When we did our last pump switch, we first looked at pumps which either were currently integrated with Dexcom or had publicly announced plans to provide future integration with Dexcom.
These were the pumps we then investigated further to decide what we were going to switch to.
We ended up going with the Tandem t:slim X2 pump and continue to use the Dexcom G5 cgm system.
Hi all, I am on the 670G and the Medtronic CGM/sensors, etc. I did not much like automode (it just can’t handle my dawn phenomenon, and other times when cortisol (sp?) seems to overtake my body). So I’m in manual mode; that’s fine. But theoretically I could keep the 670G (in manaul mode) and start using the Dexcom CGM, right? Then I would have the iPhone app and see my numbers on my Apple Watch or iPhone… assuming my insurance is OK with the switch. Am I missing anything critical in my thinking? Thanks! Carol
I use the 530G and G5. It’s awesome. The pump is out of warranty and I probably will switch to the X2 this summer.
The lack of integration doesn’t bother me, as the G5 is accurate on it’s own(most of the time) and I have the skills to operate a manual pump. I like that combo a million times better than when I used Enlites with the 530G.
Yup, that’s what I did. I actually went back to my old pager-style Paradigm pump, which I’d been using with a Dexcom 5 for several years, because as a simple manual pump it’s a lot less irritating than the 670 (only 3 clicks to suspend, vs something like 11). The only inherent problem of this setup is that the 670 still has suspend on low in manual mode, so if that’s important to you it could be a consideration. But like you I preferred the advantages of having the iPhone app, not to mention ancillary conveniences like Sugarmate for my laptop status bar etc.
That was a big concern for me, but when I spoke to my endo about bailing on automode and going back to my old setup, she said “The insurance company doesn’t care which CGM you use–the prescription just reads ‘Continuous Glucose Monitor.’” And she was right. I had to wait until I was due for a refill, but I just ordered it as a Dexcom G5 and there was no problem. Obviously not all carriers are the same but I wouldn’t anticipate a problem.
Thanks, Dr. BB and Dave44! I’m definitely going to think seriously about switching CGMs (from Medtronic to Dexcom) since I just want to be in manual mode on the 670G. The advantages seem to be: I won’t have to take my pump out of the case every
time I want to see where I’m at; fewer finger sticks and calibrations with Dexcom; 10 days instead of 7 days per sensor (assuming no “extended wear”); glancing at my watch is way more convenient and discreet. Disadvantages seem to be: still needing to look
at my pump to see insulin on board, and of course all the other information and actions are on the pump - so using two devices for information/actions instead of just one. But I still think the advantages outweigh that disadvantage. I’ll see what my endo thinks.
Thanks again for your feedback and for all the good info and advice you provide on an ongoing basis.
Hi Dr. BB, just thought I would let you know that on the 670G, the "suspend delivery” feature is on the first screen after getting past the initial lock. Also, re: suspend on low, alert on low, etc. those are all user defined. I have my pump set to alert me when I get down to 80, and “thanks very much, I’ll take it from here”. Then I can suspend delivery if I choose to, or eat some fast acting CH, or set a temp basal, or whatever. I don’t have the suspend feature on at all, just alerts for high and low. I do wish I could tell the pump to alert me when I hit 80, and suspend delivery if I hit 60… it is not quite that flexible. However, you can set as many time frames with different settings across a 24-hour period as you want, so I might set it up to suspend on a lower number at night… I hadn’t thought about that until now! Thanks again - really good to compare notes.
Well, yes, but the problem is that you have to click your way down through a bunch (six? seven?) of items before you can click on it, and including those clicks I counted ten in all to activate the suspend, vs 4 for the Paradigm. I did a series of posts about my 670G experience starting back in 2017 when there weren’t so many people on it yet, starting with my hopeful beginnings, growing experience, and eventual throwing in the towel. The relevant bit:
It literally takes 10 clicks (including opening the screen and scrolling) to get to the authorization screen, and after clicking that many times the default option is to cancel out of the operation. Mothballing my 670G
I’ve got a pretty complete rundown at that link, including the thing about the alert sound that makes you time-out of the bolus process if you’re not paying attention. But the short version is that after about a month after giving up on auto and using the pump in manual mode I was sitting in the bathroom cussing about being timed out of a bolus (again!!!) when it finally occurred to me that my old pump, which I still had, didn’t do any of these irksome things, and asked myself what benefits the new pump was giving me that compensated for the extra aggravation. After running through all the factors, taking into consideration that I was thinking of going back to Dexcom as well, the answer was bupkis.
Which is not to criticize anyone else’s likes or dislikes—obviously the 670 IS a good fit for a lot of people. It just wasn’t for me. Fortunately I still had other options.
The Gaurdian sensors are far and away improved over Enlites and 1st gen Medtronic sensors. I’ve been a Medtronic CGMer since 2009 and this is the first one I trust sincerely.
If it’s off, the site is bad or my blood sugar is doing something really, really goofy while I calibrated. That happened like 2-3 times in the first year. So incredibly accurate for me.
No hesitation. I like the whole 670G system. It took a while for me to wrap my head around the dosing shift though. It’s a big learning curve! But worth it!
I wore both a G5 and a Guardian simultaneously in the ten days or so leading up to switching over to auto on the 670, and I too was impressed—I found them pretty much indistinguishable as to accuracy. This included the fact that they both tended to understate my a.m. DP-induced BGs. Not as much of a problem for the G5, since it wasn’t presuming to run my pump for me, but obviously more of one for the 670 system. I was just always starting the day trying to climb down from 180, which ran up against the slo-o-o-o-o-w correction rate, and left me with a persistently higher A1C than I’d been getting before.
I have read that there’s a known issue with Guardians that they work better for some people than others in terms of longevity, accuracy etc., something to do with individual metabolism, but it’s not something MdT talks about so who knows. At any rate it would help to explain why some people have a great experience and others not so much. Like I say, I had the same DP issue with G5s. Interestingly I recently upgraded to G6 and I can testify that its accuracy is markedly better, including the DP-lag factor, which is significantly minimize if not entirely gone. If I had the ability to integrate the G6 with the 670 I’d definitely give automode another try, but…
Anyway, it is pretty promising in terms of what the options may be by the time I’m eligible for a new pump again. Sucks that the whole system is geared so that you have to wait years to take advantage of these developments, but that’s another topic.