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- Thread starter SB2015
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SB2015
Well-Known Member
- Relationship to Diabetes
- Type 1
If you are using the 780 in a closed loop with a sensor, you need one BG each week, when you put a new sensor in and it has finished the warm up period of two hours. I couldn’t quite believe the advertising around this but it is true. If things are going very weird it will sometimes ask for an extra one, but my adjustments and boluses are based on the sensor readings whilst looping (using Smartguard). If I go hypo I will still do a BG to confirm, but these are few and far between when I am looping.
If using the pump as a stand alone and not linked to a sensor, you would need to do a BG whenever you eat to calculate any correction needed, where the bolus cal adult or will take account of any active insulins that you already have working.
With any system if you ‘feel weird’ and sensor readings if available don’t match how you feel you would need a BG to check things.
With regard to swimming I would always remove my pump. I drowned one because, although it is reported to be waterproof if there is a tiny crack in it, then it will leak. Mine had a crack that I had not noticed, and of course I was away on holiday!!!! I remove it and suspend the insulin delivery so that the pump knows that it is not delivering any background insulin, and doesn’t get stroppy with me being away from it. I make sure Inreconnect within an hour, and replace the missing basal.
I hope that helps. Come back with any other questions.
Phil65
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- Relationship to Diabetes
- Type 1
SB2015
Well-Known Member
- Relationship to Diabetes
- Type 1
Good to hear how well the system is working for you Phil.
I remember at the start you took to it and trusted it from the beginning, and I took some time to let it take on all that I was doing before. Your ‘what’s the problem’ approach was very helpful to me. Thanks.
Geniekeepcalm
Active Member
- Relationship to Diabetes
- Type 1
- Pronouns
- She/Her
Bizarrely I have found that the last couple of sensors haven't even asked for a bg after warm up. I started using the 780 in September and then Smartguard in October. I had lots of issues with failing sensors but now seem resolved thanks to finding a tape product that doesn't cause allergic reaction and placing sensor on leg. I do finger prick occasionally
Phil65
Well-Known Member
- Relationship to Diabetes
- Type 1
Good to hear! For me, MDI and Bolus/Basal thankfully is a distant memory!
SB2015
Well-Known Member
- Relationship to Diabetes
- Type 1
Glad the failing sensors have been resolved and you have found tapes that work round the allergic reactions. I had a run of sensors that stopped early, which were always replaced. I am wondering whether there is a link between hydration levels which I was aware of with my Libre sensors, and I have given no thought to with the Medtronic ones, but it would make sense.
SB2015
Well-Known Member
- Relationship to Diabetes
- Type 1
Just replaced a cannula and …
I have switched to using Not Just A Patch for my sensor/transmitter.
I have had a few bruisers when removing a cannula, from tugs in the wrong direction possibly, or dropping the pump and it pulling on cannula (I used to apply tape to a loop of the tubing but forget to do that) or positioning it on the waistband of a different pair of trousers, …
I had the tapes that come with the sensors, and now apply one of the tapes over the cannula with the hole at where the tubing is connected. Voila - secure cannula, no tugs, no bruising.
A good use of the spare tapes.
I have switched to using Not Just A Patch for my sensor/transmitter.
I have had a few bruisers when removing a cannula, from tugs in the wrong direction possibly, or dropping the pump and it pulling on cannula (I used to apply tape to a loop of the tubing but forget to do that) or positioning it on the waistband of a different pair of trousers, …
I had the tapes that come with the sensors, and now apply one of the tapes over the cannula with the hole at where the tubing is connected. Voila - secure cannula, no tugs, no bruising.
A good use of the spare tapes.
Ditto with the failing sensors, but we have also had some pretty serious Guardian 4 inaccuracies - including one instance where it was quite scary (SG 9-10, BG 24). Following experience on this forum I am now putting more attention on making sure my kid drinks more water / drinks more regularly and is properly hydrated (otherwise it's like a camel's schedule!).
Type 1 Teddy
Active Member
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- Type 1
I'm not sure if anyone can help with this. I'm using 780/Smartguard and for the past fortnight have been having hypos every night at midnight. They can last a long time, and last night I had an ongoing hypo from midnight to 2 am. Before starting this system in August any night time hypos would be treated with 5 glucose tablets and would go in 10/15 minutes and all was fine after that. This initially started in October and my nurse made adjustments to my pump i.e. reduced carb ratio, active insulin time, plus one other thing I can't remember. All fine was fine for a few weeks and now this has started up again. I can't explain it, and to add to this the mini med mobile app has stopped working so I can't even see trends now. I am waiting for one of the nurses to call me but that might not be until Monday. The only thing that has worked to date was that on Tuesday and Wednesday I set a temp basal at 7 pm for about 14 hours and no hypos overnight and a decent blood glucose in the morning. I didn't do that last night as I got distracted and simply forgot. Not sure if this is a permanent solution anyway but will ensure I do this over the weekend. I suspect that the pump doesn't pick up my hypos quickly and so I go low and then they are severe, so changed the low alert to 5.0 this morning. The pump is already set on the 6.7 target, so can't change that. What else can I do? There are 2 issues really a) consistently going hypo at the same time and b) the fact that they last for 1.5 to 2 hours. I'm also on 4 metaformin a day (put on this when my sugars went haywire due to peri menopause a few years ago). I'm going to reduce to 3 a day as I was on this until recently and wonder if increasing to 4 has caused this. Anyway, that's probably more detail than anyone needs, and I'm not anyone can answer this, but any ideas welcome.
Type 1 Teddy
Active Member
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- Type 1
Well my diabetes nurse spent ages on the phone with me and put in some temp changes to my pump to try and keep this from occurring over the weekend. Medtronic got the app working so more discussion with the nurse on Tuesday when she is back and the pump data has uploaded to the cloud.
SB2015
Well-Known Member
- Relationship to Diabetes
- Type 1
Hi @Type 1 Teddy
I have no idea what impact the Metformin will be having on your insulin sensitivity, but wondering whether that is impacting on the pump’s automated system As it doesn’t know that you take Metformin. Do you still need to be taking the Metformin? I will leave that to your DSN.
Just reading through the timings of your hypos in the night, I am wondering at what time you last do a bolus. If you are eating late and bolusing it would suggest that the carb ratio for the evening meal is incorrect and you are getting too much insulin. This would seem to fit with the the consistency of the timing.
I know that my carb ratios are different throughout the day, with my needing more insulin first thing than I do later in the day. Do you make adjustments to your ratios yourself? It all takes a bit of trial and improvement to get things sorted, (and then the weather changes!)
another thought is whether you may need to adjust your active insulin time. This may be set too low from what you have said. Another thing to talk to your DSN about. As you have said it will be a lot easier having your conversation with the DSN now that you have the app working.
Let us know how you get on.
I have no idea what impact the Metformin will be having on your insulin sensitivity, but wondering whether that is impacting on the pump’s automated system As it doesn’t know that you take Metformin. Do you still need to be taking the Metformin? I will leave that to your DSN.
Just reading through the timings of your hypos in the night, I am wondering at what time you last do a bolus. If you are eating late and bolusing it would suggest that the carb ratio for the evening meal is incorrect and you are getting too much insulin. This would seem to fit with the the consistency of the timing.
I know that my carb ratios are different throughout the day, with my needing more insulin first thing than I do later in the day. Do you make adjustments to your ratios yourself? It all takes a bit of trial and improvement to get things sorted, (and then the weather changes!)
another thought is whether you may need to adjust your active insulin time. This may be set too low from what you have said. Another thing to talk to your DSN about. As you have said it will be a lot easier having your conversation with the DSN now that you have the app working.
Let us know how you get on.
Type 1 Teddy
Active Member
- Relationship to Diabetes
- Type 1
Hi SB Thanks very much for your reply, it's very helpful information. My DSN took me through quite a lot of this on Friday morning and put in some temp measures for the weekend, will be speaking to her on Tuesday morning to review the past few weeks. We did see from the pump that my basal/bolus split is 66% bolus, and 34% basal, it's apparently meant to about 50/50 so yes I think the evening dose needs looking at. I tend to eat around 6 - 6.30pm weekdays but weekends is later. What I can't get to grips with is the pump alorithm, My routine is roughly similar, Monday - Thursday, but very different at weekends, and I wonder if this is having an impact. I do the same thing in terms of diabetes management, carb count, take bolus 10 - 20 minutes before eating etc but just at different times, and some weekends I exercise and some I don't e.g. I usually take less breakfast bolus 4 days a week because I exercise for an hour but a normal food bolus at weekends and then go very high mid morning. Anyway I find it very confusing in terms of do I have to do the same every day for the pump to work - that's not real life - but I'm sure my DSN will help me out.
SB2015
Well-Known Member
- Relationship to Diabetes
- Type 1
With your later meal at weekends that reinforces my idea that it is your carb ratio that needs reducing. ( I ate much later last night and I am now sat here doing this as I have had an alert before low).
Do you have you got the alert before low set on your pump. I find this heads off the hypos.
With regard to your weekend post breakfast spike that also could be your ratios. I certainly find the pump‘s automated system deals well with any small spikes, to the extent that I let it get on with it once I have eaten. When I first started in Smartguard I tended to interfere with it, it now let it get on with its job.
You DEFINITELY don’t need to do the same thing everyday to get this to work. I do different things everyday and it copes. There are however loads of variables, such as the weather changes that do impact my levels, and I have just realised that my Low just now will have been caused by taking paracetamol and not changing my target level (Oops, I normally lift it a bit if I need painkillers)
let us know how things go with DSN.
Type 1 Teddy
Active Member
- Relationship to Diabetes
- Type 1
Hi SB, thanks again for you response, you're always very helpful and knowledgeable. Yes, I didn't think I had to do the same thing daily, but was getting concerned. Well I ended up having 2 DSN and a medtronic rep analysing my results!! Clearly I'm a conundrum 
, they thought I was micro carbing i.e. taking small amounts of carbs without telling the pump which I do. So if I'm low before bed e. g 4 or 5 I'd take some glucose to keep me ok. Or sometimes I ight have a chocolate after dinner if I;m going low before dinner carbs catch up. I might even have a random choc occasionally because I might not feel bolus is needed at the time.This was always ok with the old system, and the majority of the time I enter the carbs in to the pump. Anyway no microcarbing now. I have to enter all my carbs and let the pump decide if I need a bolus. Also no treating lows, I can only treat actual hypos. The nurse also changed my carb ration from 1.2 to 11. across the day as well. So last night after dinner I was pretty much at 4.4 - 4.8 all evening, i finger pricked but no hypo at all, I put my temp basal on at 8 pnish for the rest of the evening/night. I was 5.5 before bed and 7 this morning but glad I went down this route as I went10 10 during the night then down to the 7. I could see the pump giving me basal throughout the night but no corrections so the temp basal was a good idea. Today I've been 90% in target!!!!! She also suggested a different way of managing my morning exercise which worked well today. The change in carb ratio has also eradicated the highs I was getting 2 hours after breakfast and lunch. It's only day one but this is great. I forgot to ask about my metformin but she's calling again on Friday to check all is well so will check then. What BG to you to bed on and wake up with, and do you manage to do this without a temp basal?
Anyway, apologies for that being quite a long and detailed post, I never thought this pump would be so complicated but if I can learn how to manage the alogrithms then fingers crossed. Thanks again for your help.
, they thought I was micro carbing i.e. taking small amounts of carbs without telling the pump which I do. So if I'm low before bed e. g 4 or 5 I'd take some glucose to keep me ok. Or sometimes I ight have a chocolate after dinner if I;m going low before dinner carbs catch up. I might even have a random choc occasionally because I might not feel bolus is needed at the time.This was always ok with the old system, and the majority of the time I enter the carbs in to the pump. Anyway no microcarbing now. I have to enter all my carbs and let the pump decide if I need a bolus. Also no treating lows, I can only treat actual hypos. The nurse also changed my carb ration from 1.2 to 11. across the day as well. So last night after dinner I was pretty much at 4.4 - 4.8 all evening, i finger pricked but no hypo at all, I put my temp basal on at 8 pnish for the rest of the evening/night. I was 5.5 before bed and 7 this morning but glad I went down this route as I went10 10 during the night then down to the 7. I could see the pump giving me basal throughout the night but no corrections so the temp basal was a good idea. Today I've been 90% in target!!!!! She also suggested a different way of managing my morning exercise which worked well today. The change in carb ratio has also eradicated the highs I was getting 2 hours after breakfast and lunch. It's only day one but this is great. I forgot to ask about my metformin but she's calling again on Friday to check all is well so will check then. What BG to you to bed on and wake up with, and do you manage to do this without a temp basal?Anyway, apologies for that being quite a long and detailed post, I never thought this pump would be so complicated but if I can learn how to manage the alogrithms then fingers crossed. Thanks again for your help.
SB2015
Well-Known Member
- Relationship to Diabetes
- Type 1
I am glad that you have such good support In your transition to Smartguard.Hi SB, thanks again for you response, you're always very helpful and knowledgeable. Yes, I didn't think I had to do the same thing daily, but was getting concerned. Well I ended up having 2 DSN and a medtronic rep analysing my results!! Clearly I'm a conundrum
Anyway, apologies for that being quite a long and detailed post, I never thought this pump would be so complicated but if I can learn how to manage the alogrithms then fingers crossed. Thanks again for your help.
I took time to trust the pump and stop interfering. I do tell the pump any carbs I eat although if I have a fatty meal I will reduce the carbs so that the pump give me the upfront bolus and then I let the autocorrections deal with the extended bolus I would have used. I found that if I told it the whole carb count I would hypo after the meal as the algorithm is not so good at sorting lows.
If I get alert before low I still tell it the carbs I use to avert a hypo. If I go hypo I don’t tell the pump about the carbs I use to treat the hypo.
On a full day of walking I do give myself extra glucose. They used to tell us to tell the pump all the carbs but on their webinar on exercise they now tell us not to, and show a table of how many ‘free carbs’ to eat without insulin for different types of exercise.
With regard to levels when I go to bed I don’t even look (Probably not good advice!!!) I now trust it to sort things out and know that it will wake me if it goes wrong with an alert before low, which is rare nowadays. I have a target of 6.5 set (as I take painkillers all the time) and wake at 6.5 in the morning most of the time. I rise as soon as I get up but the pump corrects for that, and I pre-bolus for breakfast and things just wobble through the morning keeping me in target.
The hardest thing for me at the start was to let smartguard do the job.
Diabolized
Member
- Relationship to Diabetes
- Type 1
I've been using a Medtronic pump 640g for several years with no complaints. Currently using Dexcom 7 glucose sensors. At my last appointment, July 2023, the DSN discussed the hybrid closed loop system. As my pump warrenty was due to expire in January 2024, I was asked if this was something I was interested in. I replied that I was.
Moving to early January 2024. Phone call from DSN, was I still interested in the Medtronic 780g pump and a hybrid closed system? Once again I said yes and was told I would be contacted when my new pump had arrived. In the mean time carry on with the old 640g pump even though the warrenty was about to expire.
By the begining of February I was running low on Quick Sets. Attempting to order some more I discovered that my NHS funding had been withdrawn. I phoned the diabetes clinic. The clinic was awaiting delivery of my new pump. When it arrived I would be contacted and training on the pump set up and new hybrid closed loop system would be arranged. The clinic would supply me some Quick Sets if necessary. Two days later (7 February) 2 very large box's from Medtronic arrived unexpectedly on my door step. They contained the new pump, its accessories, new glucose sensors (are they called Smartguard?) and a new blood glucose metre. I called the diabetes clinic to let them know the pump had been delivered to my home address. I was told a DSN would call me back.
Today I am still waiting for that call back and I have two Quick Sets left. Once again I phoned the clinic. The DSN who should have originally called me back was on annual leave. I wish someone had told me! I was told to set the new pump and glucose sensors up myself "it's self explanatory, just follow the instructions in the booklet". What happened to the training? If I need help someone will call tomorrow.
I consider myself to be reasonably intelligent and I am familiar with Medtronic pumps, but I have reservations about setting this new system up on my own. To those who are already using the system, how easy is to set it up? Have others recieved training on the hybrid closed loop system? Am I just being over anxious?
Moving to early January 2024. Phone call from DSN, was I still interested in the Medtronic 780g pump and a hybrid closed system? Once again I said yes and was told I would be contacted when my new pump had arrived. In the mean time carry on with the old 640g pump even though the warrenty was about to expire.
By the begining of February I was running low on Quick Sets. Attempting to order some more I discovered that my NHS funding had been withdrawn. I phoned the diabetes clinic. The clinic was awaiting delivery of my new pump. When it arrived I would be contacted and training on the pump set up and new hybrid closed loop system would be arranged. The clinic would supply me some Quick Sets if necessary. Two days later (7 February) 2 very large box's from Medtronic arrived unexpectedly on my door step. They contained the new pump, its accessories, new glucose sensors (are they called Smartguard?) and a new blood glucose metre. I called the diabetes clinic to let them know the pump had been delivered to my home address. I was told a DSN would call me back.
Today I am still waiting for that call back and I have two Quick Sets left. Once again I phoned the clinic. The DSN who should have originally called me back was on annual leave. I wish someone had told me! I was told to set the new pump and glucose sensors up myself "it's self explanatory, just follow the instructions in the booklet". What happened to the training? If I need help someone will call tomorrow.
I consider myself to be reasonably intelligent and I am familiar with Medtronic pumps, but I have reservations about setting this new system up on my own. To those who are already using the system, how easy is to set it up? Have others recieved training on the hybrid closed loop system? Am I just being over anxious?