ButDoISay

My Life on the Medtronic MiniMed 670G Insulin Pump and More.

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How Do Guardian/Enlite CGM Sensors Work?

Continuous Glucose Monitor

Continuous Glucose Monitoring (CGM) sensors are finicky, expensive and we all know of how much of a process it is for Medtronic to replace faulty sensors. For me, changing Medtronic CGM sensors is a ritual I do not look forward for many reasons. Getting my sensor inserted and working correctly seems to be a hit-or-miss proposition.

But the delicate nature of sensors is due to the fact they are miniature electrodes that are affected by small changes in the environment around them including small movements or presence of interfering chemical substances.

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For Manual Mode Basal Settings are Everything

Importance of Basal Settings

After nearly giving up on my pump, I found the very popular book by Gary Scheiner, Think Like a Pancreas: A Practical Guide to Managing Diabetes with Insulin. (Amazon) – I think this is a must-have book for people who want tight control of their glucose numbers.

At this point I had uncontrolled, severe hypoglycemia. With a new-born baby, this was not just a drag on my life but it was a bit dangerous. I do not know how many gallons of orange juice I drank to counter lows.

I had also not paid attention on the importance of fine tuning my basals. I was using a single basal which gave me big lows at night and when I was doing practically anything that needed me to expend a little energy.

Since many new pumpers are coming from a combination of short acting and long acting insulin injections, the idea of basals is a little foreign as compared to bolusing.

I think educators need to spend a little more time on talking about how basals are the foundation of successful pump therapy.

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Tunable Settings in Auto Mode for the MiniMed 670G

Tuning Auto Mode for the Medtronic MiniMed 670G is just like tuning an engine. Changing one setting throws off the other settings

Getting Auto Mode settings just right seems to be a balancing act – more fine tuning than just dialing settings up or down

When it comes to Auto Mode for the MiniMed 670G, tuning the settings to get as close to your sugar targets feels a little more complicated as compared to the manual mode. This is because the closed loop system has a feedback mechanism which will likely throw-off one setting when you change another.

In the course of your day, the system is performing a balancing act between bolus and basal to keep you as close to Auto Mode’s fixed and preset BG target of 120mg/dL by introducing a third input – the micro bolus.

When it is all said and done, the user has control of  two settings only, namely Carb Ratio and Active Insulin time.

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How often Do I Change my Infusion Set?

I have used the MiniMed Quick Set Paradigm infusion set for the last couple years. Medtronic recommends that one changes their infusion set every 48-72 hours.

I am the kind of person who questions why I have to do an oil change every 3000 miles and not 5000 miles but think for the 670G it is important to follow these guidelines.

Any blockage on your infusion set and subsequent high glucose readings will most likely throw Auto Mode and it will take hours before you can go back into Auto Mode. This is such a pain especially in the middle of the night since you will also receive a barrage of notifications to rectify the situation.

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