My Tandem t-slim x2 will be out of warranty soon, so I’ve started looking into what options are available for my next pump. I’m primarily looking at Tandem (another t-slim x2 or mobi) and Medtronic (780G).
I was a Medtronic user for many years prior to switching to tandem. I am not a fan of the Medtronic sensors though I’ve heard that the guardian4, which is integrated with the 780g, is more reliable in terms of sensor failures and accuracy than previous generations of guardian sensor (is that true?)
I have also been told that Medtronic’s newest sensor (Simplera?) is much more similar to the Dexcom. Does anyone know if the 780g will be updatable via software upgrade (similar to tandem) to use the simplera once it’s integrated, or will I need to get a new pump in order to use the simplera?
I was told by a diabetes educator recently that she thinks the newer sensors are improving. They are, of course, not the same quality as competitors, but they are better than they used to be. That’s the word on the street, anyway.
Was your previous Medtronic pump one of their AID pumps, i.e., 680G or later?
Having switched from Medtronic to Tandem X2 CIQ, the biggest difference I found was that Tandem has a totally different design philosophy toward AID that creates a very different user experience. I found the MT automode very off-putting because when it works it’s great but it locks you out of all the parameters you need to tweak when it doesn’t.* You need to be a good fit for it, not the other way around. Whereas in Tandem all the fields are editable so it acts more as a smart assistant than a micromanaging boss. If you aren’t prepared for it, that aspect could be a bit of a culture shock.
*The one big exception, ironically, is that the 780G allows you a range of options for the BG Target setting, whereas Tandem is fixed at 110. But I’ve found that much less of a limitation in practical use than I thought it would be because of the flexibility in other settings.
The 780G user guide has instructions for doing software updates so it is possible. The simplera CGM works with the 780G in the EU so it should be easy. Or we just jinxed it and Medtronic will announce a trade in program tomorrow.
The data that has been published says the Guardian 4 is a little better than the 3 for most people. When someone says the Simplera is like a Dexcom they mean the form factor, not the sensor performance. The fact that you don’t have to train a monkey to help you apply it means it’ll be better than the Guardian 4 even though the published data so far puts its performance between the Guardian 3 and 4. Which is good enough.
I haven’t used a 780G. @Ruth4 has shared her good and bad experiences with it.
Thanks for that comparison. Yes, I did have an AID Medtronic pump (680G, if that was the first one). Despite that, I have little experience with automode because I couldn’t get the sensors to work and I ended up using the pump in manual mode. Ultimately the sensor is what prompted me to switch to tandem/dexcom.
Now I have a question about the Mobi. I understand that it is controlled completely via an app on a phone, but that there is a button on the pump which can be used to give boluses. Can anything else be done without a phone, such as reloading the insulin cartridge? If, in the unlikely scenario that I drop my phone and break it, will I be more or less just out of luck until I get a new phone?
Since I’m an Android person, I don’t actually interact with the iPhone much and I’m away from it often, but you do NEED it for some things.
Basically, if your phone gets lost/broken/stolen, you’re fine until you need to change the cartridge or start a new sensor. At that point, you either need to replace your phone or load the app on someone else’s phone and pair your pump to it. You’ll need the pairing code that’s inside the pump, hiding behind the cartridge. Since you’re not supposed to remove that cartridge other than when the pump tells you to, it’s smart to have the pairing code written down somewhere safe.
I love my Mobi, except for a few issues with the app that’ll hopefully be fixed soon (features you could see on T:slim, but not on Mobi without connecting to Internet and rooting through reports on the Source website), but you’ve definitely got to be the type of person who would otherwise be lost without their phone, and rush to replace it pump or not. I also think a watch that displays BG info is pretty critical. That’s the primary reason I was looking at my pump screen frequently before, and I’d be pretty twitchy if I couldn’t see my BG.
Edit: I just noticed that the screenshot above doesn’t mention silencing alarms. You can’t completely clear an alert without the phone, but you can snooze it for 30 minutes by hitting the button THREE times (not just once, that’s how you check pump status). Most alerts clear themselves, though, when things things get better, like BG, battery, or Control-IQ alerts. If you get something like a low insulin or a transmitter expiring alert , though… That’s gonna go off every 30 minutes until you can pair your pump to another iPhone.
Spdif…now that I got some great tips from my trainer, it’s only taking me about 3 minutes for the actual insertion. I’ll be happier, though, when we can get the Simplera. I’m using my abdomen for the G4 insertion, but I would prefer to use the back of my arms. Soon, I hope!
Thanks so much for this. I will need to think about this. I do usually have my phone with me, but I have been known to leave the house without it, or just leave it in another room in the house for a few hours. It makes me nervous to not be able to reload the insulin cartridge or change a sensor without a phone. I do like other features of the mobi though, so… hmm.
Abdomen tends not to work for me with sensors, regardless of brand. Are you still not able to insert the guardian 4 on your arm? Is it usable in any other location?
I just received an email today that there’s an update available for the 780g to enable integration with the Simplera and a few small improvements. The catch is that the update can only be installed via the Minimed Mobile app and the list of supported devices is severely limited
Briana…my trainer taught me how to use the sensor on my abdomen (sideways and in an area that doesn’t scrunch up when you bend) or lengthwise on the thigh slightly to the inner side and not on the quad muscle.
Also, to give yourself a manual correction, just get out of auto mode, give the correction using bolus wizard and then, once the correction bolus has finished, go back into auto mode.
Because I find the Medtronic so easy to use, especially when it comes to changing reservoirs, I didn’t even want to try the Tandem system. So far I’m quite happy with the 780G/G4 system, and I’ll be even happier, I think, once the Simplera is approved for use with the 780G.
Interesting. Do you find wearing the sensor on your thigh comfortable?
It’s unfortunate that the simplera integration did not get approved last year. I think that all of the shake ups happening on the federal level are likely to further delay that approval…
Oh please don’t say that! I was so hoping the Simplera would pass muster by June or July at the latest. But, sadly, I think you may be right about its being delayed.
I haven’t tried wearing it on my thigh yet. Maybe the next insertion? I’ll let you know if and when I try it. I have fat thighs, and I’m kind of afraid of its rubbing. Stomach works well, though, and since the sensor is so much small than the canulas, and nothing is passing through the sensor, you don’t have to worry about site rotation with the CGM.
According to ny Medtronic trainer, whi is extremely knowledgeable, the sensors aren’t likely to cause scar tissue for two reasons: a) they are so small and b) there’s no fluid going through them into your body. I still try to rotate somewhat, but I’m not as particular with the sensors as I am with the infusion sets.
On an upbeat note, my A1c last week was 6.3 with no lows below high 60s! A few highs, but getting much closer to a straight line for much of each day. So glad I finally did this.
