Medtronic Minimed 640G

Has anyone tried the Medtronic Minimed 640G pump? They say it’s like an artificial pancreas, because it will pause your insulin regimen when your blood sugar goes low! I am very interested but also hesitant. I have been using Omnipod, because it’s wireless and doesn’t rip off as easily. Opinions please!

What options are available to you at this time will depend in what part of the world you live. As far as I know, the 640G is only available outside the U.S. at this time. It might be available in the US sometime in 2016 … probably late 2016, but who knows?

Generally the feedback I have read for the 640G from folks outside the US has been positive. The things people tend to like are the color screen and the stronger support for it being “waterproof”. There is finally a volume control for the audible alarms which I think folks have been waiting for since, well, forEVarrrrrrr! :wink: While these features are “new” for a Medtronic pump, other pumps have had those features for a while.

The negatives I am aware of have not been anything which resonates with me so I’m not a good source of info for that. Apparently it may be slightly larger/bulkier than the 530G (aka Veo) or (earlier) Paradigm Revel it replaces. Also, it still does not support a touch screen interface. You still navigate the menus by using arrow buttons. To some folks this stuff is “a thing”. For me, not so much.

On its own, the 640G is no doubt a solid & nice enough pump. However, the feature of the 640G which in my opinion makes it unique, if only for the moment, is its support for predictive basal suspend and resume (PBSR).

They say it’s like an artificial pancreas, because it will pause your insulin regimen when your blood sugar goes low!

I can believe that Medtronic would say that. Medtronic is given to hyperbole in my opinion. However, a true AP (Artificial Pancreas) would also be able to automagically bolus for a meal and, in general, just not require much intervention from the person wearing it to maintain a pretty much flat BG (Blood Glucose) level. The 640G does not do that or even come close so I never refer to it as an AP.

Still, if you can enable PBSR and if the Medtronic CGM works well for you, then this feature can be very helpful. Some people really like this feature and are impressed by it. It is certainly what interests me most about this pump.

However … SmartGuard™, which is how the Medtronic marketeers felt compelled to refer to PBSR, can only be used if you are also able to use Medtronic’s CGM (Continuous Glucose Monitoring) sensor technology. There are two things to keep in mind about this.

The first is that it is/can be rather expensive, especially if you have to pay for it on your own.

The second thing to consider is that Medtronic’s CGM is often considered to be “less special” by the #DOC (Diabetic Online Community). More precisely some people seem to absolutely loath Medtronic’s CGM.

My personal opinion is that the truth is more that people’s experiences of this CGM can be extremely personal and vary widely. Some people have great luck with it seemingly from the first get go. Others have a hate/love relationship where the results vary from sensor to sensor. And of course there are also the haters.

hi @mrshale2114,

basal suspend is available on more pumps than the 640. it’s available, and in the US, right now on the 5## and 7## series.

just like @zjohnnyr said, for the pump to auto-suspend you will also need the integrated medtronic CGM. I have a 751, and like all pumps it generally works. I don’t always use the CGM but when I do it works fine for me. w/o the CGM, it would work the same as any other pump.

good luck!

basal suspend is available on more pumps than the 640. it’s available, and in the US, right now on the 5## and 7## series.

My guess is that @Joe is referring to the Medtronic 530G, the immediate predecessor of the 640G in Medtronic’s product line. I am not aware of another pump currently available from a different manufacturer which suspends basal.

There are two things about my understanding of the 530G (aka “Veo” outside the U.S.) I should mention. First, I’ve also never used that pump so anything I say is based just on what I’ve read. Second, based on what I read my reaction to the 530G/Veo has always been that it is an emphatically “meh” pump. By that I mean that as an upgrade from their Paradigm Revel, which I do use, the 530G is aggressively mediocre. In other words, meh.

My understanding is that the only significant difference between the 530G/Veo and the Paradigm Revel is the addition of the basal suspend. This suspend is a lot less sophisticated than what the 640G attempts to do. The 530G only stops your basal at a specified cutoff CGM value. The 640G is predictive and the suspend happens before you reach the cutoff so you are less likely to drop further. It will also restore the basal when your CGM readings rise. I believe the 530G simply waits two hours before resuming your basal, regardless of what your CGM readings might be. To restore the basal sooner than 2 hours the person using the 530G has to manually intervene.

In other words, the 530G’s approach was more of an emergency stop. While it was better (on paper) than what existed before, in practice it worked better for some than for others. Some people disliked how the 530G suspend worked so much that they turned it off.

That may also happens in some cases with the 640G, but so far the comments I’ve seen have been positive.

People using the 640G seem to intermittently have short-period suspends. In fact, while the prevention of a hypo while sleeping is usually the first benefit which comes to mind, people also seem to really like that it can side-step less serious hypos while they are awake. People have said that (if the hypo is mild enough) they don’t have to stop in the middle of doing a presentation or while driving or whatever to treat it.

You can set the 640G so that it does not alarm when it suspends and just allow it to attempt to “handle” a low on its own. If I recall correctly, a major irritation of the 530G was that it was not possible to turn off the audible alarms for the suspend. So you had to stop whatever you were doing and deal with the pump if it suspended. The 640G is not as intrusive.

While in theory I should be able to predict and stop hypos on my own with my current pump, in practice this just doesn’t happen reliably. Having a bit of automated help would be nice. But, of course, since I’m in the US it’s going to be a long time before it’ll be a possible option for me. And perhaps by that time other pumps will also offer this feature? We’ll see.

I’m in the UK and on the 640g. I started on it in May this year after being on the Veo for around 7 months. So far, I like the 640g a lot more.

There is no difference in size between the smaller veo and the 640g, although it might be a bit heavier? I haven’t really noticed. The clip isn’t as sturdy, which bugs me a bit but isn’t a deal-breaker.

It’s mostly just a more user-friendly pump. The colour screen makes it easier to see things in the dark and the set up onscreen is better (e.g. active insulin, basal and bolus are directly upfront, making it easier to input and change things. You can change your bolus speed, which I’ve found is handy for correcting highs. I also really like that the meter is set up to do manual and preset boluses – as a woman this is a nice feature when you’re wearing a dress and your pump is hidden! That little remote bolus keypad they have for the older generation pumps was a bit useless in comparison.

I’m not currently using the CGM, so I can’t say much about that. I am trying it out in a couple of weeks time, so I can check back in then to let you all know what it’s like. To be honest though, I think that CGM technology on the whole has a long way to go before it will be really useful as a means of regulating bloodsugars. The suspend feature on the 640g is nice in theory, but given that CGM readings tend to be quite a bit less accurate than blood glucose meters, I can see it being problematic sometimes. Since the pump has actually helped to stop nighttime lows for me, I’m more interested in using the CGM as a means of tracking my trends and adjusting my basals for more accuracy.