Medtronic 670g Auto mode

Maybe I am the exception, but I have had better control and fewer lows with the 670G. The sensors are accurate and my BS are more stable. When it asks for an additional BS, I just input the number displayed if I just calibrated. Not that big of an inconvenience. The key is to NOT calibrate when it asks for an additional BS. I found all the calibrations confused it. The tape that comes with the guardian censors is crap. I use Simpatch or Rocktape and cover the whole thing. I had MAJOR sensor issues when I used their tape, but hardly any since I switched to my own. Good luck!

It’s caused me quite a bit of stress! It works so well though when IN automode. And when I am out of it my blood sugars are crazy up-and-down. I almost think they are worse because my body gets used to the auto mode basil delivery and then when it’s not working right or I’m not in my body is like “woah what’s going on here?!” But I am seriously starting to have PTSD from the beeping and trying to get into AM.

can I ask what system you are using?thanks…

I’m using a do-it-yourself automated insulin dosing system called Loop. It’s comprised of a Medtronic 722 pump, a Dexcom G4 CGM, a radio bridge called RileyLink that facilitates communication between the pump and phone, and an iPhone 6 running a self-installed app called Loop. It’s an Apple based system but other set-ups use Android phones.

I wrote about it when I started back in November 2016.

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I wonder if the pump manufacturers plan to open up their systems, ever, to work with cell phones, etc., or if the risk of hacking has forced them to forever shut that down.

I’ve been using this pump for 6 months am have been in/out of Auto Mode and finally gave up and am staying in MM where I have much better SG/BG. Having had a quintuple heart by-pass in 2006 I cannot afford BGs in the high end of the “in range” 180s and often 203+. I am realistically concerned that arterial inflamation will spur plaque build up in the arteries. For me…Auto mode is a failure.

When auto mode is accurate it’s awesome…but when it’s not it is he absolute biggest pain in the butt! 2 hours post meal today I went to check bs and sg was 158…actual bg was 285…what in the heck…no rises…nothing…indicated a spike over 50 points over 120 minutes since bolusing. Oh well. When mine gets above 250 I got into Manual Mode b/c AutoMode simply wont correct highs efficiently

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If you are the exception, then I am an exception, too. The 670G and Guardian 3 have improved my numbers by so much, when I look at the pump and see that smooth wavy line going through the green area representing my numbers, I think “That is the most beautiful thing I have ever seen!”. But I do have to admit that the tape is not the best, I am currently working on finding an alternative for that, I may try the ones you mentioned. I guess we exceptions need to hold our ground as well!

Very informative article, Thank You @Khurt_Williams for posting it.

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I agree that It was a great article. I have been on the 670G for almost a year and learned several tips the Medtronic reps never mentioned to me. However, I take exception to his point that the 670 is programmed to maintain BGs between 130 and 150. During the first six months or so. I would agree. However, Now that I have learned how to avoid some of the icebergs and, in some cases, “trick” the algorithm, it now seems to try to keep me in the 120 to 130 range. On the other hand, perhaps the algorithm has become more accustomed to my lifestyle.

Since my insurance no longer covers my CGM, I have started extending the life of my Guardians. I can usually get 12 to 14 days before they start to become flakey, but my last sensor lasted 16 days.

I have also found that if I receive excessive amounts of recalculate or reconfirm requests in the first 12 hours, I can recharge the transmitter and reattach it as if it were a new sensor and it almost always acts like a new sensor should.

My 670 is my first pump. It has done a lot of straightening out of things as far as highs and lows, but it is far from perfect. When I can keep it in Auto Mode, I do well. My problem is that I am highly insulin resistant and so max out often. It sits and sits in “Auto Mode Warming Up” for days, weeks. I cannot figure out why it is so difficult to get it back in auto mode and why a max out sends it for such a loop (no pun intended). Even more frustrated when I see all the other options out there and I was herded toward the 670. That part has been a learning experience. Anyone that has advice about the auto mode thing, I’d love to hear from you.

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I have to change my infusion set every 2 days, because I’m insulin resistant as well. But I’ve not had the Warming Up issue you describe. Yeah, that would drive me nuts.

I’m still seeing a typical cycle of:

  • Sat, 9am: remove old sensor, start charging
  • Sat, 9:20am or so: insert new sensor after charging completes. Start warm up.
  • Sat, 11am? : Auto Mode finally times out since the sensor isn’t ready. Manual mode begins
  • Sat, 12 pm: Enter first calibration blood sugar. Pump immediately says to enter blood sugar again.
  • Sat, 12 pm - 8pm: Chasing the “Wait to enter BG” … “Enter BG” … loop as I check my blood sugar at least half a dozen times while in Manual Mode. Sometimes re-entering the values because it demands a BG immediately after checking my BG.
  • Sat, roughly 9 pm: Pump finally returns to auto mode.

That’s literally the best case scenario.

I’m seeing a failure rate of about 25% on sensors due to calibration failures in the first 24 hours. If I can make it past that 24 hours, I’m good and the Auto Mode is generally far superior to the manual mode settings I have. But I literally dread Saturdays now.

Sigh.

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Does this have to do with your insertion spot not absorbing as it should?

Mine are not lasting as long as they should, but I haven’t connected it to the first 24 hours as much as the last 72 to 48.

Yes! Which is why all this other garbage is so frustrating!

@CaM2 Can I ask you your average insulin use is a day? I am at 275 units average, which I’m constantly told is outrageous, but I can’t help it most of the time.

No, my infusion site usually doesn’t have issues. Most of the time. I have a couple of “dead spots” though, that I avoid.

I average about 125.6 U/day, 73.3 of Basal, 52.3 of Bolus.

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I would have to admit that is probably more than most people, but if it is the amount that keeps your numbers good, then it is what you should be using. The only concern I might have is that many pumps can barely hold that much, so it might require you to change your infusion set almost every day. Do you need this much for other sites as well? Also (and I am not the most experienced in this area), have you talked to your doctor about different kinds of insulin? I have heard that some types work better for different people.

One thing that I recently discovered can help with Auto Mode is doing your calibrations & BGs on a very different schedule. I used to do my calibrations when doing a BG immediately before meals. But when I realized that my numbers were almost perfect after tweaking stuff, I changed to doing calibrations & BGs at fixed times (in my case, approximately 7:00am, 3:00pm, & 11:00pm), and at my meals, don’t do a BG (unless my number was extremely bad), just enter the carbs for a bolus. It sounds strange, but as long as you do them less than 12 hours apart, it is actually better to do fewer calibrations. As for the “max out often” (I am assuming you are referring to the Max Delivery alert), once you get your carb ratios tweaked, you will probably end up getting a lot less of these. And don’t be afraid if some of your carb ratios look kind of extreme, when I first got my 670G, I was having breakfast spikes over 300. My carb ratios at breakfast are now just a little over 7.0, while at dinner, they are around 9.5. When I first started tweaking these number, I was worried that they were so different, but they are the numbers that work. Before I had my breakfast carb ratio tweaked, I would often get the Max Delivery, but now that I am actually getting the right amount in the bolus, I rarely have that problem. Sometimes the tweaking can take a few months, you just need to be patient. Also, in case you haven’t been told about it yet, there is an updated transmitter that will help prevent the repeated Enter BG requests, for more info see:
https://info.medtronicdiabetes.com/bgcheck
Hopefully all this helps, and remember, just like anything else, an insulin pump is a major change in your life, so it will take some time to adjust to. But everyone here is here to help you. And no matter how good a doctor you have, there will always be things that they don’t know (or maybe aren’t allowed to say for legal reasons) and that only your fellow victims can help you with.

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Please tell me how your sensors last so long. I remove the transmitter, recharge, and start it again telling it its a new sensor. I never get more than a total 10-11 days.

I follow the same procedure as you described with my G3 transmitter/sensors. I usually get 14 days. Occasionally. I only get 12 days. I always make sure the sensor is taped down securely before removing the transmitter.