780 Users

helli said:
Yes, I use Hypafix tape under my pump. I have not tried (or needed) to apply it under my CGM.
It provides a suitable barrier for the glue but allows a cannula through it easily to I would assume it would be ok for a CGM filament.

I have also used SkinTac and Cavilon as barrier creams/wipes.
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Thank you for your help
 
Geniekeepcalm said:
Thank you for your replies @hell and @SB2015. I think I'm going to have to experiment with options.

I actually found inserting the sensor/ transmitter easier than i thought. But i feel it's going to be a bit of a project till i get it right. Also at the moment only have the graph on my pump as my phone is too old to cope with the Medtronic apps ! Research needed on suitable phones.

Looking forward to using Smartguard. Hopefully switching soon.... but need to be confident i won't be removing sensors due to rash. I've never had a problem with the cannulas causing reactions.
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It is also good to be familiar with the pump’s functions in manual mode so that when you have warm up time for Smartguard (2 hours), or if anything goes wrong, you can do what you need to do yourself.
Well worth also getting your basal profile sorted in manual so that if your pump flips you out of Smartguard
your basal will be correct
I look forward to hearing how you get on with the switch.
fire away with any questions.
 
Weird hypos in the night
i am used to ‘flat lining‘ at night, but the last three nights I have been woken at around 4:00 am with an alert before low, treated, then gone hypo. This has always been my ‘dippy time’ but have got used to a good nights sleep since looping. Any ideas? No late meals to blame, no unusual exercise …. No ideas for why.
I have temporarily raised my target to 6.1

Any ideas welcome.
 
I got my Medtronic 780 from the hospital yesterday!!!!!! A birthday present for me!! I found the switch from combo to Medtronic easy. I've managed to find the money to self fund the sensors for a year. I emailed Medtronic yesterday and waiting for them to come back to me about the sensors - I returned the HCP and VAT forms with the email.
The main challenge for me with the closed loop approach will be that I need to extend my evening bolus by six hours due to the gastroparesis - if I do more than 1 unit up front I risk a MASSIVE crash that I wouldn't probably be able to consume enough liquid carbs for as my food wouldn't have digested.
From what I've worked out so far I would have to turn off the Smartguard during the extended bolus and then turn it back on when I wake at 5am for my painkillers. But I will still have the benefit of the sensors alerting me to a high/low like the Libre that I use. Although the Libre is very erratic with me, hence my wanting to try the sensors and Smartguard.
 
Hi Amanda I have found with the 780, where I would have used the extended bolus in manual, I now do part of the dose up front as before and then let the looping System do the corrections to deal with what I would have put in for the extension. So far that seems to work for me.

I think with the looping it is better if you can stay in Smartguard rather than dipping in and out, but we all manage things differently, so it is important to find what works for you. I look forward to hearing more about how you make use of the system.
 
Lilly said:
Its not just the 7 day reservoirs, the 'Mio Advance' Infusion sets MMT242A includes in the instruction book in every box, at page2 General Instructions (for the OLD 3day set) "The infusion set may be worn for a maximum of 3 days or per a healthcare professional's instructions". No doubt you would need that last bit in writing.
There is an 8.5 minute Q&A video about the new sets at
MiniMed Extended InfusionSet Q&A
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That video I mentioned doesnot mention anything about how to set the pump for 7 day set reminders.
The answer is that you cannot set the reminders to 7 days but you need to turn OFF that reminder
Rich (BB code): 
Settings > Alert Settings > Reminders > Set Change
Reminder  (to turn off the reminder)
On the positive side, as the G4 sensors are also changed at 7 days, if you change sets on same day, then the 7 day countdown displayed in the app can be used instead.
 
AJLang said:
if I do more than 1 unit up front I risk a MASSIVE crash
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I'm guessing that it may help if whilst in smartguard you @AJLang were to set a "Temp Target" (Page 171 of user guide) but as it says not without your DN guidance.
 
The G4 sensors are usually 7 day change over, so that should work with the 7 day cannulas.
I have still not tried those, but I am about to order new cannulas so may well consider that @Lilly .

Let us know how things are going Amanda. It is a change that can take a bit of getting used to but usually well worth it @AJLang
 
Thank you @Lilly and @SB2015. That is very useful and helpful advice. Unfortunately there’s now a question mark as to whether I will be able to use the pump as closed lump due to taking the maximum amount of paracetamol every day. I’ve just posted the following about CGM and paracetamol.
Medtronic have phoned me and confirmed what their literature says that the paracetamol can affect the sensor readings but it does depend upon the individual. The literature states “avoid taking paracetamol whilst in auto mode” This is in the Medtronic safety warnings. I discussed with the lady who phoned and I may try one or two sensors to see how it works with me taking paracetamol at maximum dose but obviously not in Smartguard whilst testing it.
 
Hi Amanda
I also take full dose of paracetamol at times. When I do I know that the sensor readings can be impacted. I have found that lifting my Smartguard target Bg up one notch avoids me getting unexplained lows. That might work for you too, or perhaps lift it two notches. I tested this with some BG readings for a while and it seemed to account for the impact on the sensor readings, and avoided over corrections. I hope this helps.
 
SB2015 said:
Hi Amanda
I also take full dose of paracetamol at times. When I do I know that the sensor readings can be impacted. I have found that lifting my Smartguard target Bg up one notch avoids me getting unexplained lows. That might work for you too, or perhaps lift it two notches. I tested this with some BG readings for a while and it seemed to account for the impact on the sensor readings, and avoided over corrections. I hope this helps.
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Thank you SB201405. I will have to see what happens with the trial sensors. It’s complicated because I’m on the cocodamol four times a day every day and their rate of absorption can vary quite a lot due to the gastroparesis. However even without the sensors I am enjoying my Medtronic 780.
 
I look forward to hearing how you get on, and I am glad that the 780 is working for you even in manual mode.
 
Parent here, my kid went on to the 780g a month ago, and as before it was MDI, it's been a real game changer.

The challenge we have though is around what we would previously have done re high fat / high carb meals - we don't have a lot of those but really hesitate to give the full bolus upfront - did that this afternoon for a slice of cake and hey presto, hypo 30 mins later. We spoke to Medtronic who told us to just carb count and give it all in one go and that the pump would not actually give it all in one go, but that doesn't sound quite right. So figuring out how to bolus for foods that are slower is still a problem for us.
 
Hi @Wutanga1
Glad to have your question. For fatty foods where previously I would have done a split bolus I now give a proportion up front and then let the HCl sort out the rest through its auto adjustments. It takes a bit of time for it to flatten out but avoids the hypos that I would get if I did the whole bolus up front.
I hope that helps.
 
SB2015 said:
Hi @Wutanga1
Glad to have your question. For fatty foods where previously I would have done a split bolus I now give a proportion up front and then let the HCl sort out the rest through its auto adjustments. It takes a bit of time for it to flatten out but avoids the hypos that I would get if I did the whole bolus up front.
I hope that helps.
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Thanks! That's what we've started doing too. Makes me a bit uncomfortable as then we have to accept a sometimes significant rise, but I guess knowing how much to give upfront then comes with time. We've set the target at 5.5 but can't see much different yet in how quickly that brings it down to range again if there is a spike. Although admittedly we have had far less spikes and hypos with the 780g in SmartGuard.
 
You could still use a pre bolus time for the upfront portion and as you say this amount will depend on the fat level which you will pick up with experience. (If only diabetes was a science. It just doesnt work like that). 8 keep my target at 5.5 too and the best thing for me is the way that overnight my pump settles things down and I wake back in target having had a good sleep.

switching to the HCL with 780 was a struggle for me t the start but after a month I learnt to trust it. The guardian 4 is a big improvemen, and having just one calibration needed each week is great.

keep in touch and keep questions coming.
 
I have been using the Guardian 4 sensors since late September, and am in smartguard. However I don't think I've had a single sensor last 7 days.... initially problems with skin rashes but ,fingers crossed, seems that Mepitel doesn't cause issues . Often the pump has given the sensor updating message followed by the change sensor message on day 4 or 5. Any comments/ advice please? I know Medtronic replace the sensor if it doesn't last 6 days but it's very frustrating. Not to mention expensive as at the moment I'm buying the Mepitel and the last dressings I managed to get (supply issues) cost £4 each and I need 2 every time I change
 
I also had a run of a few sensors that finished early. As you say they always replace them. I then do my change over on my usual day as that works for me. It might be worth phoning them and going through the transmitter troubleshoot, just in case it is a transmitter error instead.

I am glad that you have found a tape that works for you with sensitivity to glue, but as you say it is further cost in top of the sensors. I use IV3000 to cover my sensor where necessary. A box of 100 were sent to me for free by Medtronic. That might be worth trying.

Sensor Updating message is often where there is a rapid change in glucose levels. Does this tend to occur after a meal? Are you pre-bolus ing for your meals. This will help to reduce the spikes that happen after whilst the insulin gets active in order to deal with the glucose. Reducing portion sizes also helped me to reduce my spikes which might help.

Another time I used to get updating message is if I am out walking for a full day. I have followed the Medtronic advice on topping up with small amounts of glucose during the day, as well as trying to make sure I pre bolus to reduce the pre issues.

A final thought from me is hydration. I was much more aware of this when I was using the Libre. If readings were out quite a bit, I used to make sure that I was hydrated. It makes sense since the sensors rely on our interstitial fluid. because our sensors are now determining our autocorrections whilst in Smartguard it is just as important. However as I don’t look at my data much during the day, apart from at meals, and I am not doing finger pricks all the time I think I am less aware of hydration. I have upped my intake of water recently and I am keeping a watch on whether that impacts my sensor failure rate.

I hope something in that long diatribe is of some help.
 
Thank you for your detailed reply @SB2015 . I will monitor the times that I get told to change sensor. I always pre bolus before breakfast but lunch/evening meal is harder for me to do in practice.... I'll try though !
On the whole I'm very impressed so far , just felt frustrated with too many sensor changes. I certainly appreciate the feeling of not having to think about my blood sugars so much in order to achieve decent control
 
A bit of a moan
I have now had a third sensor that has finished a couple of days early. These are always replaced so it does not impact me financially but it is the interruptions to my routine that is frustrating, and having to go into the warm up period again. with other posts that I have read on here I am wondering whether there is a duff batch going through.

I still try to use these blips to remind me just how much Smartguard does for me when it is working well. Just when other things are not going so well, my head doesn’t adopt such a balanced view of things.
 
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