Last year, I got tired of waiting for Medtronic to get their act together and make nice with the FDA to get the 780G pump approved. So, I switched to a Tandem t:slim. Even though I had warranty coverage on my 770G through the end of 2024, Tandem/Dexcom were able to get insurance approval for the pump change.
So far, I have been quite happy with the results from the t:slim/Dexcom, with my A1C going from around 7.0 down to the 6.5 range. But, while I have have nothing but good things to say about the Dexcom, and am happy with many things on the t:slim, there are a few things really bug me with the t:slim … the biggest being the filling of the reservoir system is a joke and much more difficult than it needs to be; and the tremendous amount of insulin waste when changing cartridges.
But the biggest issue that I have is that the system is quite timid when it comes to auto-bolusing. Control-IQ does a pretty good job during normal days. But if you miss-count your carbs, or (for whatever reason) do not take a bolus prior to having a meal, it seems to take quite a while to get your BG back under control.
The 780 promises to be more aggressive in treating spiking BG levels. Auto-boluses can be given up to once every 5 minutes, as opposed to one an hour with the t:slim. Medtronic calls this “meal detection technology”. Also, after using the 670G and then the 770G for a long time, I know that the reservoir system, while a bit bulkier, is significantly simpler, and does not have any of the insulin waste as compared with the t:slim. (Tandem should really be ashamed at the design of the reservoir system of the t:slim. If Control-IQ didn’t work as well as it does, the reservoir system alone with have been enough for me to reject the t:slim.)
I know that many people had problems with Medtronic’s Guardian3 CGM, but I never did. Other than inaccuracies on the first day after a sensor change until the calibrations kicked in, it worked pretty well for me. So I am hopeful that the Guardian4 will be as trouble-free for me, with the benefits of (mostly) no calibrations. I do wish the 780 would work with the Dexcom, as the Dexcom G6 is much superior to the Guardian3 both functionally and aesthetically. But, other than the same aesthetics as the Guardian3 (which I don’t like at all), hopefully the functionality of the Guardian4 will be on-par with the Dexcom G6. And the next-gen Simplera from Medtronic looks to be even better … hopefully it will get approved more quickly.
I have registered for the 780 upgrade, and look forward to trying it out. I guess I am in a unique position in that I have plenty of supplies for the t:slim and Dexcom. So, once I get the 780 upgrade completed and receive new Guardian4 sensors, I can try one against the other side by side … I will be able to go back and forth to really see how they compare.
Should be interesting … we’ll see how it goes. I am really looking forward to getting started.