Does anyone have experience with minimed 670g pump?


#1

I’m thinking about switching to a minimed 670g pump (currently have a tandem x2) because it has the self-adjusting basal rate. Can you offer any insight into the 670g and whether you like it?


#2

Have you tried a TuDiabetes search for “670G”? There has been a great deal written about this pump system on this site. Just click on the magnifying glass icon on the upper right corner of your screen and type in “670G”.


#3

I got one three weeks ago (and using it with the sensor) - upgraded from a “dumb” Medtronic (and used to have a Tandem): My thoughts…

Adapting to the pump:

  • acknowledgement for every message entails scrolling down (1 or more clicks) and an OK acceptance which can become tedious.
  • make sure you time your sensor change for noon-early afternoon (2 hrs startup and then 6 hrs later, mandatory calibration entry) - this will avoid the 2am “calibration required” alarm. I set up a calendar alert for this.
  • make sure you calibrate before going to bed or you will get notifications relating to calibration in the middle of the night (typically I do this between 8pm and 10pm)
  • Carelink (for uploading pump data and generating reports) is not compatible with Firefox or Chrome on Mac - or Edge on Windows 10. Minor annoyance but I understand the technical reasons behind it.

Resolved issues

Positives:

  • CGM is a huge improvement over previous editions. I had used one back in 2010 or so and was not impressed so discontinued using it. The inserter was reminiscent of a medieval torture device :slight_smile:
  • CGM insertion is relatively painless and now much, much better than Dexcom G4/5
  • I have yet to get any “out of range” CGM transmitter to pump error messages (used to get these often with the original CGM and from time to time with Dexcom)
  • CGM accuracy is very good - over a one week period I compared it to my Dexcom G5 and both tracked accurately with finger stick tests, sometimes +/- 5 points or less
  • I like the ability to scroll through the CGM data points on the screen
  • Pump Auto mode is getting used to me and my use and I am very impressed with its ability to tame the high BG levels I’d seen before this pump (insulin is Humalog U200)
  • no hypoglycaemic events!
  • I really like the Audio Silence option being on a timer - will come in handy for meetings and afternoon snoozes
  • Status screen with battery, reservoir, sensor calibration, active insulin and current operation mode is excellent
  • I do like that the pump now can tell you how many units of insulin remain in the reservoir
  • I love the belt clip and use it a lot; the low profile makes it a winner

Overall - love it. With the Auto mode enabled, my blood glucose is in range 91% of the time. I would be hard pressed to do that on a manual pump/Dexcom.

I did consider the Tandem latest edition since I loved my Dexcom but my previous experience with those darned reservoirs Tandem uses gave me second thoughts. If you like their reservoir system, that not be such a big issue for you.


#4

What is the very specific WORST part of those reservoirs? I watched a video, and as a MM user, I thought the process was terrible (for the Tandem), but what specifically is the worst of it? Residual air? Lining up that huge needle with the port? Length of time for the whole process? From my perspective, the MM pump I have is dead-easy and fast to fill. My concern for switching to an X2 in the future is what you mentioned, plus possible too-fast bolus speed. I’m still trying to find that spec somewhere.


#5

@Cat99 - I assume you are aware of the Tandem updates scheduled to be released?


#6

got more info, Tim?


#7

Bear in mind I had my T:slim pump over 5 years back. However loading and priming was a crap shoot - many times I’d load the reservoir and have issues injecting the insulin. Many times it would produce errors and make me use a new reservoir (expensive). It would also often tell me the reservoir was approaching empty when I knew I still had 50+ units remaining.

The whole engineering of the Tandem reservoir gave me pause. I opened several up to find effectively a bag inside. The time to load the thing was long but I know they fixed that with some software upgrades.

The nice thing about the Medtronic reservoirs is I’ve never had a bad one. It loads reliably every time. I can tell when it’s empty by looking at it and the 670G now tells you how many units are left.

Bolus speed on the 670G can be adjusted - quick/normal. I keep mine on normal although I have yet to try the quick option. (options, delivery settings, bolus speed).

The nice thing about the Tandem pumps in general - their firmware is upgradable so they can roll out new features - something the Medtronic pumps won’t do.


#8

We have zero issues with cartridge changes on the Tandem t:slim X2.

Like anything else it was an adjustment from the Animas Ping (our previous pump) as the procedure is different. I did not find the learning curve to be excessive or unusual for any new task.

It is nice there are choices so if this is a major issue for somebody they have a few pump options available.


#9

Dave - This is listed in the Tandem t:slim X2 User Guide under specifications:

No idea how this compares to the pump you are using now.

Rate of Delivery
25 Unit Bolus Delivery Speed 2.97 Units/min Typical
2.5 Unit Bolus Delivery Speed 1.43 Units/min Typical
20 Unit Prime 9.88 Units/min Typical

Bolus Duration
25 Unit Bolus Duration 8 minutes 26 seconds Typical
2.5 Unit Bolus Duration 1 minute 45 seconds Typical


#10

I have used the 670G since October 2017. I want to say I love it. Here are a few observations.

Most of what you know about a pump is only somewhat useful. Bolusing is very different and takes getting used to. Not the process but the rate of bringing down a high bolus.

Many of your settings, Sensitivity, and carb ratios will not translate well to the 670G. It takes getting used too and being willing to approach things differently.

The first two to three weeks are a little rough, but when you hit the sweet spot. Oh man it is magic.

Note: I am a Medtronic ambassador. My opinions are my own. They did not pay me to say nice things about Medtronic devices or the company. OK, they sent me a shirt and a cup but even I am more expensive than that.


#11

thanks Tim. don’t know why I couldn’t find that in the PDF of the user manual, which is where I was referred by a sales brochure. those speeds don’t sound excessive.


#12

don’t you think that ISF and I:C ratios SHOULD translate correctly? Isn’t there fundamental issues with the 670 programming, which is why so many people hate/complain/despise auto mode?


#13

I believe Medtronic has realized this is a significant issue. From my reading, one of the main objectives of the 690G will be to address mealtime BG. Clearly there is plenty of potential for improvement.


#14

If you don’t mind me weighing in, I think the answer is yeah but no. In any artificial insulin delivery system you’re using these parameters empirically–test, change, test, and see what happens–in light of how the thing interacts with your particular physiology. You’re not trying to determine the scientifically absolute answer to how long insulin lasts in your body for its own sake; you’re just trying to get the thing to work better. Auto mode is enough different in how it functions that it can be confusing that the same terms are being used, but whereas AIT in a standard pump is just helping out with a bolus wizard calculation, it’s doing something very different when it’s controlling a continuous, dynamically adjusting stream of “microboluses,” which in turn is very different from what most of us think of when we refer to “basal” insulin. I actually think there’s more of this empirical, notional aspect built into those figures with a standard pump than most of us realize; these are all approximations of what a real pancreas does. It took me a while to get past the nomenclature hurdles but I eventually came to think of them more as “dials I can turn” and it began to make sense to me that the manual settings I had didn’t translate over in exactly 1-to-1 fashion. Something similar happens when you try to translate from MDI to a pump, if you’ve been through that–your Lantus dose is never the same as the cumulative basal dose you program into your pump.

My only real complaint was that there weren’t enough dials I could turn, and the ranges of the ones I could turn were too restricted.


#15

My feeling is that all these pump makers can tinker with hardware and software as much as they like, but the real limiting factor is the insulin itself, which is completely out of their hands, and not nearly keeping pace with these technological developments. We’re mostly still using the same stuff that came on the market twenty years ago. I’m about to try using Fiasp starting this week, but by all reports it’s a pretty modest improvement in terms of peaking and clearing compared to Novolog/Humalog.


#16

and I suspect FIASP isn’t going to solve the issue of having to fudge Bolus Wizard parameters in order to have good outcomes when using Auto Mode.


#17

One of the rumored (I have no direct knowledge) will be that an operator will tell the pump one of four things when they eat. Those will be Breakfast, Lunch, Dinner or Snack. The idea being to supposed idea will be to eliminate carb counting.

Which sounds like a good idea. Will it work? Well if it is announced we will see.

Note: I am a Medtronic ambassador. My opinions are my own. They did not pay me to say nice things about Medtronic devices or the company. OK, they sent me a shirt and a cup but even I am more expensive than that.


#18

Okay, this is me, and I know that a lot of people have little trouble with Auto mode and with the sensors, but I wanted to put my two cents in.

I love my Minimed 670G pump, but I’m not as happy with the CGM part of the system. I am going through perimenopause, so my hormone fluxuations mean that I don’t have a “normal” for auto mode to base it’s bahavior on. That being said, I can use my 5 programmable basal patterns and temp-basals, and I’m in range 75-85% of the time … not bad for a former Humulin R & N user.

The CGM is my other problem. I know that there are a lot of people for whom it works well, but my body’s chemistry messes it up. My first 4-5 days are great, but after that, the sensor gets worse and worse at detecting glucose. The nice smooth CGM tracings start to look like they were drawn by someone with a serious hand-tremor, and then on the 5th-7th day the CGM tells me that it is “not working properly” and that I should “change sensor.” This has happened with about 3/4 of my sensors. They even replaced the transmitter, hoping that it was the problem … nope!

I wish that I could tell you that this would or wouldn’t happen to you, but you won’t know until you try it. And in case anyone is wondering, I had a Dexcom G5 before this, and my chemistry didn’t mess it up. And no, it isn’t insertion location or my calibration habits, either. It really is just me. Egocentric as it sounds, I’m just dangerous! LOL

As I said before, I do LOVE my Minimed 670G pump, even with the CGM and auto mode issues, so I think it was worth it. :grinning:


#19

I’ve been on the 670 for 3 months. Prior to that I had a 722 for 8 years and a 715 for 6 years.

I miss my 722. I find the 670 to be very, very frustrating. However, it does have some benefits, it has dramatically reduced my lows. However, that’s where the positives end for me.

First, the designers of the 670 love button clicks. For reloading the pump, they tripled the number of clicks required. Warnings/Notices - you have to scroll to select OK. That’s fine for the first week, but then becomes bothersome.

The Guardian 3 sensors can be accurate at times, but most mornings when I wake up, my BG is 30-60 points higher than what the sensor is showing. This morning was the first time in 3 months that my BG has been slightly lower than what the sensor is reading.

The most irritating thing that I’ve experienced is the constant BG required demands. After waking up this morning and calibrating the sensor, within the next 30 minutes it demanded 4 more BGs. The most frustrating is when this happens within 30 seconds of entering a new BG. Yesterday, I had over a dozen BG required in less than 2 hours. Earlier this week, I had 17 in 4 hours. The worst was 11 in one hour in the middle of the night. I’m testing my BG more now that I was before the 670…and as I type, I get another BG required. It’s only been 20 minutes since the last one.

There have been some good weeks in the 3 months that I’ve had the 670, but the good weeks only equal the weeks where the thing frustrates me to no end.


#20

When you are having these repeated requests for a blood glucose, I suggest turning the sensor off for at least one hour. It sounds like the sensor is at its end of no longer working correctly. I turn mine off for about one hour, let it chill and if it does it again I either call Medtronic or replace the sensor. Doing repeated calibrations both confuses the pump and is frustrating.

Note: I am a Medtronic ambassador. My opinions are my own. They did not pay me to say nice things about Medtronic devices or the company. OK, they sent me a shirt and a cup but even I am more expensive than that.