Comparison of Medtronic 640 with Roche Combo

[Radders]

Last week I sat through a 2.5 hour Teams session giving details of the 3 pumps I was told were the options to replace my now defunct Roche AccuChek Combo. These were Medtronic 780; Omnipod Dash and TSlim.

I love the Combo, and have had AccuChek pumps since getting my first Spirit in 2008, so of the 3 pumps presented, I chose the Medtronic 780 as it seemed the closest, but when I told my DSN my choice, and that I don’t want the CGM, after initially trying to persuade me, she now says that I should instead have a 640 and that I should research it myself. Charming, I thought!

So, I’ve looked on the Medtronic website and all seems ok, but I’d love to hear from anyone with experience of changing from the Combo to the 640, or the 640 to the 780, who can point out the main differences please..

Many thanks,

 

[SB2015]

Hi @Radders
I switched from my trusty Combo to the 780, but I do use the CGM in the closed loop and would not go back.
Have they offered to fund a CGM?
Is there a reason that you don’t want the CGM?

I found it very hard losing my Combo which I had stuck with for 8 years. The 780 (and 640) are similar in size to the Combo. You do have to access the pump to do blouses which irritated me, after doing everything from the handset on the Combo. Apart from that they are very similar

It might make more sense to get the 780 which then still gives you the option of using a CGM in the future.

 

[Pumper_Sue]

Not sure but think the 640 is being replaced as it's an ancient monument in this day and age.

 

[Flower]

Hi @Radders

Ive Never used a Combo but I have used the 640g for about 8 years hoping to change next year. It’s been around for a few years now & I don’t know why you would be advised to choose the 640g over the 780g even if you’re not going to use sensors at present or at all. Without the sensors the pumps are pretty similar but the 640g doesn’t have Bluetooth to link to apps. I use Guardian 3 sensors with my 640g pump but can’t upgrade to the more recent Guardian 4 sensors with the 640g.

Having seen the speed of development and integration of tech over the last few years I personally wouldn’t choose an older pump. You would lock yourself out of potential closed loop etc for 4years even if it’s something you don’t want at present/ever. I’m finding my pump quite limiting for lack of integration to an app/mobile phone as I struggle to read the info/alarms on the screen, it’s a great pump for flexibility of basal/bolus settings etc and keeping me alive but I wouldn’t choose it today when there’s a more recent model available.

 

[everydayupsanddowns]

The main differences between the two are how they work with sensors (and possibly which sensors they are compatible with).

If you plan is not to use sensors, I think the 780 in manual mode, and the 640 without sensors are pretty similar to be honest.

Not sure you’d even still be able to get a 640 as a starter?

 

[Radders]

Hi @Radders
I switched from my trusty Combo to the 780, but I do use the CGM in the closed loop and would not go back.
Have they offered to fund a CGM?
Is there a reason that you don’t want the CGM?

I found it very hard losing my Combo which I had stuck with for 8 years. The 780 (and 640) are similar in size to the Combo. You do have to access the pump to do blouses which irritated me, after doing everything from the handset on the Combo. Apart from that they are very similar

It might make more sense to get the 780 which then still gives you the option of using a CGM in the future.

Hi, thank you for responding. CGM is available but I don’t feel the need and am reluctant to have another device attached to my abdomen, which experience has shown to be the only place I can wear anything without it causing me issues, apart from the Libre.
I am happy with the Libre and I particularly like the pocket sized reader and the one handed useability of it. I have never used the handset to control the Combo pump, preferring to use the buttons on the pump.
It appears that if I want to use the pump without CGM then that’s the only option being offered to me for some reason I don’t quite understand: perhaps it’s a matter of money.

 

[Radders]

The main differences between the two are how they work with sensors (and possibly which sensors they are compatible with).

If you plan is not to use sensors, I think the 780 in manual mode, and the 640 without sensors are pretty similar to be honest.

Not sure you’d even still be able to get a 640 as a starter?

Hi, I was surprised by the suggestion which came from the DSN, so presumably it’s available,. I’ll be cross if I research it as suggested and then it turns out not to be an option!

 

[Radders]

Hi @Radders

Ive Never used a Combo but I have used the 640g for about 8 years hoping to change next year. It’s been around for a few years now & I don’t know why you would be advised to choose the 640g over the 780g even if you’re not going to use sensors at present or at all. Without the sensors the pumps are pretty similar but the 640g doesn’t have Bluetooth to link to apps. I use Guardian 3 sensors with my 640g pump but can’t upgrade to the more recent Guardian 4 sensors with the 640g.

Having seen the speed of development and integration of tech over the last few years I personally wouldn’t choose an older pump. You would lock yourself out of potential closed loop etc for 4years even if it’s something you don’t want at present/ever. I’m finding my pump quite limiting for lack of integration to an app/mobile phone as I struggle to read the info/alarms on the screen, it’s a great pump for flexibility of basal/bolus settings etc and keeping me alive but I wouldn’t choose it today when there’s a more recent model available.

Thank you, food for thought. I get the impression I’m not going to have the choice if I decide I don’t want CGM but do want to keep using the Libre 2. I don’t like using my phone to do readings or control a pump as it’s large and cumbersome and takes two hands. I like the handiness and speed of the Libre reader and being able to control the pump directly with its buttons.

 

[Radders]

Not sure but think the 640 is being replaced as it's an ancient monument in this day and age.

Is it even more ancient than the Combo? I’m very comfortable with my Combo so if it’s not too different that will suit me! I don’t like some of the new tech, in particular I don’t want to have to use my phone as it’s large and takes two hands to do things I can do with one on my current Combo/Libre setup.

 

[SB2015]

Having read through your posts @Radders I think that you would find the 780 (or 640) very similar to your combo. I use the associated sensor and wear that on my arm, where I would have had the Libre, but you mention that you need to wear things on your abdomen.
I don’t need my phone to run the system, and my reading along with th graph are shown on the screen of my pump all the time, so no reader to carry. The display is about the same size font as on the Libre reader, which I always liked since I could read it in the night without needing to find my glasses.
My phone is only required to do the download to Carelink. This has proved useful when tackling a tech issue as the Medtronic support team can then see the data I am referring to along with any alarms.

 

[Radders]

Having read through your posts @Radders I think that you would find the 780 (or 640) very similar to your combo. I use the associated sensor and wear that on my arm, where I would have had the Libre, but you mention that you need to wear things on your abdomen.
I don’t need my phone to run the system, and my reading along with th graph are shown on the screen of my pump all the time, so no reader to carry. The display is about the same size font as on the Libre reader, which I always liked since I could read it in the night without needing to find my glasses.
My phone is only required to do the download to Carelink. This has proved useful when tackling a tech issue as the Medtronic support team can then see the data I am referring to along with any alarms.

Thank you, that’s very helpful. Interested to hear that you wear the sensor on your arm. Even with the tiny size of a Libre sensor I sometimes knock it: how does the Minimed sensor compare in both profile and diameter please? So difficult to judge from the info I’ve seen online.