I’ve been on a Medtronic 670G since Sept '18 and have had the (unfortunately) typical hate-love-hate relationship with the sensor, transmitter, looping nonsense, sticky tape goop, the whole bit. (Although I did receive my new/updated Guardian G3 transmitter in the mail about 3 weeks ago, after requesting it in January, and it HAS made a vast improvement on the calibration-loop problems; I’ve even gotten a full 7 days out of sensors a couple times this month!)
I don’t think my control is any WORSE than it was pre-670G, but it’s certainly not better. I, like a lot of other long-term T1Ds, have become accustomed over the decades to programmable basal rates, square wave boluses, and all those wonderful tools that aren’t available in AutoMode. The mental shift has been hard, to somehow retrain myself to think that “ok, now we’re CHASING blood glucose levels instead of trying to proactively control them”… And also all the alarms, etc. have aggravated my anxiety/depression disorder somewhat in the past few months (although that’s a different post).
Since I am an experienced Medtronic pump user (since 1999!) my doc was eager to get me into AutoMode as soon as humanly possible after my training session… he just programmed in my basal rates from my 530 and away we went. He is a 670G user himself, and so as his patient I think I get a mix of clinical expertise and personal bias of his own experience, which is good on some days and frustrating on others (“well this is what works for me, I can’t figure out why it doesn’t work for you.”) And he LOVES AutoMode. When we meet to review my numbers, the first thing he zeroes in on is how much I’ve been in AutoMode since our last visit… and if it’s a smaller % of time than previous, then we have to discuss why. (As if the ultimate goal of all of this is “time spent in AutoMode” instead of “achieving stable BG control in a way that doesn’t make me want to scream.”)
It occurred to me recently that with all this, it has been a friggin LONG TIME since I’ve actually tested my (still programmed) basal rates to see if they’re still appropriate for the times when (for whatever reason) I’m NOT in AutoMode. I asked my doc about testing them and he said I could if I wanted to, but he didn’t see the point since I’m supposed to be in AutoMode as much as possible. (facepalm) So rather than kick him in the shins, I went home and pulled a basal-testing protocol (given to me by a prior endocrinologist) out of my files, and I’ve been moving through that for about the past week with about 2 more weeks to go.
The results have been positive… So far, my basal rates seem to still be mostly appropriate (maybe need a bit of tweaking, understandable) but my levels have been way more stable – fewer high-low swings, a LOT less alarms. (I know this is due in part to the fact that i’m eating less because I have to fast at different times of day/night as part of the testing protocol… but still.) But more importantly, it’s SUPER REFRESHING to feel like I’m driving the bus instead of it driving me. And it’s really made me realize that chasing/reacting to BG levels is bull$hit, when we still have the technology to tackle them proactively.
I’m not going to bother asking if there are folks here who have concluded that AutoMode just isn’t for them. I know you’re there I’ve got an appointment with my doc in a week and I’m going to share my basal test data with him, and let him know that I’m thinking of giving up on AutoMode. I’m truly just happier when I’m not on it, and also I think that going back to “old school” programmable basal rates might help solve a morning glucose pattern that I’ve been struggling with for months.
That’s all for now. It’s been a while (years?) since I posted in here and I wanted to share this line of thinking. If anyone else has a doc that really pushes for you to be in AutoMode, possibly beyond the point of usefulness, I’d be interested to know how you handle that.