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780 Users

everydayupsanddowns said:
Any chance your vial of insulin could be compromised (seems unlikely across 2 different pumps over such a long time frame). Have you swapped vials? Or tried correcting with pen/syringe?
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No the insulin vials changed, because as you say it was a long time frame. I also tried correcting with the pen, but at that point the BG was so high it was probably resistant as well.
 
I have tried to think of a reason for your big rises at the start of the sensor @mschw , as it is so different from my own experience.

I know that my Libre sensors used to wobble for the first 24 hours, so I inserted them a day before I activated them (a bionic day with two sensors on at changeover) . Our sensors activate as soon as we twist them out of the container, so if we did that we would lose a day, it that might be a solution. Worth checking with Pump support line.

Any other ideas I have had have been raised by @everydayupsanddowns
I shall keep thinking.
 
SB2015 said:
So I have had a bit of a problem and I need a rant.

My most recent sensor has definitely not been behaving as usual. I have been woken early with lows about 4:00 am, today I have had a repeated hypos and finally one where SG was 6.8 and BG was 3.8. Glad I went with my symptoms rather than sensor.

I phoned Medtronic to check whether changes I planned to make to sensitivity factors would impact on algorithm, but got a lecture about how I should not be making any changes on my pump without first consulting my HCP. Ever since I have been using a pump I have done checks and made changes to ratios as necessary. I have only contacted DSN where I am uncertain about things. I have thought that any pump user would be doing the same. Am I right?

The advisor looked at my data which I had downloaded, and told me that I had been entering false carbs. I asked why she thought that and she referred to last night. I had been at a long supper party and had no idea what or how much I would be eating so had added in carbs through the evening as necessary. No ‘false carbs’ just what I had eaten through the evening. Not an ideal way of doing it but previously the algorithm would then do any auto corrections and flatten things out by the early hours.

I eventually agreed with her that I would replace my sensor and she would send a replacement. When I took it off there was fresh blood and it was very soggy under the sensor. I think I realised why things had been so awry today and now have now sensor in from a new box.

I have always had very useful conversations with the Medtronic reps on their pump line but today, fuse would not give me any advice just kept telling me that I should not change anything without speaking to my DSN. I have always done my own changes. I would not expect to be able to speak to a DSn but happily email them and find that they will reply within a day. Most of the time they simply confirm what I had thought. I had picked up at the training for my most recent pump, make changes as necessary of 10% and wait at least two days before making further changes. Anyone else make their own decisions?
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I contacted Medtronic and asked the manager of the Pump Careline to review the unfortunate call that I had had with them. I was very pleased with the full response that I received along with an apology. Everyone has off days.
 
Hi, hoping I can get some help on here please. Last year I'd been having more lows than was acceptable, got hold of my pump team, they made adjustments. The nights have definitely improved but honestly the days are terrible at the moment, really bad highs, example today, started off fine, had breakfast, walked the dogs - numbers were fine, had bagel & bacon for lunch, gave correct insulin & extra for sauce, numbers have crept up ever since, despite correcting now sitting at 22.1 nearly 2 hours later!
I spoke with my DSN about a month ago as I was feeling a bit frustrated with the highs I was getting, she didn't seem bothered but I need this sorting as my TIR is awful
 
Hi @jessd1 and welcome to the forum.

I assume you are using the Medtronic 780 since you are posting on this thread. Are you using it in conjunction with sensors in a Hybrid Closed Loop (HCL) or just using the pump in manual or I think you have the option of a half way feature where the pump can suspend if levels are dropping low. If you are using sensors are they Guardian 4 sensors or Simplera?
If you are looping, how long have you been using the system as it can take time to "learn" how your body works.
Have you double checked that high of 22.1 with a finger prick and have you checked your cannula site. Must confess I would be very unhappy with a reading that high so can sympathise with your frustration!

The more info you can supply about your system, the better people will be able to suggest fixes or things to check.
 
Thanks for quick reply
Yes I am using HCL been on it for over a year, using the guardian 4
I confirmed my high readings with a bm, then entered that into pump.
I have been a medtronic user for 17 years
Basically I was having hypos in the night too often, so got in touch with pump team & we made changes, my nights are now lovely & steady but days are not good, currently pump is saying 21.9 & 1.475u on board & offering no correction?!
 
Sorry to hear your diabetes is messing you about recently. :(

What is your insulin sensitivity set at? And did you pre-bolus for your meals (about 10-15 minutes was the recommendation I was given). Have you adjusted your meal ratios recently, or do you rely on your clinic to make recommendations for you?

What is your BG target set at? There are 3 options of higher, middle, or lower that the pump will be aiming to steer you towards.

And what have you selected as your Duration of Insulin Action?

Did you double check the carb count of the bagel? I find them tricky beasts, as they are quite a lot more dense than a roll so much harder for me to guesstimate if I’m having one from a cafe etc.

Great to hear your nights are more steady - that’s something at least!
 
everydaysupsanddowns- thanks

so my insulin sensitivity is set at midnight - 6am - 5.0
6am-8pm - 4.0
8pm - midnight - 5.0

yes I do pre bolus, for lunch I gave my insulin on way back from my walk
pump team made adjustments in december, as mentioned nights greatly improved

my active insulin time is set at 2 hours
I'll be honest yes for most of changes i get in touch with my pump team, they don't like it if i make changes without consulting them

normally the bagels are fine, have same ones regularly
 
jessd1 said:
yes I do pre bolus, for lunch I gave my insulin on way back from my walk
pump team made adjustments in december, as mentioned nights greatly improved
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Good to hear. Prebolusing for every meal (not just breakfast and lunch) was a new thing for me, but substantially helped evening BGs.
jessd1 said:
my active insulin time is set at 2 hours
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That’ll allow the algorithm to make adjustments more strongly, as it will calculate on the basis of you having less Insulin on Board, but it’s important to remember this artificially short DIA when viewing the pump’s IoB display. The actual lifespan of NovoRapid, Humalog and Fiasp is more like 4-5 hours (albeit more of Fiasp acts sooner in that time frame). So the IoB of 1.475u is most likely a pretty significant underestimate of how much lunch dose is still working.
jessd1 said:
I'll be honest yes for most of changes i get in touch with my pump team, they don't like it if i make changes without consulting them

normally the bagels are fine, have same ones regularly
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Ah OK. Well if lots of your meals have been misbehaving since the tweaks that were made, you might want to drop your DSNs a line and ask their advice? Do you have an email address for them? That’s the most efficient method of contact for me.
 
I contacted them on 1st feb as had bad cold & numbers were high a lot - asking for their advice on making adjustments, never had a response
 
Finally offering me a correction
 

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jessd1 said:
Finally offering me a correction
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That is odd that it waited so long, then offered such a whopper of a correction with 0 iob.

I don’t think I’d get that from my MM780G?

Do you use the phone app? Are you seeing deep pink basal sections, and blue ‘auto correction’ bars on the trace?

The thin pink is regular basal, the deep pink is extra basal, and the blue dashes are auto corrections.

You can also check the pumps History > Daily History for today. I would think *should* be listing auto corrections with the BG you’ve had.

I’d be tempted to call the Medtronic Helpline and ask them to check if your pump is behaving as expected? It may be that a setting has gone awry?

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jessd1 said:
Finally offering me a correction
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If I am higher than usual I find that going into the bolus calculator, but entering no carbs the pump will then add in a correction. This may be a quicker one than waiting for the autocorrection.

I may have missed this but what do you have your target set at? It is great that your nights are more settled now. It may be worth discussing with your team the idea of changing your target during the day.

Good to hear that you are pre-bolusing for lunch. I find that I need different timings for the pre-bolus at different times through the day. I have found my appropriate time for each meal by trial and improvement. You may find that for you it is more than 15 minutes. This could be useful to discuss with your team too.

I am also wondering whether it is a fault in the pump. If you phone Medtronic pump team they can take you through some tests on the pump to check this.

If your team want you to contact them before making changes, they will need to provide a reliable means of doing this. Like @everydayupsanddowns I use emails.. it is easier for me to ensure that I have all my questions set out clearly and they can respond when it is most convenient for them during the day.

Let us know how you get on.
 
SB2015 said:
If I am higher than usual I find that going into the bolus calculator, but entering no carbs the pump will then add in a correction. This may be a quicker one than waiting for the autocorrection.

I may have missed this but what do you have your target set at? It is great that your nights are more settled now. It may be worth discussing with your team the idea of changing your target during the day.

Good to hear that you are pre-bolusing for lunch. I find that I need different timings for the pre-bolus at different times through the day. I have found my appropriate time for each meal by trial and improvement. You may find that for you it is more than 15 minutes. This could be useful to discuss with your team too.

I am also wondering whether it is a fault in the pump. If you phone Medtronic pump team they can take you through some tests on the pump to check this.

If your team want you to contact them before making changes, they will need to provide a reliable means of doing this. Like @everydayupsanddowns I use emails.. it is easier for me to ensure that I have all my questions set out clearly and they can respond when it is most convenient for them during the day.

Let us know how you get on.
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My target is set at the following
I spoke with Medtronic last week as was really hacked off with how things were, we went through everything & they advised I get hold of my pump team as they thought my rates needed changing
I sent another email last night to nurse - will see if I get a response
Very tempted to make slight changes myself
 

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jessd1 said:
My target is set at the following
I spoke with Medtronic last week as was really hacked off with how things were, we went through everything & they advised I get hold of my pump team as they thought my rates needed changing
I sent another email last night to nurse - will see if I get a response
Very tempted to make slight changes myself
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I'm a it puzzled by your pic. Doesn't the 780 let you set just one target when using smartguard.
Ie 5.5, 6.1 or 6.7. Not varying from time in day
 
jessd1 said:
My target is set at the following
I spoke with Medtronic last week as was really hacked off with how things were, we went through everything & they advised I get hold of my pump team as they thought my rates needed changing
I sent another email last night to nurse - will see if I get a response
Very tempted to make slight changes myself
Click to expand...

I’m not sure that’s the setting that informs Smartguard though @jessd1

What have you got set under Smartguard settings?

1739819938134.jpeg
 
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