MiniMed™ 780G system review: Jaime’s first 30 days

MiniMed™ 780G system review: Jaime’s first 30 days

Three days I will never forget

I’m Jaime, a Medtronic Employee who’s been living with type 1 diabetes since I was three years old and wearing an insulin pump for the last 20+ years. Over the years, it's very easy to get lost in the countless blood sugar checks, numerous sensor changes, and daily management of a disease like type 1 diabetes. It's a blur of juice boxes, juggling insurance claims, doctors’ appointments, pharmacy runs, tears, waking up in the middle of the night covered in sweat, laughter, mental math, pump alerts, triumph, calloused fingers, workouts, strength, and glucose tablets. But in the last 20 years, three days stand out. Three days I will never forget. Three days when I truly felt hopeful about my diabetes. And three days where I had a sense of relief that I now have something in my corner of the ring as I put on the gloves and fight this disease. 1. My very first day on my MiniMed Paradigm 512. 2. My very first day on the MiniMed 670G with Auto Mode. 3. The day I did a remote software upgrade to the MiniMed 780G system. So, I’m very excited to share my experiences with the MiniMed 780G system — the highs and the lows (see what I did there?)!  

What I love about the MiniMed™ 780G system

The theme you will notice throughout my MiniMed 780G review is that I’m achieving the best control of my life with the least amount of brain power, effort, and exertion.

The software update was super easy to do.

I feel like if you can do an iOS update on your phone, you can do a software update for your pump.  And that’s coming from someone who wouldn’t exactly classify herself as tech-savvy. After I completed my online training, the software update process was really easy to follow.  Medtronic even sent out a nice software update guide brochure to follow which came in so helpful (I’m a visual person). It took me about 2 hours to do and then I had my MiniMed 780G system up and running.

The results are amazing!

I typically achieve a good Time in Range (TIR), but I can only do that when I’m firing on all cylinders. This means accurately counting carbs, pre-bolusing, hitting my activity levels, doing countless fingersticks, and eating a fairly low-carb diet. With my new system, I’m reading an increase in TIR!  The best part is that it’s EASY for me to do it on a daily basis.  I can consistently do it, and depending on the day, I might be knocking it out of the park. Then other days where life gets in the way, and my diabetes management takes a temporary backseat, I can still come in healthy for the day.

I got my sleep back.

Nighttime used to be a struggle for me.  I would worry about going low or would struggle with extreme fatigue due to being woken up by pump alarms. I would also proactively eat a snack right before bed to avoid lows and then struggle to stay in range while I slept.  And then in the mornings I would struggle with dawn phenomenon—skyrocketing to the mid-200s. Utterly exhausting. My night times are much more peaceful now. SmartGuard™ technology has my back—dosing quietly in the background so I can get some sleep.  I can confidently turn the reigns over at night and am so happy to wake up in the mornings in range!  It’s an awesome feeling to look at my overnight graph now and see a fairly straight line—I used to be so jealous of people who could do that!  The frequency of alerts/alarms has also dropped dramatically—I’m sleeping through the night and waking up rested and refreshed.  Another bonus: even my husband mentioned how much better he is sleeping now that I’m in range at night! #GetItBack

No calibrations when using the Guardian 4 sensor with SmartGuard technology.

My fingertips have never felt so good.  Excluding the one fingerstick I have to do each week when I change my sensor to get into SmartGuardmode, I do not have to check my blood glucose nearly as often as I used to.** Overall, I’ve found the Guardian 4 sensor to be accurate and I feel confident trusting it to do its thing. I will do an occasional finger check before I work out or before bed just to confirm, but that’s honestly more out of habit.

I feel stable.

I’m the type of person with diabetes who has a lot of blood sugar fluctuations based on stress, activity levels, and hormones.  I would constantly be chasing a high spike right before I presented in a big meeting at work or chasing a low after a gym workout.  The constant ups and downs were exhausting — mentally and physically. On the MiniMed 780G system, I’m really only interacting with the pump when I’m setting a temp target for my workouts or I have to step in to fix an unexpected low.  The pump is quietly giving me little tiny corrections in the background, bringing me gently back into range. It’s adjusting to cover me when I occasionally miscount carbs.  It’s adapting for my weird slight spikes I get when I lift weights.  I’m seeing more straight lines on my graph than I have in my life. 

The mental load of diabetes has been lifted.

It’s definitely not gone—but it’s drastically lifted.  The amount of time, energy, worry, stress, and attention I have to attribute to my diabetes is so minimal now.  I used to say that diabetes is the first thing I think about when I wake up and the last thing I think about before I go to bed….and that’s not the case anymore.  I’ve got the mental capacity, time, and energy to focus on other things—finally writing my book, running a 5k with my daughter, and planning our much-needed home renovation.  

What I wish the MiniMed 780G system had

I’ll call these my “wish list” items. As I considered my MiniMed 780G system review, these are the things that I wish it had or had the capability to do.

Arm insertion is challenging if you are by yourself.

I need to have my husband on deck every Sunday to help me insert my sensor in my arm.  I’m just not flexible enough to do it myself and lack the dexterity in my hands.  That can cause a bit of a scheduling struggle when one of us goes out of town, so I’d love an easier insertion process.

Learning to manage exercise is a little tricky when you first start on the system.

Full transparency, I didn’t use the Temp Target feature consistently before for my workouts.  I would normally just eat a snack to get me through the workout or pull back the amount of insulin I would take so I didn’t have too much insulin on board.  With the MiniMed™ 780G system, I realized very quickly that I had to use the Temp Target, or I found myself going low during my workouts.  It was a challenge some days to remember to do it in advance and to get the timing right depending on the type of workout I was going to do.  I’m still in a trial-and-error phase right now, but I’m seeing a slightly better result this week than I did when I first started.

Deliver a bolus from the app.

I would absolutely love it if I could bolus from my phone app.  Or clear alarms!  This would amazing, especially when I’ve got my pump discreetly tucked away in my clothing.  Anytime I do have to interact with my pump, I have to pull it out, so engaging with it via my MiniMed Mobile app would be much easier.    

I’d love both the pump and the sensor to be smaller.

There was no design change with either component. They both can feel slightly bulky at times.   I hope this MiniMed 780G system review helps you, and if you have any questions about my experience on the system, drop them below!   UPDATE — For more system reviews, check out:

 

** Fingersticks required in manual mode & to enter SmartGuard. If symptoms don’t match alerts & readings, use a fingerstick. Refer to user guide. Pivotal trial participants spend avg of > 93% in SmartGuard.

MiniMed 780G system with SmartGuard technology with Guardian 4 Sensor

The MiniMed 780G system is intended for continuous delivery of basal insulin at selectable rates, and the administration of insulin boluses at selectable amounts for the management of type 1 diabetes mellitus in persons seven years of age and older requiring insulin as well as for the continuous monitoring and trending of glucose levels in the fluid under the skin. The MiniMed 780G System includes SmartGuard technology, which can be programmed to automatically adjust insulin delivery based on the continuous glucose monitoring (CGM) sensor glucose values and can suspend delivery of insulin when the SG value falls below or is predicted to fall below predefined threshold values. The Medtronic MiniMed 780G System consists of the following devices: MiniMed 780G Insulin Pump, the Guardian 4 Transmitter, the Guardian 4 Sensor, One-press serter, the Accu-Chek Guide Link blood glucose meter, and the Accu-Chek Guide Test Strips. The system requires a prescription from a healthcare professional. The Guardian 4 Sensor is intended for use with the MiniMed 780G system and the Guardian 4 transmitter to monitor glucose levels for the management of diabetes. The sensor is intended for single use and requires a prescription. The Guardian (4) sensor is indicated for up to seven days of continuous use. The Guardian 4 sensor is not intended to be used directly to make therapy adjustments while the MiniMed 780G is operating in manual mode. All therapy adjustments in manual mode should be based on measurements obtained using a blood glucose meter and not on values provided by the Guardian 4 sensor. The Guardian 4 sensor has been studied and is approved for use in patients ages 7 years and older and in the arm insertion site only. Do not use the Guardian 4 sensor in the abdomen or other body sites including the buttocks, due to unknown or different performance that could result in hypoglycemia or hyperglycemia.

WARNING: Do not use the SmartGuard feature for people who require less than 8 units or more than 250 units of total daily insulin per day. A total daily dose of at least 8 units, but no more than 250 units, is required to operate in the SmartGuard feature.

 

WARNING: Do not use the MiniMed 780G system until appropriate training has been received from a healthcare professional. Training is essential to ensure the safe use of the MiniMed 780G system.

WARNING: Do not use SG values to make treatment decisions, including delivering a bolus, while the pump is in Manual Mode. When the SmartGuard feature is active and you are no longer in Manual Mode, the pump uses an SG value, when available, to calculate a bolus amount. However, if your symptoms do not match the SG value, use a BG meter to confirm the SG value. Failure to confirm glucose levels when your symptoms do not match the SG value can result in the infusion of too much or too little insulin, which may cause hypoglycemia or hyperglycemia.

Pump therapy is not recommended for people whose vision or hearing does not allow for the recognition of pump signals, alerts, or alarms. The safety of the MiniMed 780G system has not been studied in pregnant women, persons with type 2 diabetes, or in persons using other anti-hyperglycemic therapies that do not include insulin. For complete details of the system, including product and important safety information such as indications, contraindications, warnings and precautions associated with system and its components, please consult https://www.medtronicdiabetes.com/important-safety-information#minimed-780g and the appropriate user guide at https://www.medtronicdiabetes.com/download-library.

 

 

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I use the 670g with auto mode and maintain a TRI in the 90+ percentile. Woo-hoo! However, I would love the 780g to smooth out this scenario: The 670 always totally stops basal delivery for up to 4 hours after a meal bolus. I'm then functioning on bolus only, which leads to blood sugar rising from excellent to meh, or even a bit too high, especially at bed time.
Would you be willing to share whether you have your 780g settings at the recommended 2 hour active insulin time and target of 100? Also, what do you see as the amount of and duration of delivery of basal, (aka maximum basal limit), before auto corrections start delivering? I'm a bit concerned that I won't get correction doses when I'm lacking hours of basal delivery.
Thanks

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Hi, JoAnn! My doctor prescribed the recommended settings for me--2 hours for active insulin time, 100 for my target and auto corrections are on. I find if I pre bolus, the system is able to head off the bulk of my post meal highs and then make adjustments with the basal delivery and auto corrections (especially if I miscount carbs!)

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Thank you Jaime, for sharing your challenges and experiences with diabetes and insulin pump therapy, and for being open about all your ups and downs. Your struggles sound very similar to mine! I've been somewhat hesitant to upgrade to the 780G system, but I may try it sooner rather than later based on what you've shared. Thank you!

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So happy to have helped you, Jennifer!

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Thanks for your review.
I too have found the upgrade incredibly helpful towards reaching an improved TIR. Love the lower target blood sugar! Definitely recommend for tighter control, lower A1c, and greater TIR with fewer highs and lows. Amazing upgrade!!

Thanks for sharing your experience, David!

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Thank you so much , Jaime!
Reading your review and hearing you describe the daily “ups and downs” of T1D was moving. I felt seen. It is a rarity that I get to talk with another T1D, someone who walks what I walk.
I have struggled greatly with dawn phenomenon and harsh ups/downs when trying to workout. It truly is exhausting and discouraging.
So thank you for sharing and for the honest review of the 780g. I look forward to my upgrade Here’s to our healing journey!

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And thank YOU so much, Shawnda! I am happy that this review helped you and I hope that you enjoy your upgrade!

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Thank you for sharing! Exactly!! Totally agree with your opinion!

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Happy to help and share, Terri! Thanks for reading.

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Thank you Jaime! I have been using the 780g and the Guardian 4 for a little over a week now and can relate to your views. I also agree with your wish list. I was a little hesitant to start using a sensor again--I used the guardian a couple of years ago, but it became more frustrating than helpful. But, knock on wood, this system seems to be much improved and is working well for me. Fingers crossed it stays that way! :-) Best of luck to you and thanks again for sharing your story.

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Best of luck to you, too, Bonnie!

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I am using the 770g pump with Guardian 3sensor in manual mode and achieve great results with 98% in range. How would the upgraded 780g pump and guardian 4 sensor be different in manual mode?

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Hi, Marc. There are a few differences, actually. The 780G system has Meal Detection technology that provides automatic adjustments and corrections to sugar levels every 5 minutes. When used with the Guardian 4 sensor, there are no fingersticks with SmartGuard technology. The new system also allows you and your healthcare provider to choose among 100, 110, and 120 mg/dL sugar targets to offer more flexibility in your diabetes management. Take a look at the 780G website and see if this might be a good option for you: https://bit.ly/3osnId4

Thanks!

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Thanks for your review. It is very helpful from someone who has been a diabetic for a long time like myself to hear their input. I like it because it is real life and not theoretical.

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You're welcome, Joseph!

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Ok thank you

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You're welcome!

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Thank you Jaime for your review. I have been on the 780 for about 3 or 4 weeks now and I love it!! The issues you brought up were exactly the same ones I faced - a lot of alarms all night long. I agree with all of your suggestions about remote bolusing and different sites. I have an issue with the oval tape irritating my skin and this leaves ugly redness and bruising on my arms. Thanks for sharing it helps us feel "not so isolated".

Luellen

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Glad to hear that you love the 780G too!

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Great review Jaimie
I upgraded from 670 to 780 three weeks ago and I agree with you.
Hope Medtronic is listening and they do something about the size and the app
Overall I love my new pump

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Thank you! Happy to hear that you love it too!

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I feel Jamie hit the nail on the head. Her story is also my story. I have also been on a pump for 20+ years. I cannot believe the difference with the 780g. I will say I did have a habit of trying to do the pumps work at first. Hard to break old habits. once I let the pump do its job I have felt more relaxed.

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Giving over control to the pump and the algorithm can be a challenge but worth it in the end!

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All the information I have received so far will be very helpful in my making the decision to use the 780 G system. However, I am afraid I will have significant issues with using my arms as the insertion site for the sensors and all my past years, I have used my abdomen, and I may or may not be able to use my arm during each sensor usage.

My question is will it be imperative that I use my arms and not my abdomen for Sensor insertion? I am afraid this will be a dealbreaker, and I will have to wait another four years, for my ability to change systems to another manufacture.

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The arm insertion can be tricky at first. But the best performance was observed when the sensor is used in the arm. For safety reasons, the system is indicated for use in the arm.

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If I am unable to manage the arm insertion‘s for the Sensors, what are my alternatives and using the 780 G system or will I have to go back to no Insulin Pump?

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Hi, Chuck. I would recommend bringing this concern up with your doctor. They can assist you with options. Thanks!

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The 780g pump is very nice with built in features for ease of use.

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I agree! Thanks for sharing!

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What a great story. I am 1 month on new pump 780g with sensors. I love it. My pump doing all the job, I am almost free of thinking of my diabetes. Thank you for sharing your story.

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So happy to hear that, Margaret!

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Hi Jaime

Beautifully written and I’m sure that many of us can relate to the experiences you have undergone for the last 20 years.

One of the biggest changes and joys of the new 780 software is that the need for finger sticks so many times per day at the most inconvenient times (driving, sleeping, etc) is now a thing of the past. In addition, as you mentioned, waking up with good BG values I now just take for granted.
I do agree that our phones should be able to bonus, correct, or do other functions without having to go to the pump all of the time; I’m sure the FDA is most likely preventing that (my guess only)
Thanks for sharing.
Allan

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Thanks, Allan! Having no calibrations with the Guardian 4 sensor made a big difference for me.

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Jaime,

Thank you for your review. I have been on insulin pump therapy for over 41 years of my 46 years on insulin. I have been blessed. When I went on the 770 two years ago I was told about the 780. On 5/15/2023 I signed up for the 780. Yesterday (9/6/2023) I got the “call” from Medtronic that my upgrade has been approved. I have read so much about it that I was already looking forward to and anticipating getting the upgrade but your review is wonderful for this longtime pumper. My wife has had less worries the last 2 years but I anticipate even less with the 780.

Thanks again for your review,

John C. Rich

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So excited for you to experience the 780G soon, John! Happy upgrading!

Jamie, Thank you for a very thorough and honest review of the 780G system. My experience with it is very similar to yours. Overall I am very pleased with how well it is working. Yesterday I had some issues with the G4 sensors that resulted in wasting two and leaving me without any. Fortunately I still have my G3 transmitter and had one sensor, so I’m temporarily making do with that. I will call technical support today to try to resolve the issue. I know I’m not alone in running out of sensors when problems arise. The guidance that sensors last up to seven days leads doctors and insurers to prescribe it for seven days. Often the system directs me to change it on day five or six and I end up short. I wonder if it could be remedied by allowing for changes every five or six days.
Thanks again for your support and helpful comments.

Thanks for sharing, Catherine. I can share this feedback with our team!

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Jamie, can’t wait will get my 780G this week. I’m operating at 95 % in auto and 75% in target. This should be fun can’t wait.

Richard

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Great job, Richard! I hope you love the 780G!

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The sensor placement is concerning. What if you live alone and have no one to place/TAPE to the back of upper arm? Or, if a significant other is not always well enough to do that work? Makes one begin to rethink the 780.

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That's understandable, Wayne. I'm very lucky that my husband has been able to assist me but I do know others who are able to complete this without help.

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I agree on all topics. I have learned to use the MyFitnessPal app which seriously helps. No thinking about how many carbs I’m consuming. I can put my recipes in the app so I know exactly what I’m eating and how many carbs, calories sodium etc. etc. I’ve only had my update since yesterday but so far I’m loving it! :-)

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That's a great suggestion, Cathy!

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May I ask if your A1c has improved? I have the upgrade ready to go but haven’t yet done the training. I’m a little nervous about it (probably because I don’t fully understand it) but your above review has made me feel more confident…thank you!

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I'm glad that my review helped you feel more confident! While I don't have new A1c data to share, I have noticed an increase in my time in range!

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I totally agree with everything you said. I love the upgrade. exercise is still a moving target for me. I need to start using the temp. target feature. I tend to go low during the night sometimes but maybe my endo can help with that. Happy with the updates.

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Yes, the temp target is a great tool to use. Your endo might have other suggestions, too. I'm glad that you are loving your upgrade!

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Jamie- I am struggling with single 780 issue!
When I need corrective carb, AM wizard calculates an additional insulin dose.
WHY would 780 algorithm add insulin when my BG is below 70?
David H

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Hi, David. In general, it is important to log carbs into the SmartGuard Bolus feature in order to keep an accurate accounting of carbs, but in special cases of rescue or corrective carbs consumed, it is safer to not enter these carb and thereby reduce the risk of potentially delivering a bolus when it's not needed. Only enter carbs that you need to bolus for. There is no guarantee that the safety features in the MiniMed 780G SmartGuard Bolus feature will reduce the bolus to zero. I hope this helps!


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