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marie11

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Type 1
Hi I'm Marie type 1 for 42years been on medtronic 780g with guardian 4 sensor since September.
But have reached few hiccups ,
Also do many of you use temp basal apart from exercise.



M
 
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Hi and welcome @marie11 glad you've joined us 🙂

I hope things have gone as smoothly as possible over the years for you and the Medtronic 780g & cgm is working well. There's been a fair few changes over the years, I can hardly keep up with all the tech developments recently.
 
Hi @marie11

I have been using the 780 with the sensor for two years in the hybrid closed loop now. I most definitely had hiccoughs to start with But now would not want to be without the system.
Are you using it in a closed loop (Smartguard) or sticking to manual mode?

If you are in manual mode
It will be similar to other pumps, although the language used tends to be a bit different with different companies Eg ‘active insulin’ or ‘insulin on board’.

if you are in Smartguard
I use the temp target in Smartguard when exercising, setting it between 1 and 2 hours before I start the excercise. I also eat extra carbs if I am doing extended period such as all day walk. Medtronic have a programme of webinars available and one of them is about managing exercise, which I found excellent. Worth asking your DSN for the link to these (I will also look to see if I still have it)

I found the system wasn’t too good on bringing high levels down, such as after too big a meal, or when not having the opportunity to prebolus. I kept getting alarms telling me that my pump had been at max delivery for 7 hours. I changed my max basal delivery per hour and now things come down far more quickly.

It has taken me time to trust the system, and to find workarounds to specific problems. Can you specify what issues you are having with the system? Come back with any questions that you have.
 
I’m not on a Medtronic but I use the temp basal quite a lot - for exercise, for illness, for sitting in the cinema, etc.
 
SB2015 said:
Hi @marie11

I have been using the 780 with the sensor for two years in the hybrid closed loop now. I most definitely had hiccoughs to start with But now would not want to be without the system.
Are you using it in a closed loop (Smartguard) or sticking to manual mode?

If you are in manual mode
It will be similar to other pumps, although the language used tends to be a bit different with different companies Eg ‘active insulin’ or ‘insulin on board’.

if you are in Smartguard
I use the temp target in Smartguard when exercising, setting it between 1 and 2 hours before I start the excercise. I also eat extra carbs if I am doing extended period such as all day walk. Medtronic have a programme of webinars available and one of them is about managing exercise, which I found excellent. Worth asking your DSN for the link to these (I will also look to see if I still have it)

I found the system wasn’t too good on bringing high levels down, such as after too big a meal, or when not having the opportunity to prebolus. I kept getting alarms telling me that my pump had been at max delivery for 7 hours. I changed my max basal delivery per hour and now things come down far more quickly.

It has taken me time to trust the system, and to find workarounds to specific problems. Can you specify what issues you are having with the system? Come back with any questions that you have.
Click to expand...
Hi

I am on smartguard and mostly have done OK.
I recently have been dropping low 4.6 between 11pm and midnight but don't know what to do.
Would a temp basal work?

Yes I am same if high takes hours to come down and like you alarm goes of as its been at max delivery .
I have booked myself on a webinar for June as feel i need /want to understand my pump better.
Mx
Sorry I lost signal took while for phone to come back .


I didn't add have had few hypos between 2 am and 3 am they seem to be starting around 11 pm midnight When I start dropping low .
 
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Welcome to the forum @marie11

I’ll leave the 780 afficianados to give you device specific suggections - I only know what I would do on the tSlim!
 
marie11 said:
Hi

I am on smartguard and mostly have done OK.
I recently have been dropping low 4.6 between 11pm and midnight but don't know what to do.
Would a temp basal work?

Yes I am same if high takes hours to come down and like you alarm goes of as its been at max delivery .
I have booked myself on a webinar for June as feel i need /want to understand my pump better.
Mx
Click to expand...
Do look at increasing you max basal delivery per hour. It certainly sped up my pump dealing with highs.

How long after your meal is your drop at 11:00 pm. Could it be your carb ratio from your evening meal?

What target are you using? I used to use 5.5 but still had too many lows so lifted it to 6.1 and reduced the hypos. I have now stuck with that.

Glad that you are booked into the webinar.
 
Hi @marie11. 🙂 I use an Omnipod Dash. As well as for exercise, I use temp basal rates for work, choir sessions, Welsh classes, shopping, and illness.

I hope the webinar is useful. 🙂
 
SB2015

Hi,
Sorry lost signal on phone so you only got half story .
I'm starting to go low between 11pm and midnight
I have had few hypos between 2 am and 3 am which looking at graph its from this 11 pm to midnight.

I will have a look at my max basal delivery.

Last meal usually 6pm so a good number hours so not carb ratio.

5.5 as thats what diabetes nurse set it at to get my hba1c better.

Thanks
Mx
 
Bloden said:
Hi @marie11. 🙂 I use an Omnipod Dash. As well as for exercise, I use temp basal rates for work, choir sessions, Welsh classes, shopping, and illness.

I hope the webinar is useful. 🙂
Click to expand...
One thing I feel medtronic is rubbish on illness .
Just my experience.
 
marie11 said:
One thing I feel medtronic is rubbish on illness .
Just my experience.
Click to expand...
That might be solved with an increase in max basal delivery per hour.
I would try lifting your target overnight and see if that dirts the night lows. I was very reluctant to do this change but it was worth it and generally gives me TIR in 90s
What have you got the action time of your insulin set at? This is another variable that can be tweaked.
 
SB2015 said:
That might be solved with an increase in max basal delivery per hour.
I would try lifting your target overnight and see if that dirts the night lows. I was very reluctant to do this change but it was worth it and generally gives me TIR in 90s
What have you got the action time of your insulin set at? This is another variable that can be tweaked.
Click to expand...
Hi
Max basal 2.oou/hrs
Max bolus 10u.

AIT Set at 3 hours and so far so good.
Mx
 
marie11 said:
SB2015

Hi,
Sorry lost signal on phone so you only got half story .
I'm starting to go low between 11pm and midnight
I have had few hypos between 2 am and 3 am which looking at graph its from this 11 pm to midnight.

I will have a look at my max basal delivery.

Last meal usually 6pm so a good number hours so not carb ratio.

5.5 as thats what diabetes nurse set it at to get my hba1c better.

Thanks
Mx
Click to expand...
Maybe 5.5 is to tight but was told to achieve hba1c this is best at 5.5
 
SB2015.

Been in target bloods held since dinner now 5.5 with straight down arrow.
Only having a cuppa nothing to eat.
 
marie11 said:
Now alarm alert before low....
Click to expand...
Some thoughts:

Lows
At what level have you got your alert before low set? If it is set at 5 and your target is 5.5 they are very close and with the oscillations that we all get it is likely that you are going to have a lot of alarms.

If you ate at your normal time of 6:00 and you are now going low at around four hours afterwards I am thinking that it could be you meal time ratio for the evening needs to be changed, especially as this is a pattern that is happening. I kept switching back to 5.5 as I was keen to get HbA1c as low as possible but now accept that 6.1 works for me and happy with TIR in 90s.

When you get your alert before low how do you treat that? I tend to go for 1 or 2 JBs and it will often head off the low. If at home I will have a little juice.

Highs
To address highs that won’t come down I found the change from max basal to 3 per hour sorted that for me. I haven’t tried it out in extremes such as severe illness but for errors in carbs it is working now, and makes sense as I am letting the pump give more insulin to tackle highs. For severe illness I suspect that I would end up going back to manual, but I will wait and see.

We are all different and it takes some tweaks to get things working for each of us.
 
And …
what increments have your got your bolus set at. The smaller increments the more accurate your pump can be. Mine is set at 0.025, which enables the pump to make tiny changes, which our pumps are wanting to do for us.
 
SB2015 said:
Some thoughts:

Lows
At what level have you got your alert before low set? If it is set at 5 and your target is 5.5 they are very close and with the oscillations that we all get it is likely that you are going to have a lot of alarms.

If you ate at your normal time of 6:00 and you are now going low at around four hours afterwards I am thinking that it could be you meal time ratio for the evening needs to be changed, especially as this is a pattern that is happening. I kept switching back to 5.5 as I was keen to get HbA1c as low as possible but now accept that 6.1 works for me and happy with TIR in 90s.

When you get your alert before low how do you treat that? I tend to go for 1 or 2 JBs and it will often head off the low. If at home I will have a little juice.

Highs
To address highs that won’t come down I found the change from max basal to 3 per hour sorted that for me. I haven’t tried it out in extremes such as severe illness but for errors in carbs it is working now, and makes sense as I am letting the pump give more insulin to tackle highs. For severe illness I suspect that I would end up going back to manual, but I will wait and see.

We are all different and it takes some tweaks to get things working for each of us.
Click to expand...
Morning.

Alert before low is 4.0
BG target 5 5 - 7.5
Smartguard settings 5.5
TIR most days above 75% but some below 50.
IAT is 3 hours .
I belive ISF doesn't cone into it .

I do try 3,4 jelly babies or 6 dolly mixture or most recently small amount of lucozade or coke wait 15m then repeat until I start to.come up about 5 mmol.
This at times takes a very long time compared to pre new pump and sensor(for some reason).taking anywhere between 15m and over an hour .

Highs
Changing max basal to 3h if miss calculated carbs how long do you put this on for.
?


Mx
 
SB2015 said:
And …
what increments have your got your bolus set at. The smaller increments the more accurate your pump can be. Mine is set at 0.025, which enables the pump to make tiny changes, which our pumps are wanting to do for us.
Click to expand...
Bolus increments same 0.025
 
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