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Auto Mode Medtronic MiniMed 670G Pump Settings

Spike Control is Auto Mode’s Biggest Weakness for the 670G

Now that I have been using Auto Mode for the Medtronic MiniMed 670G for the last one-and-a-half years, I can say that spike control is one of the major weaknesses of this closed loop system.

Auto Mode does a decent job of controlling BGs for low to moderate glycemic index foods. But for high glycemic index foods, the pump struggles because of inherent Auto Mode safeguards.

As a safeguard against hypoglycemia, the pump pauses basal and microbolus delivery following meal bolus delivery for close to thirty minutes. This makes it very hard for the pump to catch up with a meal related BG spike.

In the photo snapshot, as soon as I bolus for my breakfast comprising a cup of tea and a piece of toast, there are purple dots dissapear for close to thirty minutes (purple dots signify every time the pump dispenses a microbolus or basal dose).

As you can see, there is a period of close to thirty minutes (green box) where the pump does not dispense microbolus or basal dose. In cases of high glycemic index foods, the MiniMed 670G cannot catch up with the runaway BG numbers.

According to Medtronic, this period of no microbolus or basal delivery is needed to determine the BG trend after meal bolusing.

Even though the pump resumes microbolus and basal delivery, it is too late and the BG spike is inevitable.

Waiting longer than the 5-15 minutes before eating recommended by Medtronic somewhat helps. But it is still hard to recover from 30 minutes of no insulin delivery.

The reason manual mode is so good with spike control as compared to Auto Mode is because manual mode allows for a good balance between bolus and basal. The user can be able to adjust the basal does just right to assist the meal bolus counteract BG spikes.

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Guardian 3 Sensor Transmitter Guardian Sensor Medtronic MiniMed 670G Medtronic Oval Tape

Use Tegaderm Film in place of the Medtronic Oval Tape for the Guardian 3 or Enlite CGM Systems

Tegaderm Film to the Rescue

When I run out of the oval tape that comes with the Guardian 3 Sensors for the MiniMed 670G, the Tegaderm Film by 3M comes in very handy. I used these films for my Enlite sensor and the Medtronic MiniMd 530G.

The oval tape is a little complicated for me that I end up peeling the wrong side or get it all tangled up before applying it on my skin.

It seems as if I end up using an extra one during insertion and running out of the oval tape the tail end of my 3 moth supply.

Tagaderm Film by 3M purchased on Amazon

The Tegaderm Film comes in different sizes and works well in covering the sensor and making it water proof just like the oval tape.

This summer I tested out two sizes bought at Amazon.

The larger size Tagaderm film (4”x43/4”)worked well for when I had to jump into the pool with the kids but it covers such a large area.

I liked the assurance that the sensor was completely waterproofed over a large area.

With the larger Tegaderm Film you certainly do not need apply extra tape under the Transmitter.

The smaller sized Tegaderm Film (2.375”x2.75) fits the same as the oval tape.

The only downside to the Tegaderm Film is that it will peel off if you do not apply it firmly to your skin.

The films can be pricey at local Pharmacies but you should get very reasonable prices (no more than $.50 per tape) on Amazon or Ebay.

Categories
Auto Mode Guardian Sensor Medtronic MiniMed 670G

A year Later – Success with Auto Mode

Exactly a year ago on this day, I met with my diabetes educator for my Medtronic MiniMed 670G training. Two weeks later I started using Auto Mode.

Along the way, I started documenting my journey on ButDoISay, nearly gave up on Auto Mode and certainly drove my endocrinologist crazy by constantly changing my delivery settings.

Her very words during our last appointment were: “Why change something if it ain’t broken”

Since we have a good rapport my answer was “You know, the scientist in me pushes me to fiddle with the settings. Right?!” And she just laughed.

Finally 100%. I took a year but I think am getting there
Time in Range is 91% in the last 7 days

Fittingly, yesterday for the first time I was 100% in Auto Mode and 100% in Target Range. Woohoo! I just can’t believe how the algorithm has learned my sugar basal rhythms in the last one year.

But seriously, the last year was also a very stressful year for me. Our youngest daughter was diagnosed with Autism at the start of 2018 and my life was completely changed. All of a sudden I started noticing all the missed milestones and my schedule was now filled with Autism parent training, speech therapy, and occupational therapy appointments.

However, the most stressful thing for me was not being ready to accept that my daughter was fine in her world and I am the one who needed to change to make sure I gave her the love and support that she needed to navigate around my world.

One thing though I did not have to worry so much about was: Do I have the correct basals set to deal with the stress and emotional roller coaster that came with our daughter’s diagnosis? This is quite liberating and freeing.

AUTO MODE TO THE RESCUE

Through this time, Auto Mode worked like a champ and I can undoubtedly say it has done a better job of adapting to all the stressful events of 2018 than I would have done if it was left to me in Manual Mode.

I no longer have to worry so much about lows when taking my daughters to two separate schools or doing yard work. (I had been diagnosed with uncontrolled severe hypoglycemia in 2013 when I got my first pump. I am also a late onset Type 1)

Despite Auto Mode’s many shortcomings that could keep you awake all night, I am glad that I never gave up.

WITH AUTO MODE PATIENCE IS KEY

This is my advice: If you are thinking of giving up on Auto Mode because of all those highs that you can’t seem to control, just give it time. For me it has taken close to a year to finally get to where I am comfortable with my numbers.

The Auto Mode algorithm seems to be more adaptive than I even thought. And the more data you feed it, the better it will become.

 

Categories
Guardian Sensor Infusion Sets Medtronic Contour next Link 2.4 meter Medtronic MiniMed 670G

The perfect storm – pizza, sensor change, and a kinked infusion set canula = readings out of this world!

 

The Perfect storm. New infusion set, sensor, and pizza.

Lesson I learned: At the beginning of sensor life, it might not be a good idea to only depend on sensor readings only.  Also, probably not a good idea to change the Guardian sensor, infusion set and eat pizza close together!


Last night, I had what I would call a perfect storm where I replaced my sensor and infusion set and then ate pizza. Unfortunately, my sensor did not catch up with a sharp rise in blood sugar since it had not stabilized. I only caught the high sugar readings when I checked my meter Blood Glucose (BG) reading.