Insulin pump/CGM systems: Medtronic 770G/780G VS Tandem Control-IQ VS Omnipod 5

Looking for info and opinions about insulin pump/CGM systems: Medtronic 770G/780G VS Tandem Control-IQ VS Omnipod 5

Hello, I am wondering if anyone here can tell me their experiences and possibly give me advice on the different systems with automated insulin delivery, specifically the Medtronic 770G, Tandem Control-IQ, and Omnipod 5. If anyone here has been in a clinical trial for the Omnipod 5 or Medtronic 780G, or live in countries where they are already approved, I would especially appreciate hearing about your experiences.

I am currently using the Omnipod Dash (which I hate because of the loud alarms and irritating sites); before that I tried the tandem t:slim 2017-18. And before that I used a Medtronic pump for 15 years. I switched to Tandem because the Medtronic Enlite CGM was so awful, and hoped that the tandem and then the Omnipod would create a better closed loop/automated system more quickly, but it was a long time coming and I have been thinking of switching back to Medtronic as they are finally coming out with a CGM that will not require constant calibration later this year (the 780G). But with the new tandem and Omnipod systems I am not sure which to choose. Any feedback is appreciated :blush:

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Well if you hate the current offering from Omnipod because of the alarms and sites then you won’t likely be any happier with the Omnipod 5. Were you ever on the Tandem T-slim with Control IQ? I’ve been on it for over a year and am overall pleased with the system. My A1C is about the same or slightly lower (6.3 ish) but my burden is much less with generally more time in range.

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I’m on tandem xc with control IQ. I’ve been pleased with the functionality. I also used medtronic for many years, but switched to tandemn because of dexcom integration. I heard nothing but horror stories about medtronic cgm and their automated pumps and wanted no part of that.

Glad i moved to tandemn and nothing else out there that really interests me.

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I went from Medtronic to tandem. The pump itself is pretty much similar. Somethings irritate me about each one.
Both are good. I haven’t had the Medtronic new sensors but the old ones were crap.
The ciq is good but it’s not magic. You still need to manage it.
I really can’t wait for the tandem mobi to come out. It seems like it will fix some of the issues I have with tandem cartridges.

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Check out this video review:

Mike

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I can only compare the tandem X2 with control IQ to MDI which I previously had (30+ yrs). I got Dexcom about a year and a half ago, followed by the pump about six months ago.
The Dexcom was a bigger difference maker for me than the pump.
The pump is not magic except that I very rarely awaken to alarms and almost always am in range over night. I dose for expected carbs and will provide additional units if I’m trending high. I still need to snack occasionally. Especially if exercising.

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You won’t get a lot of feedback on the Medtronic 770/780G. There just aren’t a lot of people using them. There was enough disfavor with the 670G, that as the warranties expire, most people are choosing to move to Tandem instead. In fact, the future of Medtronic’s diabetes division is hanging in the balance because it’s bleeding money. They have not announced a divestment, but at their last investor’s call there was talk about re-evaluating their portfolio of under-performing product lines, with specific mention of the diabetes division, and it was clearly stated that they need to ask the question “are we the right owners of these assets?”. So they are most definitely considering getting out of the pump game.

The is a Facebook group devoted entirely to the 780G. You should consider joining that to get the best first person perspectives. It was released in the European market first (because Control-IQ wasn’t there yet!), and this site is mostly Americans. The general consensus I saw was that it was a big improvement over the 670G, but does that bring it up to par with the other systems?

I’ve been very happy with Tandem and Control-IQ. I won’t say it’s perfect, but it’s been really excellent and has enabled the absolute best management of my life. It’s still in it’s first generation, with at least 2 updates in the near future, so it’ll be getting even better. It is still the only system allowing a low, narrow target range (sleep mode, 112.5-120).

I’ve been enough of a Tandem fan that I’m also excitedly awaiting Tandem’s next pump system, the Mobi. It’s half the size of the current T:slim, mostly because it has no screen. It’ll be primary controlled via your cell phone, though it will continue to work 100% when you are not near your phone. There will eventually be a plethora of wear options, including what is essentially a cannula docking station that will turn it into a patch pump just like Omnipod.

They’ve been sitting on that one for a long time, though. It’s not anticipated until next year now. Which has me really looking closely at Omnipod 5. I think it could be a contender. The haven’t released their pivotal study yet, though, which is where we’ll learn so the inside details about it and patient performance on it. Until then, it’s all speculation.

Omnipod 5 appears to more like Medtronic’s Automode, with frequent micro-boluses and little settings control, unlike Control-IQ which is entirely dependent on your own settings. Omnipod did seem to have addressed some of the biggest complaints about Medtronic’s system, though. It looks like you can bolus whatever you want whenever you want, whereas Medtronic doesn’t allow that and if you want to give a manual correction you have enter imaginary carbs you didn’t eat, because that’s the only way to get a bolus. And as someone who’s personal insulin needs are volatile and always changing, I think I might be happy to give some control over to the Omnipod 5 algorithm, rather than constantly adjusting my settings. Assuming the algorithm works!

From what I’ve gathered, Omnipod 5’s algorithm is entirely dependent on your TDD and Dexcom predictions. The only time your other settings matter is with your very first pod, or when the algorithm isn’t active. I think the video linked in the previous post seriously overstates the learning ability, though, when the only thing it brings forward from the previous session is the TDD. So, if your insulin needs are trending higher or lower, the next pod will know to be more or less aggressive. Maybe that’s a really big thing, maybe it isn’t?

@Terry4 recently shared a video with several Omnipod 5 trial participants, and a nurse who was active with the study and knows a lot of the inside details. The nurse and trial participants were all involved with the juvenile study, and children tend to be much more difficult to manage, while the people posing the questions are all DIY loopers, who tend to be very critical of the commercial systems because they don’t allow low enough glucose targets. There’s a disparity between what the questioners are looking for vs. what the juvenile participants, their parents, and their medical people want… so you’ve got to kind of read down the middle to find the truth of things. One of the positives I took away from the video was that even though the lowest possible BG target is 110, people were able to consistently sit at lower levels.

My biggest concern right now about Omnipod 5 is I don’t know how much I trust 60 minute predictions. Dexcom just isn’t that good with 30 minute predictions, especially when it changes directions quickly, how good can 60 minute predictions be? I’ll be curious to see if Omnipod 5 is casting some magic on those predictions.

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The 770g sensor is very accurate. i would expect the 780 will be more so. Most of the negative comments relate to the Enlite sensor, which is no longer being used. As you are aware the current Guardian Sensors require 2-4 calibrations per day. I usually do on average 5 per day, but as you know the 780 is slated ti be pre calibrated, and like dexcom will require minimal calibration.

I have not used the Tandem or Omnipod.

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Wow, thanks for the thoughtful response!

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I am currently on Eros Pods but am becoming more interested in the Mobi as I read about users’ satisfaction with Tandem products.

Two months ago I replaced my 670g with a 770g. The 770 is slightly friendlier to use than the 670, but provides a lot more informative reports. However, the reason I decided on the 770 is that I will get a free upgrade to the 780g when it becomes available. In my opinion, the advantage provided by the 780 is that it will automatically provide mini correction boluses when it senses your BGs are rising, which is what I consider a significant advantage over my previous pumps.

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I have only ever used Medtronic pumps/CGM. My first pump was before there were any CGMs available but I did use Medtronic’s first generation sensors and they worked well for me. When they eventually went to the Enlite sensors I had to give up because not a single one worked for me. I tried for months and literally every sensor sucked. In 2018 the old pump I was using died and I let Medtronic talk me into the 670g and Guardian sensors. They definitely are a big improvement over Enlite. They worked great for me with the 670 and now 770. I do run in manual mode, though, as the Auto Mode algorithm keeps me too high. Since I run in manual mode I get very few alarms or requests for a BG to be entered.

I don’t mind calibrating the sensors twice a day (sometimes 3 times) but I do get annoyed when I forget it’s due and the readings just stop. The sensors last a full 7 days for me and I can extend them but don’t usually bother. The readings can be off during the first few hours on the first day but I’ve read the same about Dexcom and Libre. Usually my sensor reading and my meter are very close when I calibrate.

My warranty is up later this year, either September or October. I’m not feeling hopeful that the FDA will approve the 780g here by then. I really hope so because I do want to try it but I’m not sure if I want to wait for it when my warranty is up. I am reading a lot about Tandem/Dexcom and if I leave Medtronic that’s what I’d go for. OmniPod doesn’t appeal to me at all.

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I switched from Enlite and early Guardian sensors to Dexcom G6. The Guardian sensors weren’t much better than the Enlites, at least that was my experience. I like and still use my Medtronics 670G. All of the current auto systems set too high a BG target and are too timid with corrections for me. Anyway, my basal is only 3 IU/day which I believe is too low for meaningful automated control. I really like and continue using my 670G pump.

The ideal solution would be to get a demo pump or short-term rental and give the system you are most interested in a trial run.

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I have been on the 630g for over 4 years now, and I chose that (when my Animas was terminated) over tslim because the screen was so hard to see outdoors. But I still used my Dexcom. Now my warranty is up and I can again choose to get the 770g or the x2 with CIQ. Understanding that the x2 will in the future be controlled via my cell phone, it still comes down to the fact that there has been no advancement in screen visibility for the visually impaired, which is critical should your phone not be working. And I do a lot of hiking and camping, so I need that backup. Tandem knew for the past 4-6 years that screen visibility was an issue, but the human design team seems to be composed of younger people who never had PDR.
Otoh, this is not a problem with the MM pumps, they are easy to see. So I will continue with the MM 770g and Dexcom for a while. My internal algorithm seems to work just as well, By the time I have to make a choice again I would expect design and software would have advanced to meet my expectations.
It is encouraging to me to hear that there are some people who like their MM pumps.
Mike

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The new Tandem will be smaller and 100 percent controlled via phone. I don’t know how the ap looks or if you will be able to see it, but your phone screen I’ll likely bigger than both pumps together.

I wish they would release it already.

I used to go to the events at ADA and JDA mostly so I can see and hold new tech in my hand and get a good explanation of it.

I really hope they start those up again soon.

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Me too. I am not comfortable without a backup pump controller. Same with the CGM. My understanding is Omnipod 5 will have a standalone PDM with optional phone control.

This holds true for Tandem’s Mobi, too. It’s just not as marketable to talk like that, but it’s been addressed in investor meetings. There will be an optional PDM, though it’s mostly intended for those without phone compatibility. It’s just irresponsible from a business perspective to NOT have an alternative controller device available, as it would otherwise limit your perspective buyers.

Pump control from one’s personal cell phone has been the most-requested feature for quite some time now, hence why this particular aspect is being shouted from the rooftops. It’s not the only option, though.

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I have no doubt most users will enjoy that…until their phone is lost, broken or runs out of battery. Or until they see the price tag on new phones when it’s time to upgrade. It’s a great feature but I think the FDA should require all device manufacturers to offer a backup.

Eversense CGM comes to mind, I don’t think there is any way to use it without a phone.

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I agree - I actually like the fact that I am tethered to my pump control on the Tandem pump. A separate PDM is not as good but being reliant on my phone - which I don’t want near my bed when I sleep - is almost unacceptable.

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Anyone can get a cheap android phone and use as a receiver, without having phone service, using xDrip, on reserve as a backup.

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