Problems with Medtronic 670G: ("Beginner's frustration" and reps promising that will eventually go away...)

Diabetes Technology
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I have been an Animas/Dexcom customer for years. Upon receiving word that Animas was going out of business, I wanted to switch to another pump. I heard about the “closed loop” system that Medtronic offered via the 670G. I was really excited about it. I started using the 670G 2 weeks ago, and I’ve been very unhappy with certain aspects of it …well, that’s putting it nicely. To be honest I actually hate this system so far…

I met with a Medtronic rep today to help adjust some of my pump settings. She told me that "everyone hates the 670G in the beginning and that its even more difficult when you’ve been a “good diabetic” who likes to “micromanage your care”* but to give it about a month and I will eventually “love it!”

I’m still having roller coaster ups and downs, so the celebrated function of the 670G makes no difference to me right now. The complaints at this point outweigh the good.

A few nights ago, my 670G told me that I was at a BG of 60 and dropping. I ate a snack, but felt a bit suspicious given my symptoms. Upon testing a finger stick (before the snack even had time to sink in) I discovered that I was (actually) at a high BG of 434. I tried to re-calibrate, and this caused a “sensor fail”.

What I really don’t like about the 670G is the Gaurdian sensor system. In addition to the fails, there is not an adequate amount of warning time before it suddenly expires and needs to be replaced. I actually have to keep track of a separate, tiny, battery powered “charger” and when I change my sensor, place the transmitter in the charger for what feels like a long time before it is inserted. I THEN wait the additional [2 hours] for the warm up period,(not a fun experience when a “sensor fail” occurs at 11pm and you have to wake up for work at 5:45am.)

In addition to that ridiculousness, there is a large plastic “staple gun” that is needed to insert the sensors, AND… unlike the Dexcom there is no adhesive backing, instead the Guardian sensor must be attached to the body with a very sticky adhesive tape that makes putting it on a “project” and leaves a sticky, black residue all over the sensor and my skin.

Other things I dislike about the 670G are the insulin reservoirs - which waste insulin and do not make it convenient to carry extras cartridges when travelling. There is a USB meter that plugs into the laptop to download info from my pump for Carelink - which is how the doctor gets my readings. Using Carelink requires downloading all sorts of outdated software in order for it to function. I’m talking JAVA and Internet Explorer outdated. It feels like a step backwards in context of the type of technology that is available today!

I do not like having to keep track of these small additional parts because if one thing is lost or misplaced I’m totally screwed! Last year I traveled to Ecuador and had to pack 10 days of diabetic supplies, I was very appreciative that the Dexcom system was compact and easy to carry. Going through airport security with a pump and CGM, is nightmare enough let alone having to keep track of an extra travel bag for all of this extra diabetic stuff. I can not imaging traveling overseas with the 670G and all of its accoutrements.

One more thing before I end my long list of complaints is the environmental impact. The 670G uses 1 AA battery (preferably lithium) PER WEEK!!! (and I thought that going through one batter every 3-4 weeks with the Animas was bad.)

How is Medtronic the only company to offer a closed loop system at this time when everything else about their product’s design is fast approaching obsolescence??? Had I known then what I know now, I never would have traveled down that road. I dread the thought of being stuck with this system that makes so many aspects of being a diabetic worse than they already are.

For those of you on the 670G, do you ever get past the point of hating it? Or do you suggest I “run now” and get the Tandem t-slim/X2 before its too late to exchange?

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Funny you should mention some issues with the 670G and Carelink.

I just spent 1:54 with 2 MM techs. The first one had an attitude that had me wanting to pull my hair out (and hers too. lol). I finally had enough of her overtalking me and not understanding my issue with some Carelink reports. sigh. After about 15+ minutes on hold,she got a lead on the phone. He was great. (oh, downloading the pump works currently only in IE, on Windows)

I got through the issues with Carelink with the second fellow (he was like the polar opposite of the first person) and then we moved on to pumps. Turns out my pump warranty expires at the end of this year,to my surprise, so I asked some questions about the 630G & 670G. He answered lots of questions and then I downloaded the PDF of the manual for only the 630.

Seems some things take more button presses.
The pump is larger than the 551
It has some interesting features such as Preset Boluses and Preset Temp rates. I like the idea of both of those.
It uses larger batteries and reservoirs than the 5xx series.

He said it has louder alarms. Does it?

Yes, the xmitter gets covered in adhesive goo! (speaking as a former Enlite user). G5 remains clean.

Later this year I have to decide if it’s worth getting a 6xx pump, and I don’t know if Medicare will be an issue for upgrading .

I have no intention of using MM sensors again so I see no use in asking for the 670G (ie, no need for Auto Mode for me)

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You may want to check if the Medtronic 530 is available (as pump only), if you prefer something similar to your current pump.

My warranty is up next year, and I would probably pick that if I stay with Medtronic, or switch to Tandem.

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Don’t worry about uploading to carelink

The doctor can do it ten times faster then you -

The doctor my wife goes to takes care of that - no problem

I got it to work on my computer after much hassle and I have tons of experience on PC’s

I would venture to say the normal PC user has about a five percent chance of ever getting it to work

Let the office do it -

My wife has a medtronic pump and has been down the horrible sensor road -

Their literature is good for starting wood fires

Got an Abbott Labs Freestyle Libre a month ago and so far it is working just fine -

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I don’t have 670, but have read all the posts here and other places. General consensus seems to be that if prior to 670, your control was pretty good ( 5-6ish A1C), then users were frustrated and some eventually turned off auto mode or returned pump. Others are very happy with improved control. There seems to be a frustrating learning curve for both users and the pump auto settings, and the Medtronic staff providing the help.

Some compared side by side CGMS numbers (dexcom and guardian), reporting they were generally about the same. So that was good to hear, but not everyone reported good accuracy with guardian. Most complaints were about inserting, taping, battery charging.

Have you searched this site for other discussions on 670 ?

I have only used MM pumps since I started in 1995, but will carefully look at other options for my next one.

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I love the Libre

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I suggest that you discuss with @CaM2, who seems to be having similar issues with similar hardware. Struggling with control - #6 by Terry4

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I was diagnosed in the spring of 1950 and have been pumping since 1994. My Animas pump went out of Warranty in 20016 and i ordered the 630 GR on the Pathway project which leads to the 670G after 13 months. I have been using the 630GR for 13 months which now makes it mine (no longer a rental) and I can trade it in and get the 670G. (If your not aware, Medicare doesn’t buy the pumps they rented it for 13 months in my case therefore the R designation).
I agree with much of what you described regarding the sensor shortcomings but many of the issues I had worked out over time. I haven’t had many sensor failures. I too used a Dexcom for ten years and think they are a much superior CGM but I am still looking forward to the 670G. I can still run it in Manual Mode if the Auto Mode doesn’t help me smooth out my ups and downs,as I understand it (my A1c has always been 6.1 or lower).

What I would like to know is whether or not I could use two transmitters to avoid the time lost to the ‘recharging fiasco’ as I call it, during the sensor change operation?

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It sounds like your system isn’t functioning properly. Maybe your transmitter is bad or the battery in the charger is weak. I find that sometimes the readings can be off by about 10 or so but not by almost 400.
Something doesn’t sound right with the transmitter either. When I charge my transmitter it easily lasts for the life of the sensor. You can go to the status screen and it will tell you how much battery life the sensor has left.
I agree the battery life of the pump is short, but it should last longer than a week.

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Are you an athlete? Do you want control? Have you done well on other systems that allow control? If you said “yes” then you might want to consider returning the 670g. If you said no…see below

Do you have a regular routine? Do you eat the same foods at the same time? Do you have the exact same workout? Do you live stress free? If you said “yes” the 670g should be working perfectly.

This has been my experience. I fit into the first set of questions. As an athlete, the system just isn’t smart enough and the FDA levied to many “safety” features on Medtronic to make it truly useful so I’ll wait until the technology has matured before trying another fully automated system. I will then thank people that stuck it out and made it better.

Just my 2 cents.

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Tidepool is working on getting the 600 series loaded so go check it out if you haven’t already.

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@anon32557099 Can you explain what you are talking about?

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ah, so we need a secret handshake to get in on it? Must not be a mainstream thing, then, in which case I’m really not all that interested. :slight_smile:

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Actually that is a valid post

I don’t quite understand it as I only glanced at it, but it is not a troll

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Anon may also mean someone who requested that all their posts be anonymized. Maybe it’s a symptom of the Facebook scandal.

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As you know I’ve been vocal in my opinions on this pump, and I bow to no one in my astonishment that in this day and age Java apps still exist, BUT… Carelink is OSX and Safari compatible, though it has always and forever lagged one version behind current OS for as long as I’ve been dealing with it. Fortunately Safari lets you specify a user agent and even finagle the OS version (Develop > User Agent > Other).

Not that this is anything but an embarrassment of a workaround, of course. I’m just saying it IS possible.

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What do you see as the basic issue with using Java for applications?

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I gave it over three months, which seems to be about the stage where people either start to love it or throw up their hands. For me it was the latter (I have a number of posts on my experiences with it here). There are a couple of things in your post that do look screwy to me. BG of 434 is a far bigger excursion than I ever had on auto, and I struggled with highs a lot, especially in the first few weeks. I found the sensors to be generally indistinguishable from Dexcom accuracy-wise once they were fully acclimated, though the first 24 hrs were prone to false lows and the alarms thereof, particularly overnight, so that’s definitely a thing. Keeping track of the charger and the (absurdly named) “Serter,” not to mention the ludicrous taping system–totally agree with you there as well, though there is adhesive backing (not sure why you say there isn’t???) and some people manage without the extra tape, which I agree is a major pain, sticks to itself (and they don’t give you any extras!!!) and leaves tenacious goop all over things. You forgot to mention that getting that sticky gunk off the transmitter adds about ten minutes or more to the process of changing sensors.

To me the big breaking point was that I kept feeling like I needed to fit my lifestyle to satisfy my pump, rather than the other way around. I lived with that kind of treatment for 20 years before I finally got on basal-bolus MDI, and then ten years later a pump. Both of those advances made me feel more like I was in control of my life and my treatment, instead of my treatment controlling me. But the whole hybrid closed-loop thing felt like a major step backward, like I kept having to organize my life around trying to make the algorithm behave. At the same time it locked away all the tools I was used to using inside a black box, leaving me only feeble little parameters for adjusting around the margins, as if I couldn’t be trusted to handle this dangerous insulin stuff and wasn’t I glad to have the algorithm nanny take all that difficult stuff out of my hands for me. Well, no, actually, I wasn’t.

To some degree this is Medtronic’s fault, but I think it’s important to ask to what extent it’s built into the whole closed-loop endeavor. There’s a fine line between having a device take the controls so you don’t have to think about it, and taking control out of your hands because you can’t be trusted with it. There’s a way in which that has always been a tension in the treatment of T1. It’s the only disease I know of where the patient is required to dose herself with a powerful and potentially dangerous—even deadly—drug, 24/7/365, with no immediate professional supervision, on a daily and even hourly basis. When I finally got off the R/NP regimen after two decades it felt like being let out of prison. Since then this is the first major treatment change I’ve experienced that felt a bit like being put back in that cell. I think it’s important to ask of ALL these systems as more of them come online whether they are designed more to give us the ability to live our lives freely, or to ease the medical establishment’s misgivings about the “how can we stop letting these poor idiots dose themselves?!?” problem.

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Security, mainly. It is one of the most attacked and exploited platforms on the Web since forever, which is why practically every time I go to upload my data I seem to find my local Java engine is out of date, even if it’s only been a couple of weeks. I don’t have to install a security update every week or so in order to use the Dexcom data reporting system. And then Java sneaks in this little checkbox that, if you don’t uncheck it, grabs your browser settings to make Yahoo or some damn thing your homepage. And in terms of UI design it’s just incredibly antique. Carelink always feels like a visit to the World Wide Web ca. 1998.

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:grinning:

I think systems like this should permit users, with their eyes wide open, play with all the levers. Why does a system have to be designed only for the least informed and experienced among us? How about a beginner/novice/expert switch we could select?

Many of us with several hundred thousands of hours of direct insulin dosing experience could spin circles around most in the medical establishment.

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