Tandem T.Slim X2 or Minimed 780G AID

Technology & Management
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Glad you are happy with TSlim/Dexcom/Control IQ. As I have had the 780g for over a year my experience refers to the 780g and not the 770g. The 780g works as I explained. The sleep and exercise targets weren’t mentioned because this is possible in both algorithms but C IQ has only one “normal target” and Smartguard with the 780g has three. Targets may be “customizable” on the TSlim but I would doubt that this is possible within C IQ and would have to be done as a manual setting (I may be wrong on this)

As you mentioned C IQ adjusts the basal rate (as with the 670g) and the 780g automatically calculates the basal rate as described in my post. In terms of the battery, I am free to use rechargeable batteries if I so wish so this point against Medtronic is irrelevant. For the sensor, I have had the Medtronic G4 since June of last year - zero calibrations, and I would put it up against the Dexcom any day - Dexcom does have 3 more days of sensor life. I think that Medtronic will likely stick with the 7-day sensor cycle (ST) to coincide with the 7-day extended wear infusion set.

Finally, I never said that the 780g is better but it is more flexible and the auto-bolus more assertive than Control IQ. We’ll see how Tandem responds in the next major release of Control IQ 2.0. Competition is a benefit to all T1s!

1 Like
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@tellblom
Martin, as you are in Europe I am almost certain that Medtronic is shipping the 780G with the new G4 sensor. I can attest to the performance of both the 780g algorithm and the G4 sensor that requires zero calibrations. You may also be able to get the new 7-day Extended Wear infusion set. Those that have it are now changing the infusion set and sensor only one day/week.

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You are indeed mistaken.

And, in case it needs to be said for the benefit of anyone reading this thread: The point here is not to “win” for one company/pump or the other. It’s to share accurate information so everyone can make informed decisions for themselves.

I use the T:Slim X2 with Control IQ. Part of Control IQ is setting up one or more personal profiles. Profiles can be activated automatically or manually. So you can have a nighttime profile and a daytime one and the pump will automatically switch between them at the hours you designate. You can also manually activate a profile by pressing a couple of menu buttons. Profiles consist of baseline basal rate, correction factor (how many units to give for how many points above the SG target), carb ratio (how many units to give per amount of carbs consumed), SG target, and insulin duration (how long the pump should estimate insulin will remain in your system). You must have precisely one profile active at all times for Control IQ to work.

You can easily copy a profile. You’ll be prompted to give the copy a new name. You can then adjust the variables on the copy as needed. So if you just want to change the SG target, you could copy your main profile, leave the carb ratio, etc. as-is, and input the new SG target.

So, yes. You can set your own SG target and it will work to set the variables for Control IQ. You can set up multiple profiles, each with a different SG target, and switch between them as you see fit.

You complained that you didn’t like the Tandem battery. I explained the two systems.

Medtronic uses a AA battery. These are readily available, but it’s highly recommended that you use a longer-lasting lithium battery (not rechargeable) or a rechargeable NiMH battery. All of which need to be purchased separately at your own expense. Batteries usually last a week for rechargeables or two weeks for disposables. If the pump determines that the battery level is low, it will stop functioning. Replacing the battery means removing the battery cap. The battery cap is a small plastic disc with a strip of aluminum glued to it. It’s easily fumbled, dropped, and potentially lost. The pump will not function without it. If anything happens to the aluminum strip, the pump will not function. Your life depends on the pump functioning. When the aluminum strip became detached from my battery cap, I was lucky that I was able to find the strip and glue it back in place without impairing funciton. I had Medtronic mail me a replacement cap and made sure to always carry a spare with me. I had the battery fail unexpectedly while I was out at a meeting, and the pump rejected both battery caps and the spare batteries I had with me. It took quite a bit of panicked fiddling before I got it working again.

The Tandem pump has an internal battery. It does mean you have to stay close to an outlet to recharge it on a regular basis. But it doesn’t take too long to do so. There’s no battery cap. There’s no additional expense. There’s nothing else you need to carry with you. The charge lasts for about a week, but you can top it up any time you like. I usually do so at around 50%. Eventually, the battery will lose its ability to hold a charge. But it’s been entirely reliable so far, and such batteries usually last several years. So I should be fine until I’m due for a new pump. However, should the battery fail, I would be stuck without a functioning pump until Tandem mailed me a new one. That’s more of a problem than simply replacing a AA battery, but it’s also not particularly likely.

Indeed it is. I’m glad to see both companies improving and learning from each other.

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@WearsHats I will admit that the possibility to create numerous profiles is currently an advantage of Control IQ. However, I still doubt that Control IQ operates with these personal settings. As with the 780g Control IQ and SmartGuard can “adjust” the basal rate and stop prior to lows but in Control IQ the auto-bolus is “stopped” in sleep mode and I would think that most “custom” profiles would only apply “outside” of Control IQ. With the 780g you can schedule the basal rate, carb ratio, and ISF over a 24 hour period and the AIT can be set to as low as 2 hours but there is only one setting that applies to AM and MM. Unfortunately, with the 780g these settings have to be set individually in separate parts of the settings menu and cannot be grouped as a profile. One “new” aspect of Control IQ that I have learned is that auto-bolus is active during the temp auto used for exercise. With the 780g auto-bolus remains active in what you would call “sleep mode” and the auto-bolus can be left on or turned off. When put in “temp target” of 150 the 780g turns off the auto-bolus.

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I’m telling you: personal profiles are integral to Control IQ. It won’t work without one. And I worked with my endo to set up separate profiles for sleep and wake specifically to use with Control IQ. And they do make a difference with Control IQ on. Even in conjunction with sleep mode. I don’t know how to make it clearer. Your bold assumption is wrong.

As for sleep mode: It does indeed turn off auto bolus. The idea is that you’re not going to be taking in any more food for hours, and it’s not worth risking a low BG. That said, it will more aggressively adjust basal rates to keep you to a lower and tighter range. In fact, I’ve unofficially been informed by a Tandem trainer that some patients find they have better control using sleep mode 24/7. On the other hand, sometimes I deliberately don’t turn on sleep mode when I go to bed on a full stomach. So I have that option, as well.

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Thanks for providing your experiences here. As a 770 user in manual mode, I look forward to trying the 780 and newer sensor.

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@WearsHats I read the manual again and you are correct that Control IQ uses the “active” profile so you are able to adjust the basal rate, carb ratios and ISF. However, you are not able to change your target of 110 except with sleep mode (112.50-120) and exercise mode (140-160) and no matter what you change the AIT to it will always be 5 hours in Control IQ. You also have to exit Control IQ before setting a temporary percentage adjustment of the basal rate. With the 780g both the ISF and basal rate are automatically calculated by the algorithm every five minutes - the relevant ISF is used by the SmartGuard bolus and auto-bolus, therefor there is no option to set either outside of the algorithm. In certain situations this could be seen as a “weakness” of the 780g algorithm. For example, after a cortisone shot I have to increase basal insulin to 200% for a few days. I find that the auto-basal can adjust up to 150% but beyond that I have to exit AM until I’m back to 150%. I suppose that with Control IQ I could have a higher basal rate set in personal profiles for such an event.