780g algorithms

Does anyone know much about the new 780g algorithms that 770g users can upgrade to? I’m trying to verify that it is much more aggressive than other options on the market. We all know the 670g was pretty bad imo using a learning scheme and alarms etc. Dremed is the engine in the new 780g pump. Besides a lower target than any other pump, can we confirm the pump is going to be more aggressive ? I know the micro boluses in the 670g used a learning algorithm that just don’t work well for me as they are too weak. The highest micro I have ever seen is a .125 and just one time. Others are like .025 etc. The current 770g is pretty weak as well. I can confirm besides one overlay tape that I use from a third party, the sensors is awesome compared to the last. Good accuracy so far. Guardian 4 coming out is certified to support bg values you can dose against. Finally, a box of 5 sensors for me is 70 dollars a month. This is so much more reasonable than their previous offering and makes dexcom really expensive in comparison if you self pay like 300 a month. There is Bluetooth connectivity for phones for dashboards etc that I have not used yet because my phone is not compatible.

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No, sorry, Flynn. But, it sure is a good question.

@Rphil2 just upgraded.

Hi Flynn

I recently upgraded to the 770g and love it. But to my knowledge the only people who might know about the 780g algorithms are those in the clinical trials and even they will not know if what they used are the final version.

They tell us to expect them in late spring 2021. However summer would not be out of the question.

I am sorry I cannot help out. I wish I could. I am anxious.

Usual disclaimer about me being a medtronic ambassador, I don’t get paid, I like the shirt, my opinions are my wife’s, after all we have been married for 43 years and I gave up years ago. You understand.

Here is all I have found so far

All I know is that the automode target will be user-adjustable, down to 100, vs fixed at 120. That was the change I found myself crying out for when I was attempting to make the 670 system work for me, so that seems pretty huge. I’m coming due for a new pump in March 2021, so starting to get serious about the Mdt vs Tandem decision. I’ve actually just been using my old pager-style Paradigm with a stand-alone Dexcom G6 since giving up on the 670. I’m doing pretty well on it (5.8A1C), so I may decide I don’t even want to bother with these auto delivery systems, who knows…

Found this little piece regarding the 780G
UC202013491 EE MiniMed 780G QuickStart Guide mmol 06.05.2020(1).pdf (3.3 MB)

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I note that the guide indicates you’re still required to calibrate 2-3x/day. So that’s one strike against it. It refers to setting a “temporary fixed target” but I didn’t see where you could set the non-temporary one. I wonder if that means that it’s still going to be fixed at 120 under normal operation. I suppose you could just run “temporary” ones all the time, except that I suspect the system would complain. The 670 was full of gotchas like that, including things like complaining if you went too long without needing any microbolus activity. “BG too stable, can’t have that!”

I think there is some confusion over what generation of Medtronic CGM sensors are being used. I haven’t been following this closely, but I think the next model of Medtronic’s CGM sensors will not require initial calibration. But it’s not available yet so currently available Medtronic pumps will still use the Guardian 3 sensor/transmitter combo.

I assume the pump will be able to use the next model of sensors when Medtronic releases them or, at worst, an update to the pump’s firmware will need to be downloaded to enable that.

Anyone have any links they want to point towards?

I’m feeling really good about a conversation and some information I learned today from Medtronic Europe. The Older Medtronic series pumps including the newer tandem IQ/control are really based on exact carb counting. tandem IQ/control, 670/770 requires carb counting that is rather spot on. If you typically under count it will have trouble keeping up without correcting for it. We all have seen this with un-announced meals or just under counting carbs. It can ruin your day. The new 780g released in Europe solves this problem in a much better way. So, while I did not get the how - I did get some definition around the algorithm being more aggressive than what is currently on the market. The Algorithm was currently developed in Israel for adaptation. The 780 solves for this in a much better way with the new Dremed algorithm. This has been presented to the FDA for review. The 770 is the bridge to the 780 and will be less money from what I understand. There is some conversation on the 780g forums in Europe that talk about the functionality. People seem really jazzed. Fingers crossed to get this to the US which is coming per Medtronic.

opps according to the diatribe it still defaults to 120. However according to them as well the 780 is flexible to 100. so i wonder what the 90 to 110 i entered involves? I guess I will figure that out.

rick

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Good to see Medtronic improved their pump. Competition is good.

I’m a happy Control IQ user. Not sure I agree with what you said, but regardless looking forward to the 2021 algorithm enhancements and remote bolusing functionality from phone.

Just remember that you’ve got to take everything you hear from a company representative with a grain of salt. They’re not going to tell you good things about the competition i can tell you from experience that this is not true at all of Tandem’s Control-IQ. I just generally guesstimate insulin and it’s great at smoothing out the rest. I seldom bolus for small snacks and I sometimes forget to bolus for a meal at all until my “did you bolus??” alarm goes off at 140.

Today was one of those nights… It’s not a model graph to be proud of, but if is a good real world example. I had a bowl of split pea soup, 2 buttered thick slices of homemade bread for dipping, and a cup of hot chocolate with mini marshmallows for dessert. I’m no low-carber.
Anddd totally forgot to bolus until the alarm went off at 140. I was already on a normally unstoppable accent at that point. But Control-IQ adjusted my basal and added extra insulin in the background. Not enough to fully cover my meal. I still had to bolus. But it gave enough to avoid disaster. I topped out at 188. While it’s higher than my personal upper range of 160, it’s only barely outside the ADA guideline of 180, and only for 3 readings. Had I remembered to pre-bolus, or bolus at all really, I probably would have never crossed 140.

I don’t have experience with the 670g, so I can’t speak on that specifically…

But I think the biggest problem with switching to automated insulin dosing is that it exacerbates any problems in your pump settings. It’s always been a struggle to find a balance of numbers that “work” for someone. Many people fight and fight and never do actually find a working combo. One setting that would deliver too much insulin can be offset by another setting that would under-deliver, and you might THINK you’re dialed in… You don’t realize how far off your settings actually are until they’re being implemented minute by minute to make adjustments. It highlights every weakness.

That’s why you see such a strong division of love it or hate it amongst Control-IQ users. The system works phenomenally with the right settings, and I can’t wait to see how much it gets better with the looming software update that is supposed to improve customization options. Unfortunately, not everyone has the knowledge or the support to get their settings dialed in. Those poor souls are still on the frustrating rollercoaster that bad settings yield.

While I’m no fan of Medtronic and I know there were other problems with the system, I highly suspect that a lot of their furious 670g patient base was also because of this incorrect settings problem. The pumps can only work within the parameters you set. Being the first on the market, I think it was such a disgruntling change that many gave in to the frustrations before finding a way to make it work for them. I think it was a cost they paid for being first to market. I think they greased a few wheels for Tandem to come in and rescue the weary.

That said… I think it’s a given that the 770 and 780 pumps will bring a better user experience. They HAVE to. Metronic has been very forthcoming about the 670g not being “well received”, and all of their conference presentations I’ve seen have focused on the improved patient experience. In terms of glycemic control improvements, they were pretty much on par with Tandem’s 2019 Control-IQ trials. I think I’ve gotta give Tandem the edge there, though, because Tandem’s next gen software, due early this year, should offer further improvements yet, leaving Medtronic a few years behind.

But clinical trials aren’t the big picture. I’m very curious to see how the 770/780 plays out in the real world. While I currently think the X2 is the best pump on the market, I’m not brand loyal to Tandem. I’m out of warranty in five months, and gathering all the info I can to make my next decision. I’m a little too excited for the unveiling of Tandem’s T:sport (working name, might be different when it comes to market later this year), though, so I might be biased. I could talk myself into a Metronic if the 780 proves more impressive, though.

I am at a loss on whether I should upgrade my 630g to the 770 and the guardian 3. I am in Canada and use a dexcom g6 with my pump. I am really leery about medtronic’s sensors. I know some people have great accuracy and others not so good. I like the idea of this pump being able to get software updates. Medtronic is supposed to launch a calibration free sensor that won’t need any over tape. This all sounds very exciting. Eventually they might even integrate with dexcom, who knows. I am really leery about upgrading. The worse that can happen is that I go back to dexcom if the guardian 3 sensors don’t work for me and wait for medtronic to get with the times. I know the g6 is pretty accurate but there have been times when I’ve actually been high and it didn’t catch it. Everything has it’s flaws. I am always on top of my diabetes and follow all the rules. What has been your experience with the guardian3 sensors? Thanks.

Night and day. The Guardian 3 is a big step vs the Medtronic Enlyte sensor. I no longer have disconnects or Isig or alarm issues. They finally got it right. Funny how I use to call Medtronic to have a sensor replaced. I’m also a previous dexcom user. The only issue with guardian is taping. Overall the dexcom is a better CGM but I like Medtronic from an integrated package. Most of us go out and don’t use the Medtronic supplied tape and buy patches which fit over the sensors. They are waterproof and keep from moving etc. The accuracy for me is the same if not better than dex . Yes calibration is still necessary. But going away soon with guardian 4. The pump is the cornerstone of your decision so I recommend guardian. If you asked me a year ago I would choose differently but with the new 780 coming the enhancements and algorithm far exceed what is available in the Medtronic eco system and what is available commercia. lGuardian 4 is also pending some time next year and will be smaller, no calibration and or taping. I’m a former DIY pumper and used dexcom. Overall I love the freedom from restrictions I had and dex worked great. No matterr your decision the systems are a lot better. If you want the new algorithm and intelligence from dremed, dex alone will not get you there.

I agree but if you want validation spend time of the 780g Facebook forum in Europe. You will get a different read. 1000sor more diabetics are on this and love it. Many are the legacy Medtronic users and other pumps tethered to dexcom etc. There are also some good presentation for viewing in clincial trials. Mind you that we only hope that the new algorithm comes to the US from Medtronic which is what they are promising. I also thought the US was ahead in diabetes research etc. All the DIY movements get steam across the pond.

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Hallelujah!!!:+1:That makes me feel wonderful! I, myself was looking for alternatives to the sensor tape. Do you restart the guardian3 sensors? Do you get the sensor patches from a website? Is Medtronic going to charge people for software updates? They better not! It would be a bad move on their part, I think. I am very sensitive to lows (especially in the warmer temps) and it would be nice for my pump to suspend when low and adjust my basal rate and do corrections. 12 years ago when I was on an Animas 2020 I would have never thought that this was even possible. I have been talking with a few people in the UK that have the 780 and alot said it was good. I would love a pump that helps take the burden of managing diabetes and integrates with a cgm. Another reason for me wanting this pump is because I won’t be able to get a new pump until Feb 2023. I also tried the tslim but some of my basal rates are below the minimum on a tslim. I wasn’t able to use it. That’s a long time to wait, especially if better algorithms become available. You see, in Ontario diabetics on an insulin pump recieve anew pump every 5 years and we also get 2,400$ a year. 600$ paid every 4 months to help with supplies. This upgrade is 899$ until April 30 2021. I have a few more months to research it. I like my 630 it’s just alot of work to manage.

I buy the patches off of eBay. They are just round patches which come in all types of colors to cover the sensor. I usually get a pack of 50. Unfortunately I know the expenses of diabetes all too well. I only have casualty insurance. I pay cash for pumps and sensors. I find dexcom to be the worst and only caters to people with insurance at over100 dollars a sensor. Medtronic is such much more less. People need to buy diabetes product like they are cash even from insurance because dexcom is getting away with charging too much.

Here is a site for 770g sensor tape. I do not like them, but I understand some do.

i do love the site patches from Grif Grips