Filling the reservoir ???
I am another Medtronic (20+ years) to Tandem/dexcom convert. I made the switch about 3 months ago, and I’m happy that I did.
I was in the same situation (my Medtronic was out of warranty). The cde at my doctor’s office told me that Medtronic would still overnight me a pump if mine broke, but that I would have to return it within 90 days. So, I would have 90 days to commit to a new Medtronic or switch. Thankfully I did not have to test it, but that’s what I was told…
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Fixed it
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Ok. I just went thru several weeks of reading up on every pump available. My goal was not so much of lowering my A1c but to level out the highs and lows during the day.
I settled on the Tandem Slim with IQ control. Not only was it one of the smallest pumps but also worked with a minimal amount of insulin on board. And even better it is the only pump that works with the Dexcom sensor. I talked to my Endo Doc about it , but I don’t qualify for it on Medicare as my C-Peptide is to high ( make to much insulin on my own)
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Is your C-Peptide value near the maximum value that Medicare allows for its pump eligibility threshold? I seem to remember that other T2Ds have dealt with this situation and were able to nudge their c-peptide levels a little lower by using a lower carb diet. Not sure if my memory is accurate here but you can do some TuD searches based on C-peptide and Medicare pumps.
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I had 3 different endos my last 2 years at the local MTF (since aged out to Medicare). Going in with an AGP report and insisting that goal/criteria is Time In Range worked quite well. AGP focused very brief discussion of hypos on time in hypo, instead of the number of episodes.
My CGM is now G6, but I stuck with my 670G pump. No rule that Tandem pump is required when using Dexcom sensor. All the algorithms are too cautious for me and my basal is about 3 IU/day. Add in easier of reservoir change and the air issues, the Medtronics pump is a better fit for me.
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I have been using Medtronic pumps for the last 16 years. They are the only brand I have ever used. I’ve had mixed results with various combinations of their pump & sensor. MY first pump was before CGM. When they came out with the 522/722 & Sof-Sensor I used that with decent results. The sensors were generally pretty good and I didn’t even mind the huge insertion needle and harpoon inserter device. When I got to the 530g (I think?) with the newer Enlite sensors I found they did not work for me at all. I tried for months. Every Single Sensor would read supper low, and not just on the first day. My BG could be in the 200s and the sensor would be 62. I finally gave up on them and had no sensor for the next 5 years. That was partially my fault because when the warranty was up I got a call from Medtronic and I told them their sensors sucked and I would be looking into Dexcom but I never did. Life and work got in the way. Then the 530g died when it was well over a year out of warranty. In desperation I called Medtronic and they assured me that they had all new sensors now and they were so much better than Enlite and the 670g pump was amazing. I let them talk me into it. I have to say that the current Guardian sensors DO work well for me. In the 2 1/2 years I’ve been using them I’ve had to pull a few because of “sensor updating” or losing connection to the transmitter but I don’t know if I’ve pulled any simply because they were inaccurate. So the pump works fine, the sensor work fine, but Auto Mode did not work fine. I just paid to do the Pathway to the 770 in hopes that they roll out the 780 here (USA) this year and I get to try it. My warranty is up in September 2022.
If I get to try the 780 with its new algorithm and I like it I have no problem staying with Medtronic. They are easy to deal with, they follow through on everything, I have a lot of supplies and older pumps to use in case of emergencies. I would really like to try auto mode and have it work. If I do get to try the 780 and don’t care for it then I will consider Tandem next year when it’s time for a new pump. It is scary jumping ship after so long and there are things about the Tandem that don’t appeal to me. I also don’t know if Dexcom will work for me. Everyone heard about how “awful” the Medtronic sensor are but for me, 2 out of the 3 iterations I’ve tried have been great. What if it’s Dexcom that doesn’t work for me? I have seen posts from people who say just that in various forums.
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@John70 this seems to be the conclusion I’ve drawn as well reading up on coupled with afriend’s real-world experience on Control and Basal IQ over the last year.
@William7 this is incredible helpful advice!!! Thank you. I’m moving from seeing the endo,who just retired, in the office to the CDE. I’m hoping the CDE is on board! I’ve been at civilian clinics the last 7 years and they have been amazing compared to my MTF experiences. I’m just hoping it all works out.
Great feedback although the new 870 from Medtronic now in Europe is more aggressive than tandem and the Dex combo with the new dream med algorithm from Israel.The key is not the technology per say as we are all always chasing the new it is how we make these transitions. I applaud your efforts and I’m sure you will get there.
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I feel ya brother. I gave up on Medtronic for similar reasons. I was tired of getting up in the middle of the nite to use the bathroom and having my “tether” ripped off me bc the pump was under the pillow.
I’ve never seen Medtronic as particularly innovative on either the hardware or software side. I think Control-IQs algorithm from Tandem is an excellent choice. One of the questions you should contemplate is “tube or no tube”… that’s a big choice IMHO. Your option is the Omnipod 5 which is coming out in July… similar algo to Tandem but its not as aggressive and is really meant for people who have a higher a1c to begin with.
Tidepool has. combined with the tech from the Open Source Loop community to create an FDA approved commercial version.
Here’s a recent post comparing the various tech coming out this year and next.
Endo: I don’t think you need his permission to switch devices. Its a personal choice. Remember that an MD is an “expert” in their trained domain but you are the leader of your healthcare team. You can take in his advice (and the advice of others and the research you do) and then you can make an informed decision.
The problem with experts is that they make the patient a quiet and passive participant in your own care. Take an active role…
If you’d like to discuss more on that, please let me know. Most of my clients have similar thoughts regarding their relationship with their medical professionals.
FYI, I am undergoing the same evaluation that you are.
Lets commiserate!
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I’m having a lot of the same struggles right now. My last pump upgrade was to the 670/Guardian 3, and I hated it so much that after 3 months I went back to my old Paradigm pump/Dexcom 6 combo. Now it’s been 4 yrs, so the 670 sitting in its box unused for most of that time is eligible for an upgrade and I’m torn between Medtronic and Tandem. I think part of my problem is just that I’m still feeling pretty burned on the whole closed-loop thing. Everything I hear about the latest Medt algorithm is really positive compared to the old 670 version, but the Guardian CGM is such a negative for me. OTOH, there are good things about the Tandem, but the reservoir and inset system seems so kludgy compared to the simple and robust Medt, and I actually like the new Mio design I recently started getting from my distributor without asking. At this point procrastination may win out for the time being. My sturdy old Paradigm is still working same as ever. Kinda like R2D2 in the later Star Wars movies. Looks dated but takes a lickin and keeps on tickin as they say.
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Based on that experience, I don’t see how you could be torn between the two. I’ve never used medtronic 670, but based on all accounts they were selling a half baked solution. I’d feel cheated.
But I guess there’s always hope Medtronic will eventually get the CGM and algorithm right.
Thankfully there is choice now that pushes all companies to improve their solutions.
I used the paradigm pumps and it was pretty bullet proof from a pump standpoint.
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My old paradigm still works. Sitting in a drawer.
The pump itself was awesome. It never gave me trouble beyond scratching up the display making it hard to read.
If they had integrated the dexcom into their system as an option, I would still be using a Medtronic pump today.
They are coming up with a no calibration version soon , so maybe it will be good enough at that point.
I have 3 years to wait on my current pump to see what’s out there. I have no brand loyalty, I just want the best available.
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The thing is, these systems are marketed as making things easier for us, but the flip side is that they also alleviate a lot of the responsibility for the medicos. There’s always been this aspect of T1 that goes against the medical grain, in that they have to cede control of dosing with this powerful, potentially dangerous medication to the patient. There’s nothing else like that in their world. So a black-box that does everything—“set it and forget it!”—is a big relief for them as well as (in theory) for us. But that’s not how I experienced it, after decades of dealing with insulin and my own body’s reaction to it. It wasn’t so much about doing everything for me as it was about locking me and my grubby little paws out of the control room so I couldn’t hurt myself, poor benighted idiot that I must be. I think for a lot of medicos that’s a feature, not a bug.
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Here’s a good review on Medtronics 780 and Guardian 4, which appears to be available in Europe sooner than US.
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I was a MiniMed/Medtronic user since 1990. Back then there wasn’t a lot of choices & we went with the one my team knew the best. Used it through all my pregnancies (the main reason I went on a pump). The pumps were reliable, the customer service was great (but never really needed it) and for the first time in my life I had some flexibility. I didn’t have to wake up at a certain time due to injection timing. I actually felt what hunger was because before I eat to insulin timing. My diabetes wasn’t running my life every waking moment.
But over the 20+ years using their pumps, I had 3 different ones and each one was pretty much like the last one. And when the sensors came into the picture, I was thrilled and then disgusted. Thrilled at the thought of knowing what was blood sugar was and than disgusted when I realized they didn’t work. But I stuck with them because they worked. I mean 3 pumps in over 20 years, means they work no work well.
But I finally made the change to the Tandem. My doctor was very comfortable with Medtronic but had heard good things about Tandem based in our county. So we made the switch. The service, training and follow up was great. It was a t:slim. No big bells no whistles like my current one but it was nice to see a pump company making some major upgrades. I did hate the cartridge change. As most Medtronic users say. But now years later, it is my new normal.
I was part of their trial to do upgrades over the computer. My t:slim got an upgrade to handle bolus corrections that automatically did the increase or decrease based on current level. (Missed that from my Medtronic pump). So I was all in when basal IQ came out and did the new pump with them. My numbers started to come in line with not a lot of work on my part.
Now with control IQ, I work less than I ever have. I made sure I had good numbers going into the upgrade. My basal rates, carb ratios and correction numbers were nailed before I got the upgrade. When I finally got my approval for the upgrade, I went for it no haven’t looked back. I want easy. I want less work. I want to think less about my diabetes. I got all that with this new upgrade! I run the pump just like the company stated in their training. It works very well for me. I wake up every morning with a great number. I sleep through most every night with no alarms. I don’t worry about taking a correction bolus before bed, knowing the pump will take care of any problems.
I am thrilled this pump company is thinking about upgrades all the time. They listen to their clients to see what changes they may need to make.
My medical team loves the pump. I can give them anything they want from pump history. It comes in very handy when doing clinical trials. They can pull info whenever they need it as I have given the approval. You don’t have to.
I guess you really have to decide what you like and what you don’t like about your current setup and if the Tandem setup will help with those biggest issues. Not every system will be everything for any one person. But there are some deal breakers for some people. Some people hate having to push multiple buttons, or hate alarms or hate long site changes or hate certain infusion sets, or length of tubing or battery/chargeable. So many things to think about but only you know what might be a deal breaker for you. There are many sites that do comparisons between pumps. Check them out and see what might work for you. Maybe a Omnipod might be a better fit? Good luck and the cool thing is there is no rush. You have time to work through all of this.
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This more than anything would be a huge (and very welcome) shift from the Medtronic 670G!
That’s funny and sadly true. I have a young face and am a pretty quiet individual so that definitely works against me and my grubby little paws in times like these. Thanks for the laugh. 
This is very helpful! Thank you!