Trials and Tribulations with Medtronic 670G AutoMode

When you think about it, AIT is a different critter under Auto Mode than in a standard pump because of the microbolus thing. Each one of those little blips is subject to an AIT estimate. Every five minutes it’s looking to see how long the last little blip still has on its clock and adjust the current blip accordingly. So if you tell it 4hrs it’s going to be v-e-e-e-e-r-r-r-r-y conservative about how much it’s going to give you no matter what the SBG is saying. Similarly, if you take it all the way down to 2hrs–which is probably a lot shorter than what you entered in your standard pump–you’re telling it to discount the effect of the previous blip a lot more, while in reality what you’re doing is making the effect curves overlap a lot more. If that sounds like you’re treating these parameters not so much as hard-and-fast scientific facts but more like a story you’re telling it to coerce the thing into doing what you want it to, you’d be right. Mine is currently set at 2hrs.

Similarly with CR, which I suspect you’re going to need to start adjusting too. In a standard pump it really only applies to meal bolusing and the bolus calculator. With auto mode… well, no one seems to know, officially, but in practice it seems to make a difference to microbolus rate as well. I’ve got six different rates going now, all of them low enough that the pump gave me an “Are you sure you really mean this???” alert, and it’s finally starting to be more aggressive about correction doses and post-prandials, so it seems like I’m moving in the right direction. Dawn Phenomenon is still being a problem, but there’s progress.

If you’re on Facebook there are two groups I’d recommend: 670G Users, which has a couple of hoops they want you to jump through before joining (they really only want people who have the sensors and are using–or at least have used–Auto Mode), and 670G Support, which isn’t quite as closed. I think the level of expertise and experience on the Users group is a bit higher, so it’s worth going through the rigmarole, but they’ve both been helpful to me.

I also have two other threads on this that may be of interest:

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