medtronic 780g

[matthewthomas]

hi everyone, i’m not sure how this works as i’m new here lol but i’m needing some advice. i’m currently on the medtronic 780g with guardian 4 sensor. everything was fine since i started but ever since being in smartguard, the sensor will suddenly disconnect and will just show “- - -“ on my pump and in the app. it gives me 4 hours to test or for it to reconnect before it goes back to just being a pump with a cgm. my pump is literally right next to the cgm, my question is, what could be causing the disconnection? i’m not laying on it as it’s on my stomach and it happens while sat down. i also wanted to ask, is it normal for bg to rise even with the smartguard’s auto correction and auto basal? it just seems to keep rising and rising until it just drops suddenly. it’s my first time on a pump with cgm and smartguard tech. i’ve had had type 1 diabetes since 2016 and before this i was on the accu chek insight. any help or advice is appreciated. thank you all in advance!

 

[Pumper_Sue]

Hello and welcome to the forum,
Sorry I can't help you, have you phoned medtronics help line?

 

[rebrascora]

Hi and welcome.

I can't personally help you as I am on MDI but I believe @SB2015 is using that pump/sensor combination to loop so may be able to help now that I have tagged her.
Have you contacted the Medronics rep/helpline to ask about the problem

 

[matthewthomas]

Hello and welcome to the forum,
Sorry I can't help you, have you phoned medtronics help line?

i haven’t yet, i wanted to see if anyone else has the same problem and what they did to solve it. i feel if i was to call they probably wouldn’t be anything they could do lol but i’ll try them next. thank you for your help!

 

[matthewthomas]

Hi and welcome.

I can't personally help you as I am on MDI but I believe @SB2015 is using that pump/sensor combination to loop so may be able to help now that I have tagged her.
Have you contacted the Medronics rep/helpline to ask about the problem

i haven’t yet but i’ll try them next. thank you for your help!

 

[SB2015]

Hi @matthewthomas and welcome to the forum from another looper on the 780

It is well worth phoning the Medtronic pump careline. They are brilliant, and if you are using carelink they can have a look at the data and see what is happening and track down what the problem is.

With regard to your issue, are you saying that your sensor and transmitter are in your abdomen alongside the cannula? I use my arm for the sensor when I have assistance to put it in, especially the transmitter which is a bit fiddly with one hand. If on my own I use my abdomen.

Using the GuardIan 4 most of the time I get away with one finger prick after the two hour warm up and that is it for the week. It does sometimes go into checking mode, but I am happy that it is checking that things are okay since it has taken on a lot of the responsibility that you would have had without looping. Good that you have checked for a compression problem and confirm that that is not the issue. If it continues to tell you that it is reconnecting for more than three hours the advice is then to replace the sensor. They always replace these if they have not run their full course.

I would definitely phone them. They really are there 24/7 and brilliantly helpful.
let us know how you get on.

 

[matthewthomas]

Hi @matthewthomas and welcome to the forum from another looper on the 780

It is well worth phoning the Medtronic pump careline. They are brilliant, and if you are using carelink they can have a look at the data and see what is happening and track down what the problem is.

With regard to your issue, are you saying that your sensor and transmitter are in your abdomen alongside the cannula? I use my arm for the sensor when I have assistance to put it in, especially the transmitter which is a bit fiddly with one hand. If on my own I use my abdomen.

Using the GuardIan 4 most of the time I get away with one finger prick after the two hour warm up and that is it for the week. It does sometimes go into checking mode, but I am happy that it is checking that things are okay since it has taken on a lot of the responsibility that you would have had without looping. Good that you have checked for a compression problem and confirm that that is not the issue. If it continues to tell you that it is reconnecting for more than three hours the advice is then to replace the sensor. They always replace these if they have not run their full course.

I would definitely phone them. They really are there 24/7 and brilliantly helpful.
let us know how you get on.

thank you so much for your help!! yes, i have my sensor and transmitter in my stomach with the cannula about 5cm away and my pump on the belt clip. it only seems to happen now i’m in smartgaurd, it never happened before

 

[SB2015]

Whereabouts is your pump? Rememebe that the transmitter is talking to your pump, the position of the cannula is irrelevant. I have found that if I have the pump on one side of my body and the pump in the opposite that can cause issues . My pump (Hermione) sometimes gets in a bit of a strop at night if my pump is floating around on the opposite side and the signal doesn’t get through my body.

Are you looping? Or are you in manual mode. This will still give alarms for lows and highs, and it is important to get the basal rates right for this mode before going into Smartguard, as it will become your backup.

I had a month of issues that I did not get my head round initially and returned to my old Combo pump before starting again. I now would not want to stop looping. It is so much easier and requires a lot less thought from me. Try to stick with it if you can And keep the questions coming. Any change is difficult to manage as it requires a large amount of trust in a machine When we are used to taking the responsibility.

 

[SB2015]

Also

in Smart guard your pump is chatting to your pump every 5 min so a lot more important that there is a clear signal between the two. So unlikely to have been so much of an issue until you went into Smartguard, so no surprise that that is when it became an issue. I am a lot more tolerant of its strops now and then as I realise it is doing so much of theta I did before.

 

[matthewthomas]

Whereabouts is your pump? Rememebe that the transmitter is talking to your pump, the position of the cannula is irrelevant. I have found that if I have the pump on one side of my body and the pump in the opposite that can cause issues . My pump (Hermione) sometimes gets in a bit of a strop at night if my pump is floating around on the opposite side and the signal doesn’t get through my body.

Are you looping? Or are you in manual mode. This will still give alarms for lows and highs, and it is important to get the basal rates right for this mode before going into Smartguard, as it will become your backup.

I had a month of issues that I did not get my head round initially and returned to my old Combo pump before starting again. I now would not want to stop looping. It is so much easier and requires a lot less thought from me. Try to stick with it if you can And keep the questions coming. Any change is difficult to manage as it requires a large amount of trust in a machine When we are used to taking the responsibility.

my pump is close to my sensor. the first time it was on my arm and i didn’t have any problems even tho it’s possibly further away than were i have it now. i haven’t heard of looping before, but i’m smartguard. i was using just a pump and sensor for a week before going into smartgaurd. i was wondering also, is it normal for bg to rise a lot even with auto correction and auto basal? mine seems to do that for a while then drop suddenly. it never seems to go past 14 but it just climbs and climbs and then it goes into normal range or near normal range. i thought smartgaurd would’ve made it so it wouldn’t keep climbing lol

 

[SB2015]

Smart guard is the term Medtronic use for their looping.
It does take a bit of time for the automated system to bring you down if you go high since the novorapid takes a bit of time to get active. I find the biggest help to the system is that I still pre bolus for meals. Are you doing that? The interval between my bolus snd meal is different through the day and it took me some time to work out what that needed to be. A bit of trial and improvement.
One of the great things is how the pump sorts things overnight. Any wobbles over cards or impact of fat content are all sorted for me whilst I sleep. I wake to a nice flat line and nicely on target.
When are you getting biggest rises? If they are after meals try adjusting the prebolus time. Come back with more questions.

 

[matthewthomas]

Smart guard is the term Medtronic use for their looping.
It does take a bit of time for the automated system to bring you down if you go high since the novorapid takes a bit of time to get active. I find the biggest help to the system is that I still pre bolus for meals. Are you doing that? The interval between my bolus snd meal is different through the day and it took me some time to work out what that needed to be. A bit of trial and improvement.
One of the great things is how the pump sorts things overnight. Any wobbles over cards or impact of fat content are all sorted for me whilst I sleep. I wake to a nice flat line and nicely on target.
When are you getting biggest rises? If they are after meals try adjusting the prebolus time. Come back with more questions.

yes i do a bolus before meals. it’s sometimes after meals but sometimes it’s really random. there’s no pattern to it, it can be fine one day and the next day it’ll just start rising for no reason. it’s kinda concerning cause it seems to be giving me so much auto basal lol

 

[SB2015]

yes i do a bolus before meals. it’s sometimes after meals but sometimes it’s really random. there’s no pattern to it, it can be fine one day and the next day it’ll just start rising for no reason. it’s kinda concerning cause it seems to be giving me so much auto basal lol

How far ahead of your meals are you bolusing? For me in the morning it needs to be at least 30 min, and about 20 for the rest of the day, but it took me time to fix in these and we are all different.

When I was out this evening I bolused once the meal was in front of me, so I inevitably went high afterwards, whilst the insulin caught up with the carbs. Add in the the fattier content and my pump is still doing corrections four hours later. I do know that by the morning it will have got things sorted, and I just accept that where I cannot give the Novorapid a head start before I eat this will be the consequence. It was the same when I was not using Smartguard/looping but the difference is that I have learnt to let the pump do the autocorrections rather than my interfering.

I hope that things settle for you.

 

[SB2015]

it can be fine one day and the next day it’ll just start rising for no reason

just wondering whether there is any link to what you are eating or the amount of carbs.

Before using Smartguard/looping if I had a meal of more than 50g of carbs I needed an increased bolus For the same reaction of the insulin. I therefore chose to limit my carbs in any meal (most of the time!!!)
Similarly with the fat content. I would need to extend my bolus and deliver it over many hours. I guess that is what the pump is effectively doing with the continued corrections. Another factor is if I am already high when I eat. The insulin, even though I have added the correction in still needs a bit extra to do it’s job.

I find sometimes I can’t see the pattern in what is going on, but keeping a log of what I eat, fat content, Bg, amount of time before meal that I allow insulin to get going, …and share this, sometimes they can see the pattern that I had missed. Well worth talking to your team.