Medtronicâ€™s new 670G system for managing diabetes is exciting, indeed: it combines an insulin pump and CGM (continuous glucose monitor) with an algorithm to keep glucose in range. Itâ€™s dubbed a â€œhybrid closed-loop systemâ€ because it has both Auto and Manual Modes, but it is essentially the first iteration of what an Artificial Pancreas will eventually look like.
As a first-generation product, it is tricky to navigate for many new users. Weâ€™ve been fortunate to talk with a number of tech savvy PWDs (people with diabetes), including a few who work in the diabetes industry, to gather this rather detailed list of tips. These are not the â€œofficialâ€ recommendations youâ€™ll hear from the manufacturer, but rather real-world practical tips that come straight from the mouth of those whoâ€™ve used this new Minimed system.
If youâ€™re using or considering the 670G, you may want to print out this guide:
Manual vs. Auto Mode:
When you train on the 670G, thereâ€™s an initial 7-day period where you learn to transition from Manual Mode to Auto Mode. You should attempt to optimize your basal rates during this period. Also be aware:
Your â€œTotal Daily Basal Doseâ€ goes down in Auto Mode, in part because it is programmed to decrease your Auto Basal to aggressively defend against hypos. The decrease may also be due in part to:
- the more aggressive I: C Ratio
- the fact that many users input â€œfake carbsâ€ to drive their BG down from the correction target of 150mg/dL to the preset Auto Basal target of 120mg/dL, and
- the more you rely on â€œfake carbâ€ boluses to redirect corrections down to 120mg/dL, the less need there is for Auto Basal to facilitate these corrections
The normal pump setting for insulin action time is usually 4 hours, but with the 670G, it will probably go down to 3 to 3.5 hours. Be aware of this when inputting your setup. Specifically, the insulin action on prior pumps is typically set at:
- 4 hours for adult PWDs with normal insulin sensitivity
- 5-6 hours for pediatric PWDs or elderly type 1 PWDs who are insulin sensitive
- 3 hours or less for insulin-resistant PWDs
As noted, the 670G will aggressively defend against hypoglycemia while in Auto Mode. If you are using Manual Mode most of the time, a shift to Auto Mode will accommodate mild to moderate upticks in activity without a need to change your target BG from 120 to 150mg/dL.
For strenuous activity, you may need to change the BG target in Auto Mode to 150mg/dL and supplement with carbs.
One of our contributors to this list actually told us: â€œIâ€™ve concluded that being able to avoid frequent hypos is worth the hassle of managing all the alerts and over-notifications.â€
Hope this helps!
This content is created for Diabetes Mine, a leading consumer health blog focused on the diabetes community that joined ishonest Media in 2015. The Diabetes Mine team is made up of informed patient advocates who are also trained journalists. We focus on providing content that informs and inspires people affected by diabetes.