Medtronic 630G

Is anyone using this pump who was using a Paradigm pump before it? I’ve decided to go back to the pump after my MDI/Levemir/Tresiba trial and couldn’t be happier so far (until my sites start to fail that is). I qualify in March for a new pump through the provincial government and I’m evaluating my options which aren’t plentiful in Canada. I’m currently using a loaner Veo until then. I like the fact that the 630G is waterproof, but that’s about the only advantage I can see. It looks like more button pushes to do the same things as on my Veo. I’m wondering if I should just go with a Veo if they will sell it to me. I’m not a swimmer and water sports/beach days are so rare I probably would just use Levemir when they happen. I know the Omnipod is an option but I have one currently (which is why I’m using a loaner Veo) and decided after using it for a few years that a tubed pump is a better fit for me.

@Scott_Eric
If you are in no rush and think the Tandem might be a good fit for you, the expectation is that Tandem will have approval to be marketing and distributing their Tandem t:slim X2 pump in Canada at some point during 2018.

But until it happens, it is still only an expectation.

In terms of Tandem and waterproof, I consider the Tandem to be as waterproof as any other pump. Tandem has a water resistant testing/certification for 3 feet for 30 minutes (IPX7). However on the phone with Tandem customer support, they specifically and directly told me they would replace the pump under warranty for any water related damage. That is good enough for me. I have no plans to get crazy with the pump and go deep water scuba diving or anything like that. Casual water and boating activities are what we are thinking of.

Hey Tim,
I would wait if I thought it was worth it but the thing I don’t like about Tandem is how long it takes to refill/prime. I’ve seen videos of it and it looks like it takes forever. Has this improved? I know this might sound petty, but I can refill/prime my Medtronic pump really fast and this is a huge deal breaker for me.

@Scott_Eric
Everybody has their own set of requirements. Certainly if you know what you want it helps you make the best choice for you.

When we first switched from the Animas Ping to the Tandem t:slim X2, the cartridge change seemed a bigger deal. Once we got used to it, it now seems to be a non-issue. I am not sure how long it takes. I take my time with it.

We are currently on our last supply box which uses the luer lock connector. Our next box of cartridges/infusion sets uses the new t:lock connector. Tandem states that the t:lock connectors will use 4.4 units LESS of insulin during the fill/prime process and decrease the time required for such by 30 seconds.

I was in the 670G priority program, which involved using a 630G for a few weeks.

Well, another is the “Suspend on low” feature for preventing lows, which a lot of people love, but it requires using the Medtronic Enlite CGM system, which is not as accurate as either Medtronic’s own Guardian 3 or the Dexcom G5. The latter are about equally accurate in my experience, having used both, but Guardian 3 only works with the 670G.

I count 9 clicks from waking the screen to Suspend (well, you can scroll some of that, but it’s slower). Which is, yeah, kind of a pain. But what really makes it art is that all that clicking gets you to a suspend-yes/no screen, and the $!!!#)&&#@ default is NO. I mean, come on–the fact that there even has to be that last little bit of safety theater is bad enough, but I’ve basically confirmed I want to do this multiple times just to arrive at this screen, and you can’t have it default to YES?

Same logic applies throughout the user interface. Bolusing has its own way of being extra annoying, because after you enter your data and hit proceed, it gives you a beep that you are going to instinctively recognize as saying “Doing it” but actually just means “Going on to the next screen, where you still have say ‘YES YES YES DO IT ALREADY!!!’” That last screen is where it gives you the option to do a Dual or Square bolus, so there’s at least some sense to it, but then don’t freaking BEEP just because I’ve arrived at that choice. I’ve had this thing for going on 6 months and I still get caught out by it maybe 3 times out of ten. Where the real twist of the knife comes is that when it times out if you don’t click Deliver, it doesn’t just bump you back to the bolus settings you just entered; it makes you go through the whole thing again. And if that’s not enough, even more annoying–or at least ironic–is that once you’ve clicked into the bolus section, if you change your mind and back out, it beeps at you for doing that, too.

Ok, this is turning into a rant, but this is the kind of stuff that tends to not bug you so much at the beginning but gets more annoying the longer you live with it. Not to say I’d disrecommend these pumps, they’re pretty bulletproof-reliable, and the company isn’t likely to go belly up, which is an increasingly important consideration (I had an Asante Snap for a while, and being orphaned is no fun). But there are times when I wish I could be in a room with the UI developers and a baseball bat.

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Yeah, all of what you just said is the reason I don’t think I want it. I can bolus in my pocket without even looking at the Veo which is one of my favourite things about it. It actually has the suspend on low feature, but I use a Libre (and Dexcom before that) and I’m not interested in that feature anyway. I still have my trusty blue Paradigm 722 in a drawer and it worked last time I tried it, maybe I’ll just use that until it dies if/when I have to give the loaner back - it had even less confirmation screens than the Veo!

I’m on the 630. I was SUPPOSED to be in the pathways program and should have received the 670 last spring. However, my insurance changed and now I must wait until April. I used my “free upgrade” to 630 for the sole purpose of switching to the 670 which so far has not happened (but will hopefully). I was on a Paradigm- the 523 for four years.

630- It’s big, it’s bulky, and yes more button pushes to deliver a bolus or look at the menu. Sometimes I forget the extra button push for blousing (guess our brains get programmed after 4 years on one pump) which results in no bolus for a meal. Bad news.

I didn’t think it was waterproof. I was told it is water tight. Meaning on a scale of whether electronics are waterproof or not 0-9 the 630g is an 8. Does anyone else have better information? I’ve dropped it in water, and had it in the shower with me (while not directly under the spray-no problem)

Did I mention it’s big and bulky? And the clip is not as secure as my old paradigm which means at the gym or just whenever I move a lot it often comes unclipped.

To me there is no compelling reason to start on the 630g by itself UNLESS you can use that as a platform to spring to the 670g. Why Medtronic even released it at all is baffling to me. Tandem makes a slimmer model and it sounds like you are happy with your Veo. The threshold suspend has worked wonders for me (lowered my A1c 1/2 point in 3 months), but I’ve been using Enlites for almost 3 years and have had good success with them (Even on my old paradigm 523). So for me that’s been okay.

Best of luck.

Likely Medtronic did not expect the 670g to be approved so quickly.

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That’s what I heard as well.

MKSS, you make me not want to get upgraded (my 551 is still under warranty until Dec 2019), given all of those issues your 630 has. I don’t want bigger, I don’t want a flaky clip, I don’t want more button presses! All pumps should be 100% waterproof to about 10’ IMO. It’s crazy that in this day and age they can’t do better waterproofing of essential medical equipment that is worn 24/7. Every time I go to Vegas I decide if I should do pens for a week instead of pumping, due to the hassle of not having a waterproof pump at poolside. I’ve learned to NOT go off the pump, but to leave it in the hotel room when I go down to the pool, and carry a Humalog pen in case I might go up too high. Works out better than trying to normalize my bg’s using Lantus & Humalog pens for the entire week.

I’d like to know more about this UI or user interface process especially when designing an insulin pump. Why do some decisions appear so poor to those of us who live with these devices 24/7, yet must have seemed reasonable, at least acceptable, to the actual decision makers?

I suspect that the UI budget is not very large and the competing engineering and regulatory requirements are valued more highly than the user experience. I think often times the company will offload responsibility for a poor UI onto the FDA. I’m not as likely to believe this deflection since the FDA in recent years has been doing their best trying to expedite their role in the introduction of new D-tech to people with diabetes.

This situation wouldn’t be so bad if large D-tech companies were able to iterate more quickly. As consumers, we see a new phone version come out at least once per year. Big D-tech companies like Medtronic seem to be moving quickly if they can introduce a new model every four years. That compounds poor UI decisions as it adds insult to injury.

For me, stepping into the world of do it yourself automated insulin dosing systems is an exhilarating experience as technical improvements debut several times per year. It’s like an alternate universe.

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EDIT: The following info pertains to the MM 523 and earlier. NOT the 551 or later, as I had written.

Besides UI issues, the thing I run up against frequently, using my 551, is that when I select a temporary basal rate & duration, as soon as I hit ACTIVATE, the pump will give me a tiny bit of basal! I hate that when the whole idea is to slow my basal way down. that little bit isn’t earth shattering, but to me, it’s bad programming. Their excuse is that the pump needs to start calculating from “time zero”, how much and how often, to give the basal infusions. The upshot is that if you were to program a temp rate (above zero), change your mind and cancel that temp rate, then program another temp rate, you will get another initial basal infusion.

I hope I explained that correctly. Basically, when you want very little basal insulin for a while, you are forced to receive an immediate bit of basal, unless you disconnect the tubing at the set for a few seconds, until the insulin has been delivered. It’s hard to see it for low basal settings, but it’s there.

I agree, with the caveat that it may be the company doing things it thinks will mollify the FDA, particularly when introducing something new like the hybrid closed-loop, and that it’s not just the FDA they have to mollify; it’s also the medicos who have to like it or they won’t ok it for their patients. There’s no question that having to trust us to set our own doses of a dangerous drug 24/7/365 goes rather strongly against the grain for the medical profession–not for no reason, but there it is. So showing they’re bending over backward in the direction of safe safe SAFE is helpful there. A UI necessarily has a point of view built into it, and the more I use this one the more everything about it just screams “Look out–yer gonna hurt yourself with that stuff!!!”

From that p.o.v. the 670 represents a big step forward in their comfort level, in that it takes so much of the control out of the patient’s hands, and what control you do have is severely attenuated and girt round with protective spells and barriers. Probably the most conspicuous example is the fixed target of 120mg/dl. There are people who are getting 5.9 A1C’s within that restriction, but human variability means that for a lot of us–decidedly me–we need to be able to set that notional target lower in order to actually achieve it in reality. I’d almost certainly still be using auto if I’d been able to do that.

That was what finally decided me to switch out of auto one morning after about two months of struggling. I’d made a lot of progress but I still wasn’t back to where I was before I started auto, despite having to work at it a lot harder than I had with my manual pump. That morning my DP had ballooned back up for no apparent reason, reversing the progress I thought I’d been making in tweaking the thing, and I had to ask why am I having to work so hard for the mysterious Algorithm when I could do a much better job myself if I could just get my hands back on the controls?

The real kicker was that, having been at this for 34 years, I’ve been through 4 major regimen changes–R/NPH to basal-bolus MDI, MDI to a manual pump, and now a hybrid closed-loop pump–and each time the change has brought a greater sense of freedom, that I was better able to organize my treatment around my life and not the other way around… except for this last one. It really felt like a step backward in that respect. I felt like I was laboring to please my pump when it should be working to make me happier and less stressed about this disease. So I pulled the plug on it and went back to manual.

Better leave it there before going any further off topic. A lot of others have had a better experience with the thing. Look up Richard157 for a much more positive take. And of course YDMV as always

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Never noticed that before–I’ll have to look for it next time I set one.

I just tried it and can’t see it deliver a basal. Perhaps this model that I have had for 2 years doesn’t do what the last several models did, which was what I described in my previous post. I’m going to say now that the 551 doesn’t seem to have the same issue. I’m going to call MM and ask them…

MM verified that the 523 does indeed act in accordance with my description of temp rates. They also verified that the 551 does NOT act in the same fashion.

@Scott_Eric
I know Tandem is not (yet) available in Canada. As well, it sounds like the Tandem cartridge fill/prime may be a deal breaker for you, but I thought I would at least mention this feature on the Tandem t:slim X2 as it sounds like this is an important feature for you:

https://www.tandemdiabetes.com/docs/default-source/product-documents/t-slim-x2-insulin-pump/1000124_b_tslim_x2_user_guide_web.pdf?sfvrsn=ebb739d7_18

Description of the Tandem t:slim X2 “Quick Bolus” feature:

Setting up the Quick Bolus function enables you to deliver a bolus by simply pressing a button. It is a way to deliver a bolus by following beep/vibration commands without navigating through or viewing the pump screen.

The default for the Quick Bolus function is off. Quick Bolus can be set to either units of insulin or grams of carbohydrate. The increment options are 0.5, 1.0, 2.0, and 5.0 units; or 2, 5, 10 and 15 grams of carb.

[User Guide has directions for the initial configuration to enable this feature and select either carbs or units and choose the increment. One time configuration unless you later want to change this.]

Below is how the quick bolus is used (after the initial configuration).

  1. Press and hold Quick Bolus Button. The Quick Bolus screen will appear. Listen for 2 beeps (if Pump Volume is set to beep) or feel for vibrations (if Pump Volume is set to vibrate).

  2. Press Quick Bolus Button for each increment until desired amount is reached. The pump will beep/ vibrate for each button press.

  3. The pump will beep/vibrate once for each increment pressed to confirm desired amount.

  4. After the pump beeps/vibrates, press and hold Quick Bolus Button to deliver the bolus.

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Yes, this would be useful! In fact it’s better than the MiniMed easy bolus since I can’t easy bolus by carbs, only in insulin units. Honestly my bigger problem since going back to pumping is reliable sites though. I took a break because I was having so many site failures. I’m trying the steel sets but so far can’t get them to last more than a day without pain/spiking blood sugars. I’ve tried quicksets which almost always kink, and silhouettes which only work well in my abdomen which is full of scar tissue. There’s no easy solution to this thing…

@Scott_Eric
(Tandem again - sorry that is our current experience)

I had mentioned Tandem switching to the t:lock (away from the luer lock) as an advantage in terms of the cartridge fill/prime. (ie - uses 4.4 units of insulin LESS and is faster by 30 seconds - according to Tandem) However, this same change has the disadvantage of now only allowing infusion sets to be used with the Tandem which specifically have the t:lock. (ie - the cartridge must be able to properly connect to the infusion set). Some people have mentioned not being able to find a particular infusion set they want which has the t:lock.

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Keep in mind that steel sets are not supposed to last three days. The package insert for the Contact-Detach set says to change it out every 24-48 hours, and I imagine other steel sets say the same, since they’re all basically made by the same company. I see a lot of people posting about this “problem” with steel sets not lasting several days, but in my mind as long as these sets last 24 hours they’ve done what they were designed to do.

I live in Ontario and I’ve been on the Paradigm 522, then the Veo and the 630G since November. I didn’t have much choice with my new one as the Animas ones aren’t available and I’d have to pay too much out of pocket for the OmniPod. Besides, transitioning was easy since I’m so used to the Medtronic pumps.

It is bigger mostly because it takes an AA battery. When you look down at the pump everything is upside down. Clip is not as strong. I can’t hang it from the bottom of my nightie anymore. However, you can use the clip to open the battery compartment. Very cool.

With the older ones, I could easily look down and see the time. Now, you have to press a button to activate the screen.

The screen is amazing. Lots of different colours and easy to read. A big improvement.

I was excited about the waterproof aspect too. However, I’ve gotten conflicting advice from Medtronic staff and other pumpers. I was used to wearing my pump in an Aquapac waterproof case when I shower, because I like to take long showers. I hear, “Go for it! Wear it in the shower, that’s what it was designed for”. Then I hear, “You never know if the casing might be cracked and you don’t want to risk any water getting in”. So I still use my Aquapac.

If you can afford to use a sensor, then that is the biggest reason to choose the 630G. Many handy functions. If you don’t use a sensor, maybe the Veo would come out as a stronger choice.

One of my favourite functions is the preset temp basals. You can set the time and the level. I have one for afternoon of errands and one for when I spend the morning in bed.

I only half fill the 3.0 reservoir. So I have to wait longer when changing up. If you use more, then this wouldn’t be a factor.

There’s a lot of button pressing. Not a deal breaker for me. You get used to it. The chance to wear a pump really over-shadows this aggro.

Hope this helps!