Back to Medtronic rather than Dana

[SB2015]

I had an interesting discussion with my consultant today, and the relative merits of Dana and Medtronic pumps. Based on that I think that I am back to Medtronic.

Some have experienced issues regarding support from Dana, and it has taken four days to replace a pump in one occasion. I have also still had no reply from the local rep.

Medtronic seem to be bullet proof and offer what I am after (manual entry of BG in Bolus calculator), sensors that can suspend if going low. I will just have to adjust my positioning of the pump to ensure I can access it to administer the Bolus.

There is still a possibility of the 670G. I am just not sure about having to always fund the sensors, the higher target BG level for the corrections and being so hands off.

Thank you to @Flower and @everydayupsanddowns for having me so well prepared for my discussions.

 

[trophywench]

Well any time you feel the need to suspend insulin for any reason, you can surely tell any pump to deliver 0.0 units?

 

[everydayupsanddowns]

Well any time you feel the need to suspend insulin for any reason, you can surely tell any pump to deliver 0.0 units?

Yes... but you aren’t always watching are you. For example the sensor on my MM640G automatically suspended for an hour and a bit at 2.49am today as my BG was heading downwards and I might have been approaching hypo at 4am, rather than levelled off in the low 6s, which is what happened. And I didn’t have to tell it to suspend. Or when to start again. Nor did it need to sound a screechy alarm to wake me (though it could have if I wanted it to).

I just woke up at 7ish and thanked Threepio for sorting it out for me without waking me up 🙂

 

[trophywench]

Ah so the normal Medtronic pump that everyone can have on the NHS NP, does this?

I was under the impression that only the Medtronic all singing all dancing pump one could combine with a cgm, could do this, not the ordinary one which people such as myself could easily get. Hence I assumed that only folk who were eligible under the NHS for CGM would be able to get hold of that pump - but now I'm confused cos I wasn't aware that SB had CGM other than a Libre?

Obviously I recognise how good it is if you can get both and all the pluses there - but this raises another question for me personally and often things that affect one person also affect other folk - so here goes with it.

When I had my first pump nearly 10 years ago - for the first time in my life, I reduced my A1c under 7 down to the high 6s (old money) but lots of hypos because I also lost 'early warning' symptoms so I often didn't even realise I was on a downward trend until into the 2s or lower - also caused my existing retinopathy in one eye which had disappeared - to reappear in both eyes! Not acceptable is it? Having resigned myself to low 7s ever since I get really good timely hypo warnings. Now - it's all very well suspending basal when you're low and descending - but how many times is the hypo caused by too much basal when you've been pumping for donkeys years and should you be smack on 5.0 before (eg) lunch experience you automatically reduce your bolus because that's what experience tells you to do? Perfect today cos that was my BG so I had the same bolus as normal for my sandwich but didn't add the carbs for the 1" slice of swiss roll I had for pud! Surprise surprise - not - BG was 5.1 before dinner.

It's only because I've been learnt properly how to apply what to my own D I spose - but I honestly don't think the NHS should be asked to fund such things for normally intelligent folk like me, Mrs Ordinary. If/when I become mentally incapable - well that's different.

 

[Pumper_Sue]

The pump can only suspend your basal if you have the Medtronic sensors to tell it what to do @trophywench

 

[SB2015]

Ah so the normal Medtronic pump that everyone can have on the NHS NP, does this?

I was under the impression that only the Medtronic all singing all dancing pump one could combine with a cgm, could do this, not the ordinary one which people such as myself could easily get. Hence I assumed that only folk who were eligible under the NHS for CGM would be able to get hold of that pump - but now I'm confused cos I wasn't aware that SB had CGM other than a Libre?

Obviously I recognise how good it is if you can get both and all the pluses there - but this raises another question for me personally and often things that affect one person also affect other folk - so here goes with it.

When I had my first pump nearly 10 years ago - for the first time in my life, I reduced my A1c under 7 down to the high 6s (old money) but lots of hypos because I also lost 'early warning' symptoms so I often didn't even realise I was on a downward trend until into the 2s or lower - also caused my existing retinopathy in one eye which had disappeared - to reappear in both eyes! Not acceptable is it? Having resigned myself to low 7s ever since I get really good timely hypo warnings. Now - it's all very well suspending basal when you're low and descending - but how many times is the hypo caused by too much basal when you've been pumping for donkeys years and should you be smack on 5.0 before (eg) lunch experience you automatically reduce your bolus because that's what experience tells you to do? Perfect today cos that was my BG so I had the same bolus as normal for my sandwich but didn't add the carbs for the 1" slice of swiss roll I had for pud! Surprise surprise - not - BG was 5.1 before dinner.

It's only because I've been learnt properly how to apply what to my own D I spose - but I honestly don't think the NHS should be asked to fund such things for normally intelligent folk like me, Mrs Ordinary. If/when I become mentally incapable - well that's different.

Well done Jenny, on such excellent control. In spite of all that I try to do, and because I am so concerned about ‘going too high’ I end up with one or two hypos every day. I know I could raise my targets but I would get bothered by higher readings (and any amount of telling myself not to worry just does not make any difference). I suspect that there is some magic that I am missing in my basal/bolus rates, but my days are so variable in any week that even with TBRs I just don’t avoid the hypos, and I don’t always pick up the info from the Libre in time to head it off.

So the Medtronic basic (340G) will give me the option of self funding sensors and activating the suspend (automatically) when necessary, in order to head off these hypos. With this pump I will be able to use the sensors when we can afford them (I am not expecting anyone else to pay for them) , but it will still work normally if I can’t afford them (unlike the 370G, which I think would leave me feeling a bit out of control anyway). Added to that I can manually enter the BG from the Libre (or sensor : @everydayupsanddowns would this be automatically picked up for a Bolus calculation when sensor is in use?) and reduce the number of finger pricks.

So Medtronic are top of my list at the moment, although I know that I will miss the bluetoothness of my Combo.

 

[Flower]

The sensor value is not picked up automatically for the Bolus Wizard but you can enter it manually. A glucose reading on the linked Contour meter is sent automatically and stays current in the calculator for approx 5 mins - from memory

To input a reading you select BG then input reading from whichever source you choose and continue with carbs etc

 

[everydayupsanddowns]

Ah so the normal Medtronic pump that everyone can have on the NHS NP, does this?

I was under the impression that only the Medtronic all singing all dancing pump one could combine with a cgm, could do this, not the ordinary one which people such as myself could easily get. Hence I assumed that only folk who were eligible under the NHS for CGM would be able to get hold of that pump - but now I'm confused cos I wasn't aware that SB had CGM other than a Libre?

My first pump was a Veo, that was able to link with Medtronic sensors to give ‘suspend on low’.

My next pump was a MM640G, which allowed the pump to suspend *before* you got low - IF you were wearing sensors.

The latest MM670G adds ‘auto mode’ to adjust basals and ratios every 24hrs, and add insulin to avoid highs as sell as suspend to avoid lows aiming to always keep you near 6.5mmol/L. It is only available if you can commit to wear sensors most of the time.

Medtronic sensors are rarely available on NHS.

But... the pumps themselves have been offering this capability, or shades of it, for about a decade.

It only works with Medtronic’s own sensors and transmitter (unless you go off into the realms of #wearenotwaiting... but that’s a whole different conversation!!)

As to manual basal adjustments... When wearing sensors I still get prompts to tweak my basal pattern (just like I have since MDI days several times each month) but rather than thinking to myself ‘Hmmmm, I’ve been going a bit low mid afternoon for a couple of days running’ I am able to think ‘Hmmmm, Smartguard has been kicking in mid afternoon for a couple of days running’ without me having to spend those minutes hypo with my warning signs firing.

 

[trophywench]

If anyone tells me with sufficient provable medical reason that I need to run lower than I currently do - well then yes I would reconsider, obviously. However perhaps I'm unusual in being so relaxed about my D control? Seems to me to cause more stress - which as everyone knows wrecks control anyway hence IMHO, avoiding stress is as, if not more, important than BG control.