So I dusted off my old enlight transmitter - thought I’d use the pain in the keister CGM for a few days to review basal rates. But, shocker, the transmitter won’t charge. I have a lot of soft set supplies hoarded from my last attempt to use CGM 24/7 (burnout) so I checked yesterday with Medtronic about enlight replacement cause I’m years over the warrantee. This of course led to the replacement conversation about my 523 pump. Sales rep was impressed with this week’s HBA1C of 5.3 and I thought that would be the end of his pitch but he pointed out I could simply not enable the loop feature on the 670G and just reap the benifit of other features, including the waterproof technology - queue the music - I could then add that paddle board class, etc…Now he’s pushed the right button. I have a sad crack over the battery compartment on my trustee 523 so will have to do something this year - does the 670G have enough tech outside the loop system to justify my time?
Really interested in this question too. My Minimed is officially out of warranty next month–my first pump after 10 yrs on MDI and 20 on R/NPH before that–and I’m not exactly thrilled about going on with Medtronic but I’m not sure any of the other options are that much better to make me want to leave the devil I’m at least familiar with. Enlight integration with the 670 is also not a big selling point for me–a big part of the reason I went for the Dexcom CGM was because it would give me more choices when it comes to integration, as opposed to the Medtronic approach that really wants to lock you into their ecosystem. The moduar approach seems much more the way of the future. And speaking of the future, there’s the concern about opting for something you’ll be stuck with for the next four years while newer/better systems that are in the pipeline may be coming out much sooner than that. So maybe I should just hold off and see what develops in the extra-Medtronic world in the next year or so. My current pump is actually less than a year old–had it replaced last summer due to button freeze–even though, as I understand it, the durable medical coverage period stays the same. I’ve been really interested in what Bigfoot comes up, since they took over Assante’s design assets. I was on the Snap for about 3 months before the company expired and while it wasn’t perfect there were a lot of things they did that were so much more user-friendly than anything else out there. But that could be a long wait, and god knows I don’t want to get orphaned again.
So many factors to juggle–I’d be very interested to hear how others navigate through this maze to arrive at a decision.
I am thinking the Tandem X2 will update for the G5 this year as well (and the predictive low that goes with it.)
Thing is, probably next year will get the next update to cover predictive highs (probably with the G6.) And that is not something the 670g will be able to do.
I love the idea of Bigfoot, but I don’t think it will make it fully into the market for a few years. I might make that my next pump after the X2.
I found the following ‘review’ helpful, although done in 2015 from a trial participant.
My pump warranty was up last year, and I opted for another MM523. I had used the original MM sof-sets CGMS, 10 years ago with my 522. After 2 years, I switched to Dexcom Seven, and would find it hard to go back to MM, although I know there have been improvements with the enlite. Yet in the review, says this:
The 670G was amazing and I honestly can’t think of something that was bad about it. The Enlite 3 Sensor could definitely use a little work.
My understanding is that the target 120 is the lowest it could be set. If it allowed a lower target, I might consider it.
The ability to have alarms on a different device is absolutely important for me, since I used to miss many night time alerts due to the pump being buried under blankets. So another advantage for Dexcom for me.
So if those items were improved, I might take another look next time I’m due for new pump.
I agree with DrBB and thinking there will be many other options in the near future.
On the 670G you can set the automatic basal adjustment to manual, thus bypassing the “correct to target (of 120)”.
Maybe the 630G would be a better fit if you wont use that feature.
It may be possible to use a calibration off-set to fool the enlight. To do this you would check your blood sugar and “add” a factor to your calibration. So for instance if you want a target of 80 mg/dl then check your blood sugar and if your reading is 100 mg/dl then add 40 mg/dl to the reading and enter 140 mg/dl as your current reading. Your 670 then will try to bring you down to what it thinks is 120mg/dl but actually that would correspond to 80 mg/dl.
If I set to manual, there is no advantage over what I have now.
Not quite: you can set the system to manual only some of the time but take advantage of the loop action other times. Also, the 670G will come with Medtronic’s most accurate sensor to date – that’s my personal biggest reason why I will be getting the 670G. (For people who are using pumps older than the 630, the waterproof factor and the option to bolus from the meter could be helpful too.)
“Fooling” the system can get pretty complicated pretty fast; not to mention, your records over time will not be very useful.
My hope is instead is that there will actually be an unofficial (but built-in) workaround. (Something along the lines of the current experience using Carelink on an Apple device with MacOS Sierra, which the company does not formally support, but you can download your pump and meter of you reset the browser User Agent.) Fingers crossed!
Not sure what you meant by that. The 670G will absolutely react to and try to cover a high (over 120 anyway) with a greater amount of insulin.
I’m excited for the 670. I currently struggle w/ my basal rates due to female hormones and stress-the idea of the 670 sounds good. Am currently on 523 as well and have Enlites that work for the most part. But I just saw my endo this week and he was kind of like,“eh…who knows how it will work?” He’s very skeptical because it hasn’t been offered to docs yet to see it. I think there is just a lot of hype on Medtronics part which is troubling to me. If all the people who were in the trial were allowed to remain On the 670 after the trial why hasn’t Medtronic gotten the 670 out to the doctors and CDEs? If the 670 is supposed to be so amazing why are they not actively training medical professionals now? I feel like we’re all going to offered the pump at the same time and it’s anybody’s best guess how it will work? All we have now is the claim of Medtronic that it will be amazing. Doesn’t feel like good science to me…
The 670G will basically adjust a basal rate delivery for something over 120.
The X2/G6 combo will be a lot closer to how Bigfoot works to corrective bolus for a high.
I thought it was the other way. If you are under 120, it will reduce basal to get BG to rise over 120.
I don’t see the temptation here. I’ve never used a Medtronic pump because I feel like the design is outdated (with the exception of the 670G’s new design), but after using an Animas Ping for 6 years, I finally realized how much time you waste scrolling up to the bolus amount, scrolling to enter the time, etc. I switched to the t:slim X2 last year and bolusing is a lot faster since I don’t have to scroll up to the carbs, scroll up to enter my BG, and then scroll up to the bolus amount.
I also am not a fan of Medtronic’s CGM. I did a study in 2015 for the Enlite vs. Enlite 3 (I think the Enlite 3 has a different name now, but the underlying tech is the same), and the performance wasn’t particularly great (although that was with the sensors in my stomach, and even Dexcom sensors don’t work well in my stomach - but they do on my arms and back). Also, I found the transmitter attachment with the tape to be particularly clumsy, in addition to having to charge the transmitter. And the insertion hurt more - I had one sensor bleed so much on insertion I had to take it out.
So while I really like the idea of the hybrid closed loop, my problems are with the rest of the pump. In my opinion, the safety of the t:slim’s microdelivery technology that separates the tubing from the insulin in the reservoir, plus the rechargeable battery, touchscreen, general intuitiveness of everything the company makes, and software updates, makes the t:slim X2 a better package overall, even if right now it doesn’t match the automated insulin delivery technology in the 670G.
For me, the decision came down to these factors:
- My Ping “worked” but was out of warranty - if I got a new Ping, I’d be stuck with it for four more years and if another company came out with something I felt is significantly better, I wouldn’t be able to switch. The Vibe’s ugly screen and use of the G4 (without the updated algorithm) basically negative (IMO) the benefits of seeing CGM data on the pump.
- Tandem announced the t:slim X2 with software updates. I’d been following Tandem for a while and their pumps always intrigued me. Software (automated insulin delivery and CGM integration) seems to be the future of sophisticated insulin delivery.
- UnitedHealthcare’s (ridiculous) policy restricting people over age 18 to Medtronic pumps in most cases. (As evidenced by my discussion above, insulin pumps are not at all one-size-fits-all.) I was/am still young enough to be exempted from this policy, but I didn’t want to have to use a Medtronic pump in the future or at the very least have to fight for an exception - I do my research, and I definitely have an opinion.
After my Tandem warranty ends, I figure I’ll reconsider my options and either stick with Tandem depending on their offerings, or maybe there will be some new players by then - iLet, other closed loop systems, etc. It’s also interesting to note that Tandem licensed Bigfoot Biomedical’s AP algorithm.
Like you I am trained only with Medtronic devices - CGM is not an issue as I don’t intend to use that feature much - I despise having two devices hanging off me so only considered using CGM to survey the bolus action as I sleep. So I think it will come down to “the devil I know”
I wish I were 17 and detail oriented. Hie last shot at the CGM does not concern me - I won’t be using that feature much. Thanks for the link😀
Yep - my hope also. Not going to target 6.5 - might be helpful for any potential caregivers if I’m ever bedridden.
I think it’s been vetted for quite a while outside the US so it will definately work as advertised. I know it’s tough to deal with all the other hormonal stuff. Have you tried low carb high fat during those hormonal parties? My doc and I were discussing her attempt at working with birth control induced weight gain and LCHF - it was effective. And interesting as the impact of the estrogen based Meds was much smaller than the progesterone based Meds - weight gain would be tied to insulin action so a diet that does not require so much insulin would be helpful.
Evan - your post has got me motivated - I think my endo and I will spend the next appt. looking at device samples. Understand as I’m only 3 years off collecting social security the amount of brain matter available for new tech is limited. Even less space for math so nothing complicated. Also my thumbs won’t work with little tiny buttons - it probably took you 5 mins to post your well crafted reply - my index finger took that long to type the first couple of sentences!
Thanks @evan10s, that’s a useful overview and echoes a lot of my own thoughts. I’ve been interested in Tandem for a while too–they were one of the companies offering a discount for pumpers orphaned when Assante cratered, and I went as far as getting a hands-on demo. I liked the interface and the software update capability means you won’t miss out on major interface and operating improvements going forward, something that is long overdue in pumps generally. So it’s a pretty strong contender for me at the moment.
Oh, and welcome to TUD! It’s a very well informed and helpful community–hope you stick around.