Automode exit

I am on the 770 insulin pump and automode doesn’t seem to be addressing my dawn phenomenon. I was wondering if anyone just exists automode and does a temp basal to make up for the rise?

I’m on Tandem with C-IQ, not Medtronix. I experience Feet on the Floor more than DP. C-IQ does a good job in keeping good control. But FOTF is a different story. I take Synthyroid fasting and continue to fast for 30 to 60 minutes watching my BG rise.

I do a correction which keeps BG in good order.

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I’m on the 770G, and stay in Automode except when changing sensors.

I too had issues w/dawn phenomenon back when i began on the 670G in automode. Adding a higher basal rate in my Delivery Settings for the early morning hours helped conquer it for the most part. For me, I set my basal to increase from 03:30AM - 06:00AM (I get up at 04:45AM). This works for me.

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Are you saying that if I increase my basals in the early morning automode will adjust accordingly? I thought programmed basal rates didn’t affect automode?

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If any semi-automatic pump isn’t handling a rise effectively, regardless of the pump brand or type, you have several options. The pumps’ automatic mode is intended to maintain BG within a range. It is not effective in bringing you down into that range in a reasonably short period of time and can not prevent you from going hypo if you overdose enough.

The simplest and most reliable for a one time or short-term problem, is doing calculated manual corrections.

The second easiest is to exit automatic mode and set a temp basal, but if you forget to restore autiomatic opertion, this loses the limited protection provided by the automatic mode.

If this is a chronic problem and the pumps algorithm follows a set of biometrics or a basal profile, you can adjust the profile or enter new data, then exit and reenter auto mode. Generally, this acts as a reset and is used as the basis for future delivery.

As @pstud123 already mentioned, Automode is intended to maintain BG within a range. It cannot however fully compensate for BG rise/fall beyond a certain rate. It works within the basal rate currently being administered. Since my BG tends to rise in the early morning hours before I wake, I have an increased basal rate to compensate. That allows Automode to supply more insulin than it would in another preprogrammed rate. Here’s what my typical daily basal looks like.

This is what works for ME. You’ll need to work with your endo to find what works for you, though admittedly, I came up with this pattern on my own with a lot of trial and error:

Basal Pattern - 30.9U/day

  • 00:00 - 03:30 - 1.10U/hr
  • 03:30 - 06:00 - 1.30U/hr
  • 06:00 - 18:00 - 1.35U/hr
  • 18:00 - 24:00 - 1.25U/hr

I’m in Automode ~90% of the time, and my BG remains in-range 75-80% with these settings. This is based on my monthly Carelink report. If you aren’t using those, they can be a big help.

My own current profile looks like this after 6 months of cautious diet changes, weight loss and experimenting.

and my scatter chart for the past 30 days looks like this :

I’m very fortunate to have had a combination of factors that let me do this. Old, retired, housebound, having a constant diet and activity from day to day, fairly good overall health for my age- and a background in engineering.

But this ISN’T rocket science. It’s basic arithmetic after looking at the right charts. (Glucose scatter charts are PWD best friend).

I wish there was a better onboarding process for others using the same tech as I have, perhaps a week of outpatient training and guidance from experienced users. It’s a shame that instead we have endos who set “goals” that are simultaneously too conservative and difficult to achieve because PWD aren’t getting the information they need to make informed changes to their self-care.

imo If everyone was prepared with realistic expectations of the work required to use these tools, the knowledge of what to do when things don’t work they way they are supposed to, and professional resources available 24x7 to assist when we actually need guidance and help, we all would be doing better with less stress- including our doctors.

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I haven’t tested basal rates in about 4 years. Automode was running like this:
8p- 12a .025
I feel comfortable enough adjusting my own numbers. I increased my morning from .275 to .300 and we’ll see how it goes.

By the way. After how many days will I notice a change in my morning rate? Thanks.:+1:

That’s hard to say. I’d recommend you look at weekly/monthly averages vs day-to-day. So give it a try, compare a week of your new basal to your previous week and see if you can detect a downward trend in your morning BG.

Agree with the scatter charts, they tell the story. That’s an impressive looking plot @pstud123

Thankyou. I will watch my weekly readings and see what happens.

I wish I could take full credit for the results but as I said my situation is extraordinary. I don’t have to deal with the complexities of a more normal lifestyle. I’d gladly trade some time in range for more mobility and social interaction.

One thing that every pump user should know is that it’s essential to have a verified good basal profile. If you don’t, when the pump is unable to maintain automatic operation for things like routine loss of CGM signal or must be turned off because the CGM site/sensor is flaky, you are SOL.

My G6 experience is that in ~25% of new sites the CGM can’t be relied on for dosing for up to 36 hours and the same was true for the Libre 2. I’ve had some sensors where I used many more strips during the true “warm up” interval than I would have in 5 days of MDI with a BGM. I routinely need to do 4-6 BGM readings for each new sensor.

I’m using the 770 also and sometimes for 3 to 4 days in a row the CGM will report that it has ‘gone out of Auto’ and has reverted back to manual basil. The only way I have found to determine why this happened is to have you pump set to auto upload to Carelink and then call Medtronic and ask a rep to look at Carelink and determine why this occurred. They are pretty good at diagnosing the problem.

You definitely need to validate your profile again.

And instead of relying on Medtronic’s tech support, you should learn enough to troubleshoot most CGM sensor/pump/site issues within 24 hours of a site change.

I know that Medtronic and Tandem both have simple troubleshooting handouts with checklists of what to do when things aren’t working right,
as well as user manuals that are more informative than level one help desk responses.

Don’t tell me what to do