I can’t imagine life without it

Nalani has been living with type 1 diabetes since she was 8 years old and started her first insulin pump at 10 years old. She started on the MiniMed 670G system two years ago and today talks about how the system has impacted her life. 

While the MiniMed 670G system has been available for the past two years in USA (from June 2019 in South Africa), we have received a lot of questions on the experience of those using the system. Today, I’d like to introduce you to Nalani, a physician assistant in California who dedicates her life to helping others with diabetes.

I’ve recently been thinking about how much I love my MiniMed 670G system. When I say that I love it, I mean that I can’t imagine my life without it.

I have always had very good control. Before starting the MiniMed 670G system my A1c level was 5.8%. I had pretty steady blood sugars (BGs) and liked to run them between  3.9 to 5.6 mmol/L as often as I could. I have always been more afraid of the highs than the lows because I worry about complications, but because I was running my glucose so tight, I was experiencing a significant low at least once or twice a week. I live an active lifestyle, have an incredibly demanding job, and the struggle to keep my BGs low, but not too low was difficult.

When I first started the MiniMed 670G system I was frustrated because my glucose was always - around 5.6 to 8.3 mmol/L, which was WAY too high for my comfort. There were many times that I wanted to stop using SmartGuard Auto Mode so that I could have my  3.9 to 5.6 mmol/L back. Instead, I decided to stick it out, and I’m so glad that I did.

After 3 months I retested my A1c and it was 6.4%. I was thrilled! Not only was my A1c still at goal, but I was not having any* lows. I have been on the MiniMed 670G system now for over 2 years and that 6.4% was the highest A1c that I’ve had. Not only that, but my lows are essentially gone, and my glucose is much more stable.

I initially struggled with alarm fatigue due to the frequent BG/calibration alarms, but being in Auto Mode was worth it. Thankfully, Medtronic now has an enhanced Guardian Link transmitter and most, if not all, of my unnecessary alarms have been eliminated!

The MiniMed 670G system has given me a lot of things back. I have had diabetes for basically my whole life and didn’t even realise how frequently I was thinking about my glucose, making small pump adjustments, or eating little snacks to try and avoid my hypos (I’m a micromanaging diabetic). Starting on the system was the first time since I can remember that I have been able to sleep through the night. I can now exercise, clean my house, and go dirt biking without fear of low BGs.

I can’t believe how lucky I am to wear this amazing product. Now, let me tell you a bit about the technical side.

Auto Mode uses a special algorithm to continuously modify the amount of insulin given by the pump. This small spurt of insulin, which is recalculated by the algorithm every 5 minutes, is dependent on the user’s sensor readings, and augments the pump’s basal feature while in Auto Mode. This algorithm targets a sensor glucose of 6.7 mmol/L (can be adjusted to 8.3 mmol/L during exercise) and readjusts its settings every night at midnight based on the previous 6 days of data.

It is important to remember that as with other pumps, the user still needs to input their carbs into the bolus calculator. Auto Mode uses the same carb setting for the bolus calculator in Auto Mode as it does in Manual Mode. You and your clinician will need to work together to come up with your appropriate carb factor. Correction boluses are calculated by the algorithm and target the correction to a sensor glucose of 8.3 mmol/L. The algorithm then continues to use the micro-bolus feature to correct the glucose to the 6.7 mmol/L target.

Many of the patients I have seen in Auto Mode spend <1% of time in hypoglycemia!

As I mentioned earlier, the MiniMed 670G system has done wonders for me. It was an adjustment period and it took me a while to let go of control, but overall my experience with this pump has been amazing and I am truly grateful.