finger pricks now always confirm my sensor 4 readings, after years of hating Sensor 3's serious inaccuracies. I have no idea why some people have to change infusion sets after two days or why the Extended Reservoir (not available through my hospital) is supposed to work for seven days. RESEARCH PROJECT ANYONE?
Type 1 since 1956,30 Units Novarapid per day. 74KG 1.8m, 780G and Sensor 4 NHS funded, about 110gm carb per day, no meat. 86% in range. Very happy but getting old (84)
Adam
 
Hi @adamrit

When I was on my accuchek I used a cannula for 6/7 days. Like you I can fill the smaller insulin cartridges with enough for six days, but I find that the cannula sites get a bit skanky after three days, so happily half full the cartridges and change every three days. The important things as that each of us finds what works for us.

I am very interested in the new sensors with an integrated transmitter that Medtronic are trialling at present. I await with interest.
 
I have just watched this video about the new Simplera Sync sensor which will be available to link to the 780 for HCL. Looks so much easier than the guardian 4 sensor and transmitter insertion. My only concern is that it will have a different glue. Just hoping that I do not react to it. Hoping that I will be able to get a sample to test.

 
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