I’d love to read more of your comments, given your one year of experience. What sensor do you use? Is it the Guardian 3? Have you ever had poor control due the pump responding to inaccurate sensor readings? How often do you fingerstick? Has you pump ever delivered too much insulin because of an inaccurate high BG reading?
@dalton I would love to hear all about it. Please fill us in.
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The Medtronic 670g pump has been a life-changing experience. It truly takes all the worry out of managing your diabetes. After three months of use my A1c dropped 2.2 points, And still in the 6 to 7 range. I find the new guardian sensor very accurate. The only lows that I have had ate from over bolusing. I wake up every morning around 110-120 with no overnight lows. I can work all day miss lunch and not go low. This technology is going to help so many people.
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I have had no issues with the function of this pump. The sensor is very accurate, and safe. You calibrate minimum of twice a day .
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That (A1c in the 6 to 7 range) would be a step backwards for many of the PWDs I know. Even in light of the fact that the Medtronic 670G would mean less work, I wouldn’t be willing to settle for the higher A1c.
I could see this being useful for people with much poorer control.
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My A1c is 5.0. I can’t even begin go describe how willing I’d be to plug myself into a pump that could just automatically make it 6.0 (or anywhere else within a reasonably healthy range) with only a small fraction the effort, stress, and burden in my life if that was an actual possibility. I am not convinced yet that we’re there yet, but this has captured my attention and my ear will be to the ground.
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I guess you are right in general, but just to clarify – in the specific case of the new 670g system, it is not approved for use by children under 14, which is one reason I didn’t think of that scenario. (And as my comment might show, I am not a caregiver for a child with T1D, which I am sure gives a very different perspective. Thanks for providing it.)
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Thanks for responding with a useful comment and a very relevant example. I am glad that you had the technology to help you in that critical situation. And I am not saying in general that having connectivity is not useful, but to me it’s a secondary, “bells and whistles” type of feature. I just don’t see all the other major improvements in the technology as eclipsed by the absence of that option. But I understand that different diabetes experiences (having more severe ups and downs than I currently do) might raise its importance.
You know, if the pump really can automatically adjust your BGs in all the spaces between eating, with no effort or input on your part, that WOULD be huge. I guess what I wonder though is how well your basals, ISFs and carbFs have to be dialed in order for the algorithm to work? Perhaps Dalton can explain how much effort he puts in to tuning those base parameters on a day-to-day basis.
I use openAPS and would say it will probably shave of more than a point off my son’s A1C eventually, but it is NOT effortless (I can describe how the algorithm works in another post when I have time) . We are constantly tuning basals and other factors.
Undoubtedly they are using a much more sophisticated algorithm but as far as I know they are not using machine learning to pick up patterns before they occur and given that it’s not meal bolusing I can’t see how they can figure out especially the carbFs.
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So as I’m reading everything it seems this would be great for folks who don’t really have a dialed in basal or don’t make dynamic basal changes based off activity etc. For those individuals I understand why this would be tremendous.
Question:
-Does the pump correct a miscalculated bolus with increased/decreased basal? In other words does it add more basal if post prandial blood sugar is trending upwards? Or is the user still required to do a follow up correction bolus?
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I don’t know but I’m sure it must have some way for adapting to that. i mean, a large portion of high BGs are likely a result of bolus, not basal, problems…
I don’t have the numbers in front of me, but a large slice of people with diabetes have A1c’s above 7.0%. As you consider people at < 6.5% and < 6.0% the population quickly falls off. The early generations of the AP will not help those already doing well keeping their BGs in check.
My biggest disappointment with the 670G is not allowing a user selectable BG target. But if that’s what it takes to gain this tech traction in the marketplace then those of us not served well by this advancement must bide our time. Our needs will be addressed in the coming years. I don’t see my optimism here like that mythical promise of “a cure in five years.” This will happen and it’s not that far into the future.
For those of us that target more ambitious diabetes goals, I encourage you to consider OpenAPS and the Loop, do-it-youself systems. I am convinced that with the passage of time, a little faster insulin and shelf stable glucagon, the future will be brighter for all of us.
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My sentiments exactly!
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Here is a good article by Catherine Price at A Sweet Life describing how the 670G works. It answers a couple of the questions asked in this thread and addresses the comments on the fixed target BG.
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Yep, according to the linked article, the 670G “keeps you as close to 120 as possible”. Unfortunately (speaking for my daughter and a handful of folks here on TuD) we do better than this on our own. So my daughter will definitely not be rushing off to get this “pseudo” AP, as in her case it makes absolutely no sense to switch to a pump that would undoubtedly raise her A1c.
It’ll be interesting to see what kind of a1cs users who set it and forget it start checking in with. 120~ approximately 5.8 a1c according to my calculator. If that comes with a reduction in stress and burden and corresponding improvement in quality of life I think it sounds like a pretty good deal.
I’d really like to hear from and see some actual numbers and cgm graphs from users. The question in my mind is how much does the “basal only” automation actually help in real life-- with people who actually… ya know… have to eat.
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The article indicates that eventually Medtronic will consider more flexible targets. For the vast majority of people with Type 1 diabetes, a target of 120 is a huge improvement. And there are times in life that many of us might find a 120 a reasonable target. I even wonder if my quality of life would be enhanced by trading a higher A1c for less mental burden. At my age and having had T1 for 40 years, my reasonable good health is due to more than just “good” A1c’s because I had many years without home BG monitoring. As all of us should and do realize, we are a very small subset of people with diabetes who have the knowledge, motivation, and resources to do better than “your average bear.”
I won’t be purchasing the 670G but I still consider it to be a huge deal for PWD. I wrote a blogpost about this last week:
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I don’t doubt that switching to a Medtronic 670G “hybrid closed loop system” would improve BG control for quite a few people.
I just hope that those who go this route do their homework first and proceed with their eyes wide open to the fact that the 670G is not a true AP. And that when the real APs hit the market (which I hope will be within the next 2 to 3 years), the vast majority will be stuck with this pump for awhile longer because their health insurers will likely not cover the cost of another pump for 4 to 6 years after their purchase of the 670G.
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Well, I don’t know what to think about this. My Hba1c has been lying at 6% flat last two times I checked it (Mar and Jun 2016) and since I’ve started with the Loop (Sep 1st), I think that it has dropped even more. According to the Clarity, at least, the estimation is 5.6%, which is a good sign.
In order to get acceptable values, I’ve set my target range in the Loop to 80-115 mg/dl, which has shown to be necessary in order to give the system time to work in order to reach my real life target of 70-140 i have on my Dex app.
Having 120 as the lowest value is not good enough. That means that I will never reach the, actually normal, sub 80 range and will spend most of the time in the, actually too high, 130-140 range, especially after meals.
As for the product itself, it’s good that the development is moving ahead, even though these limitations are not good enough. I understand that the primary concern have been the hypos, but the hypers should not be tolerated too easily either.
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You know, I hear what you’re saying but I’m not sure if Loop is a totally fair comparison. I don’t know exactly how Medtronic’s program works, but it’s very possible it achieves a closer fidelity to someone’s target number than do these home-built AP algorithms that are based on a pretty simple heuristic. They’re programs have to work well for everyone with a minimum amount of fiddling, so I’m guessing they’re using more sophisticated control algorithms. So it’s possible that you could also achieve a 6.0 a1c with their algorithm. Pretty sure 5.6 would be out of range though…