The Auto Mode experience: 670G two weeks in

Is there any Looper who has stepped over to 670G who could share the experience and comparison. I understand that non-Loopers get amazed by the things that 670G is doing, but for somebody who is already successful in looping it may not be an improvement.

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My biggest complaints with Automode are…

Strike 1. If you’ve been using a 630G pump, you probably have atleast a year’s worth of data sitting in Carelink that could be used to train the “Algorithm” for the 670G’s automode. This kind-of seems like a no brainer, but Medronic chose to make the transition unnecessarily difficult for all it’s 670G users by having to learn from scratch. Really, really dumb.

Strike 2. Automode bolus correction for high blood glucose appears pretty worthless. It lets you enter in a blood glucose value, but only gives you about 10% of the insulin required to correct that high BG. And, here’s the kicker… It doesn’t tell you that you were not given enough insulin to correct the high. It does show you the insulin dose amount, but that really caught me off-guard to see it was only giving me about 1.3 units, when my sensitivity ratio says I needed about 13 units. That is a huge difference! Medtronic’s “fix” (I called them today) is to exit out of automode, bolus, then restart automode. Really, really dumb.

Strike 2.5 Carelink no longer has/supports a CSV (comma-separated-values) output report. I developed a spreadsheet that I use to try to tweak my basal rates, carb ratio(s), and insulin sensitivity(s). Now I can’t use it, because I can only get reports in pdf form.

that’s awful! I have downloaded CSV files many times, to view data in Excel. YIKES! (and the “exit auto mode to get a REAL correction” is insane. MM is going downhill, IMO. I’ve been on their pumps since 1996. Five models. Not sure I’ll stick with them for the next one.

Have you tried this workaround? (assuming there is still a data table of sorts to export) How to import a table from PDF into Excel | The Economics Network

I’m going to see if I can get a report of out of the downgraded Carelink, that will show what I used to get in a CSV.

EDIT: there is no report to get to the data that we used to have access to. AAARGH! I’ve been on hold w/ MM for 12 minutes so far…

EDIT 2: wow. tech support is so swamped, someone came on the line to see what I wanted so they could summarize and “someone will get back to me”. Don’t even know if it will be today. MM support is going DOWNHILL!

We have had the technology to build a closed-loop control system that can effectively regulate blood-glucose values for about 15 years now. The bozo engineers at Medtronic need to hire some real control-systems and instrumentation engineers. I’m an Electrical engineer, and I am appalled by the software, control-algorithm performance, and hardware on these designs.

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So which company in your opinion is going to come out with the dream machine? I hopped on board because I needed the control now and I’m getting it on the 670. I think a lot of their “designs” in the Automode were concessions made to the FDA, but they came out with it last year and we can buy it right now. Everyone else just says “it’s coming.” I don’t think there is a bad pump company out there. They all seem top notch. Have you researched who is coming out next with a closed loop system?

Jess - I have been scouring the forum for you experience and you hit it. I dont understand how to give bolus using the pump when I need to bring a high BG down. The pump recommends some crazy value that is 15% of what I normally would take. So as a result, I create a phantom carb. I did just read that I need to exit Automode to correct the high BG. Has this been your work around? I also read others suggest to adjust to your active insulin time from 3 to 2.5 hrs and so forth. So far I’m not impressed but I hav only been using automode for 1 weeks now. Any suggestions?

Of the two parameters you can adjust in auto, AIT and I:C ratio, AIT seems to be the most powerful in making the pump more/less aggressive about correcting highs. In my case I dropped it all the way to the minimum (2hrs) and it did make a difference, though I still struggled with controlling DP and keeping my overall numbers in the range I was used to before going on the 670. Other people increase AIT because they find they’re running too low, so it isn’t the same for everyone.

Definitely too soon to make any final judgments. People who have found it works great for them almost uniformly say it took ~3 months or more before it started to seem like it was getting dialed in right. OTOH I gave up after six months, so as always YDMV.

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The Carb Ratio and Microbolus are unrelated. The Carb Ratio(s) are used when determining how much to do for anything you eat (the carbs), but the Microbolus(es) are used when attempting to keep your numbers level. The Microbolus(es) are often referred to as a basal that is continuously & automatically adjusted basal, and if you have ever used a pump that does not have Auto Mode (or an equivalent feature), you will know that the basal does not change regardless of how many carbs you enter. When you are high, you will receive larger microbolus(es), but not nearly as much a correction bolus would. The microbolus(es) do, however, factor in the Active Insulin, so if you have more Active Insulin (whether from a correction bolus, meal bolus, or both), your microbolus(es) will obviously be smaller.

Yes, as I said in the comment you’re quoting, that was the official answer I got from my trainer, back when I posted this, but there were a number of experienced users who were claiming otherwise, hence my uncertainty at that time.

Re microbolusing: it’s sufficiently different from a basal in a standard pump that the analogy is almost more confusing than helpful–or at least I found it to be so. Auto Mode required a whole different way of thinking about things, part of the learning process. Still didn’t end up working for me, though.

Ive bolused for “phantom carbs” many, many times. Its alot less work than going out of auto mode, bolusing, going back into it. IMHO. I do however bolus LESS than I would off of the 670G because I know my basal will be increased during highs, so I take that into consideration.