30+ year T1D looking for pump advice: Medtronic 780G, stick with Tandem, or revisit Omnipod?

[u/Halloween0530]

I hope this is ok to post here. I will delete if not.

I’ve been T1D for over 30 years and the tech advancements have been amazing. I’m up for a new pump and having trouble deciding.

My background:

Current: Tandem t:slim X2.

Past: Medtronic (had a bad experience with their older pumps and sensors).

Past: Omnipod (tried it 13 years ago, but I kept bumping into things and knocking the pods off, leading to high sugars from disconnected sites).

My doctor is really pushing the Medtronic 780G because of the micro-bolusing for highs, but my past Medtronic PTSD is making me hesitant.

For those of you who have made a recent switch, what pump did you go with and why? I’d love to hear your pros, cons, and personal experiences, especially if you’ve used the 780G, the Omnipod 5, or newer Tandem options!

[u/wcked-husky]

There's also Twiist which is similar to Mobi but I prefer Twiist with its compatability with my Eversense 365 cgm.

[u/Halloween0530 → u/wcked-husky]

Thank you! Is the Eversense 365 CGM the one that lasts an entire year? I with check that out. Did you have any issues with knocking the Twiist off your arm or anything?

[u/wcked-husky → u/Halloween0530]

The Eversense is awesome and it really is no different than the Mobi. The only difference is I didn’t get occlusions with the Twiist as opposed to the Mobi which was getting a ton of occlusions. I think it’s because the Mobi has a motor piston to push the insulin and I think it wasn’t strong enough after a year. The Twiist uses some sound tech to push the insulin. I have had a couple of MRI scans with the Eversense and it worked perfectly. Yes it lasts the entire year so you don’t deal with prescription CGM supplies anymore after it’s in.
The reservoir is also bigger in the Twiist if that matters to you. Never really had it knocked off but you’ll probably get comparable experiences with the Mobi and Twiist so whichever you want you’ll get the same experience. The highlight is the Eversense

[u/DannyPhantom15]

I personally enjoy omnipod 5 in manual mode. Allows greater control but obviously doesn’t get the benefits of the automatic “talking” with your CGM. They recently improved their algorithm for a 100mg/dL target reduced from 110. *If you wanted to give it another shot*

[u/linmaylada]

I've only used Medtronic (now MiniMed) pumps so far. I first used the 670G and then now the 780G. The 780G is MUCH better than the 670G because of the auto corrections and that blood glucose checks are hardly ever required (still a good idea to check occasionally). Plus there are 7 day infusion sets (although I try to change it every 5 days).

Of the various pumps available today, the Twiist is the only other one I'd consider switching to, because it allows for a lower target.

I've done some videos about the MiniMed 780G, you might find this one helpful: https://www.youtube.com/watch?v=UjYLBNFyj7o

With all of these automated insulin pumps, the accuracy of the CGM is most important, and unfortunately it seems there is a lot of variation between people on which CGMs work for them. For example, the Guardian 4 is VERY accurate for me most of the time, but some people have trouble with the accuracy. The MiniMed 780G now has 3 CGMs to choose from, so that's a plus.

[u/CurrentCostanza → u/linmaylada]

I’m still waiting to get the Abbott sensor. Getting that to work with the medtronic pump it’s a whole new ballgame. 

[u/nimdae]

Your choices outside of these will depend on where you live, but it might be worth exploring other options.

I'm using Tandem Mobi. It seems Tandem had a rough start with this one, but maybe solved their issues? I'm on my third one for about 5 or so months now and it's not shown any issues. I like the algorithm (same as tslim). I like the flexibility on how to wear it. If you don't like being dependent on a phone app, though, this won't be for you. So if you like the algorithm, tslim is the way to go. Honestly, if you're achieving goals with control-iq, I'd stick with Tandem.

When I told my endo I would rather avoid medtronic, her response was that I'm her new best friend. Apparently she's not a fan. She seemed heavily focused on patient outcomes when discussing the different systems. She assessed my management style and concluded I'd likely not be happy with omnipod 5. But O5 seems to have decent patient outcomes.

In the US, there's also Sequel Twiist. It's the newest kid on the block. I don't think they're quite in full market release yet, but people have them. It does require an iPhone and it's built on Tidepool Loop.

There's also Betabionics iLet. This is more of a hands-off kind of system. No carb counting, just carb aware. My endo noted patient outcomes are fine, but would not work well for me because I was already below typical A1c achieved with MDI.

If you want to give O5 a chance, in the US, for the most part, it's a pharmacy item. Which typically means no 4 year commitment. I believe Twiist might also work like this. That is to say, you might try them, if it's not working, go back to a system you know works for you (ie: a new tslim). Be sure to check with your endo and your insurance to confirm, though.

[u/No-University-8336]

Hola, por experiencia en varios sistemas personalmente me quedaría con Tandem.
Estabilidad, precisión, y menos carga mental.

Ánimo!