Switching from Tandem t:slim X2 to Medtronic 780g - Pros & Cons

[@TheCJOHNSON93]

I switched from the T-Slim x2 to the Minimed 780G last month. My BG is the best it’s ever been since I’ve been diagnosed in 2007. I had to do so much micromanaging with the T-Slim x2 to get even close to 90% TIR. SmartGuard is much better than Control-IQ for me. Control-IQ just can’t keep up with preventing highs due to the 1 hour limit. Sleep mode didn’t work for me either. So happy I made the switch 😊

[@barryreadeau9763]

I was diagnosed type 1 at 9 years old in 1966 pissing in a cup,putting 5 drops of urine and 10 drops of water in a test tube,dropping a tablet in tube fizzling to change too different colors to see what range my sugar MIGHT be in. I also remember my mom having to sterile glass syringe because there was no disposable syringes either. Started with Medtronic 502 in 1991 and had been on Medtronic pumps till 2021 when Medicare told me I had to start the Tandem t slim X2!!!! So used to changing out the Medtronic way and going to the Tandem way was rough and still don't like it. My last visit to my Endocrinologist he suggested going to the 780g and my Tandem warranty is up this coming August and hearing Medtronic is teaming with Freestyle Libre is even better😊

[@marionkirkham8576]

I remember the fizzy tablets! Diagnosed in 1969 at 1 year old.

[@poultrymom21]

Im 38 and type 1 since 1997. Im on the medtronic 780g and gardian 4. I love it! Works amazing and my a1c is great. Never had a problem with the sensors.

[@poodlebone]

Medtronic's first sensor came out as a stand alone unit. It did not communicate to their pump at the time. It had a large transmitter that attached to the sensor by a short cable. I met one man that used it, it wasn't a pretty setup! When they introduced their Paradigm models 522/722 in maybe 2006 (?) they were able to show the sensor readings on the screen but there was no algorithm. The next couple of models all used the same sensors but offered some new functions. Then they came out with the next model that used the Enlite sensors. They still had the same form as the previous Sof-Sensors, the transmitter looked the same, still had to tape it all down. Then they started the Guardian series of sensors with the newer pumps that look the same as the 780g available today. No matter what sensor they've had, they visually look identical. The sensor filament has changed over the years, the transmitters have changed, but once you insert it they all look exactly the same. The original Sof-Sensors were known as The Harpoon by many users. Not a fun insertion! They lasted 3 days (2 hour warmup, minimum of 2 calibrations a day) but once the session ended you could just go into the pump menu and start it again without needing to touch the sensor or transmitter. After those three days you could start it again but it would only work for 1 day because the transmitter required you to charge it every 7 days. I had very good luck with those original sensors and by carefully peeling off the tape (I used my own) I could remove the transmitter, charge it, and put it back on. I had one sensor that worked for 56 days! Because we had to calibrate them I knew that it was accurate. The Enlite sensors were trash. The Guardian sensors also worked great for me. I have tried every sensor except that original stand alone CGM (it was the same Sof-Sensors used with the earlier Paradigm model pumps) and except for the Enlite, they worked well for me. I've used the 715, 722, Revel, 530g, 670g, 770g & 780g pumps. A little under two years ago I switched to Tandem. Dexcom is so much easier to deal with, no having to tape the whole thing down like Medtronic. I like having more control over my settings. I like the smaller size and touch screen. Medtronic wins for their reservoir and infusion set choices, and the fact that my 20 year old pump still works. The rechargeable battery in the Tandem pump will eventually stop working, especially if you put it in storage. I love my Tandem but if I was forced to go back to Medtronic I'd be upset but I'd do it.

[@Glamdring196]

Oh this is such perfect timing. My warranty is up in February and I was weighing different options. I’m probably just going to stick with Tandem (if it’s not broke, don’t fix it!). They are wayyyyy overdue for a massive hardware update for their main system (fingers crossed for the X3 soon). I also would like them to have a more aggressive algorithm which seems to be a consistent complaint from other users. Tandem has been working well for me so far (80% TIR consistently). Great video and interview

[@Knit.Purl.Repeat]

Again really interesting! I have been on Medtronic for 16 years and am switching to Tandem slim (arriving this week!), primarily due to a lot of the features/issues with the Medtronic pump itself, their sensors (always trouble with them), and it over correcting (similar to your guest). I had the same issues with bent cannulas when I used Medtronic's infusion sets that are identical to the ones I am getting from Tandem to start (makes me a bit nervous), so I think it's that design/materials overall that is the issue (do they use the same manufacturing facility, I wonder). I have had none of those issues with the most recent Medtronic sets, so hopefully Tandem gets on the ball with improving their options. Thanks again for sharing this with us and I hope your guest gets the best pump situation for him, soon.

[@jeanneg7430]

I have been using Medtronic pumps since 1994. I have talked to my endocrinologist about making changes each time that my warranty was about to expire & it was time to look at the new options, and we go over the benefits and the potential downfalls of both keeping what I have and about making a change. There are times that I have grown very frustrated with the 780 G (or any of the other Medtronic devices that are out there), and my endocrinologist always goes through some of the issues that he is aware of happening, so that I know that each type of pump (& unfortunately, each type of sensor) has its own issues too. I like the new tech with the 780 G, but franly, I preferred some of the things that I liked about previous versions of my pumps. I would like to see the sensors last longer (& infusion sets too, if it doesn't create too many issues with scar tissue). I was part of the beta group that tested the Guardian sensors (although, I don't think we knew that brand name at that time). If I remember correctly, those were supposed to last 3-5 days (I'm leaning toward 5, but that was a long time ago). Those were required to go in the abdomen & had to be situated according to where the infusion set site was located, so there have definitely been at least moderate improvements on that. I have had diabetes for more than 50 years and I went through 3 successful pregnancies (thanks, at least in part, to having a pump). I agree with today's guest, that by the time you have done this for this long, you want to be able to catch a break where diabetes care is concerned & not have to give up your life or risk having your life come to an end to get that break. One of my earlier endocrinologists was actually on the team that did the work to create the first Minimed pump (& back then, it was Minimed - not Medtronic). He had been working on a "cure" for quite some time & before it was able to go through all of the steps required via the FDA (I think that was the clearance on which he was waiting) he passed away. 😥I'm looking forward to Medtronic teaming up with someone aside from Guardian, even if it's just to ensure that we have options (my insurance will cover the pump - & last I knew Medtronic's was the only pump they covered - & the sensors too, and while they will cover certain test strips, they won't cover the ones that we need to use with the 780 G; that one seems silly). So, Justin, your recent comments about the crazy things about insurance were very valid too.

[@robiningram3968]

I used Medtronic pumps from 1993-2023 and only once had a kinked cannula! I switched to the Tandem T-Slim X2 and have had many kinked cannulas! Unfortunately you don't know it's kinked until blood sugars rise and all other possibilities of why are investigated. You have to remove the cannula to find out if that's the reason for the high blood sugar, and that waste happens surprisingly often. I like the Tandem's size much better than Medtronic. I'm very short and can't bend at the waist with that huge pump on my waistband or in a pocket!

[@Lloyd973]

I am an insulin dependent type2 diabetic. I was diagnosed over 30 years ago. Been on the tandem X2 for three years now. I use Dexcom’s G7 CGM. My current Tandem pump is my third Tandem pump in as many(3) years. The very first pump I received from Tandem was dead on arrival. Tandem has the most disagreeable customer service reps I have ever spoken too. Was on the Medtronic’s pumps for 15 years. Switched to Tandem because I have essential tremors and had difficulty with pushing the Medtronics Pumps buttons. I agree with the statement about control IQ. It doesn’t work for me either and yes I tried sleep mode. Avg A1C went from 5.7 without control IQ to 7.3 while using control IQ. Quit using control IQ and A1c returned to 5.7. Just my experience.

[@matthewcolburn9930]

I’ve used Medtronic for years starting in the early 2000s and am currently on the Medtronic MiniMed 780G with CGM and my sensors with Medtronic never last the full 7 days. The Medtronic sensors really need improvement. Even though the Medtronic loop algorithm is superior to most other pumps Medtronic pumps are not physically dependable. Being extremely active in the outdoors I have not had a Medtronic 780G last much longer than a year before a critical error makes it unusable. I got my first 780G in 2020 in Switzerland replaced 3 time by Medtronic Switzerland, then 1 time by Medtronic Taiwan and lastly by Medtronic Israel and as of now have had it replaced 5 times because of errors. My first Medtronic pump at the beginning of the 2000s was almost indestructible but now the longevity of Medtronic insulin pumps is extremely short with weak durability. The fact that Medtronic pumps are no longer durable enough to function in normal life for me makes them a life threatening risk. I no longer feel my Medtronic 780G pump is dependable. This adds a lot of extra stress to life. The issue with Medtronic sensors is also a huge issue that makes me question continuing to use Medtronic. I will soon switch to using Simplera sensors and am hoping it preforms better. My dream is the Eversense sensor with the power changes they are working towards used with the Medtronic pump and algorithm for its CGM loop. I can’t wait for the Eversense to become available with pumps as it is more accurate and lasts a full year for one sensor. Soon it will be longer I think depending on their power updates. It also can’t get nocked off. I hope Medtronic gets its pump durability and sensor longevity fixed as their algorithm is still ahead of the other companies but that won’t last forever. I just wish the pumps were physically dependable again. Pump durability failure with critical error 35 has now almost killed me 4 times while out in nature far from available alternatives and during non business hours. One failure was in a coastal mountain that I then had to hike 5 hours to my car all night and drive 4 hours to the closest location with cell signal and arrived at the closest pharmacy at 7am that was closed because it was the weekend in a remote location. It’s been a nightmare. Medtronic has professionally and kindly made replacement pumps available but these issues should not have ever existed. Why when the pump reservoir screw fails to be functional with critical pump error 35 do they stupidly make all the pump info become unavailable and the CGM cease to be readable on the pump along with a pump alarm that is impossible to disable. It’s incredibly not logical. The error makes all the pump software unusable. It would be like getting an alarm in your car that tells you your tire is flat and the car should not be driven but because of the alarm the engineers also makes the car unable to start or let you turn your headlights on or even unlock the doors or look at the settings. The stupidity is overwhelming and creates unneeded life threatening risks. Currently one of the biggest issues with most insulin pumps and CGMs is that the designers and engineers have no idea what it’s like to use them to sustain their personal lives and so they make horrible design and software flaws. I so want insulin pump and CGM companies to be successful, but they all seem to make such huge design mistakes that if they were forced to use them to sustain their lives they would never make. I rate diabetes pump and CGM designers and companies on par with congress. Hopefully things will improve but it seems no one is taking action and it’s mostly just talk. It’d be great to see all pumps work with all CGMs. Then we could choose the best of both options. That’s the ideal until a permanent cure is found.

[@chrisbunney5477]

Wow, thanks for the detailed comments. Sorry to hear you have had so many problems. I have been on the 780G with CGM for almost 3 yrs and am very happy. For 95% of the time, it is as good as an artificial pancreas, enabling 94% time in range and 5.7 HbA1C. I have the same problem with the Guardian 3 or 4 rarely lasting the full 7 days. Mostly about 5 days. I think it is due to software problems but i have no idea. The only other problem is the battery compartment cracking occasionally. Still works fine.

[@dwightl5863]

I can agree with Mike that the Tandem fill process is a bit more tedious. But he did mention that he liked the small size of the Tandem and that is in part to the cartridge, rather than the syringe based storage for the Medtronic. Agree with the clear syringe on the Medtronic it is easy to see the amount of insulin remaining. But in using the Tslim for over 4 years, that has not been an issue for me at all. The gauge on the display gives you the number of units remaining and I have never gotten an "out of insulin" message with the display saying I had units remaining. Probably still some insulin in the cartridge but it's not worth it to me to try and suck it out with a syringe. Clear cartridge would be fine but the insulin is in a plastic bladder in the cartridge so probably not so easily discernable in any case. Key to these systems are the CGM's. Algorithm's only as good as the information it's given. Medtronic was and is in need of a decent CGM for years in about all the reviews I've read. Dexcom G7 is not as good as I wish it was. Two sensors ago I had a G7 that didn't need a calibration, lasted the full 10 days and within specification's the whole time. Present sensor has needed a lot of calibrations the first day and a half. Same lot number too. Seems the big variable in this is the wearer. And just like diabetes itself, it doesn't act the same from day to day either.

[@angedemon72]

After 41 years of T1D I know so much like him,i had a pancréas transplant 20 years ago but that's work for 6 months and then he died too so ...now i will start with the medtronic 780g this month with simplera sync

[@bretwilcox5025]

I have used both pumps Medtronic gave me A1c of 5.8 and tandem 6.4. I stayed with tandem due to the sensors. My dad is 81 he went on the iLet and went from a 9.8 to a 6.4 within two months I am jealous. I just wish there was more infusion sets available. For the iLet. Customer service with eyelet is some of the best I’ve ever seen.

[@NeilDeacon]

I’m based in the UK, I’ve been diabetic for 53 years, I started using insulin pumps in 1998. I have been on the Medtronic 780g for nearly 4 years, my TIR is averaging about 93%, the 780g does need to have its settings adjusted but has been quite good. I’m currently o the G4 sensor and hoping I get the Simplera sensor soon…

[@jodyloomis1369]

I was on the Medtronic 530g with the gradian when it first came out. The CGM was horrible and switched to Tandem with G6. I would have figured Medtronic would have fixed this issue by now!! The Medtronic pump was very very reliable didn’t have to worry about sites working like Tandem… We need a 7 day wear ASAP!

[@cherryjohnson5835]

The Medtronic 780G is my 1st real insulin pump. I used the V-Go 20 and 30 before. I started using the Medtronic in July or August 2024. I use the extended infusion set and I always get the full 7 days out of it. The Guardian 4 almost never last the full 7 days. I get 4days most of the time. Medtronic does replace them for free but since it happens so often sometimes I don't call every time. If the CGM was a G7, things would be perfect. The Guardian 4 is the headache with the Medtronic system.

[@sjwproductions3117]

The biggest issue with the use of the T:Slim education, this interview emphasize this. The use did not understand how the CIQ algorithm functions or the dependence on the user settings. As an example the basal changes that are implemented in the same amount he described the 780 doing. The key is that the basal settings in the Tandem is driving actions, therefore, if the if the basal and CF are not set correctly, the pump can’t fix that in most circumstances. However, if set correctly the setting will do basal correction in the range of the 780 bolus mini dosing when you look at the numbers. Unfortunately, due to not having access to the basal adjustment data in the T:Slim, it does not provide the comparison. Kudos to Medtronic in making the data easier to look at and use to more clearly understand the AID function. He did make some good points about the poor Tandem cartridge design. If you look at the total extra dosing delivered by T:Slim or 780 in the same situation/day they would be pretty close. I’ve spent hours helping T:Slim users understand the function of the CIQ algorithm and how to set it up to work best for them.

[@kscott9709]

I've been Type 1 for 56yr in the UK, using standard pumps for more than 10yr, & Ypso MyLife Loop (driven by camAPS FX) with Dexcom G6, for last 18m. It's achieved a fantatic improvement to my HbA1, Time in Range, & Quality of Life. I didn't think it was perfect - but it seems so much better than what I heard here! This algorithm is definately beter than Tandem, & I think makes the Meditronics system look pretty weak. Their cartridge system is head & shoulders above both. The size is tiny. The cannulars are great. They've not yet switched to G7 - but they do accept Libre 3. Some people don't like that they have to keep phone in range, but work on getting yourself a decent back up profile - & you can happily leave the phone for an hour or so. Look 'em up.

[@MrJak427]

I want that pump so bad but the fact that they wont allow an apple phone to run the software leaves them dead in the water for me. All the brands have big weaknesses that a 10year old could easily tell them about yet they all just seem to not want to listen🤬🤬🤬😤🤯 I’m due for a new pump right now and I honestly do not want to give any off them my money

[@MariahDietz]

Medtronic owns many patents for insulin pumps, which is why the cartridges are such a headache with Tandem.

[@leonahanson9127]

I have been using meditronic pump for a while when medicade would only pay for dexcom between finger sticks and the cgm was always off by 150-200 they always falling off always putting on tape over the whole thing working with 13 cow dogs fixing fence it was awful. Then medicade was covering the meditronics cgm they stayed on 3 points off here there right now our new insurance doesn't cover the cgm or tubing so I'm back to mdi loved the 780 pump works great!!!❤❤❤

[@h.k.2413]

Hey Justin, thanks for your informative videos! I have recently discovered your channel and it has been so refreshing to see your positive attitude :) Would you make a video about Ypsopump and CamAps? Thank you!

[@rocko100able]

🧂🕯️ I'm a newbie, and I'm only a type 2 diabetic well controlled, but I still have neuropathy in my feet, and I need all the information I can get, and I really appreciate your reviews that covers a wide range of broadcast that cover diabetics needs and the products available.

[@drizztdurden9045]

Thank you very much. Vos témoignages sont émouvants. BoNNe AnnéE :)

[@tprodyma]

I've been a T1D for57 years and I'm now 60. I, too, am on the Medtronic 780G and rarely have a failure with my sensor. Maybe it's the placement of the sensor? I always use my abdomen.

[@albertneubauer7445]

great man !!

[@HenryRumbea]

Hey Justin, I found a way to make my Medtronic sensor last 14 days. I currently use a 670, and live in Latin America where finding supplies is extremely difficult and expensive.

[@diabe_tech]

Tell us more!

[@HenryRumbea]

@@diabe_techfirst of all y use skin tac and skin grip for the sensor not to fall off. Then once the sensor expires I just recharge de transmitter and start it a “new sensor” it provides me accurate readings. Same with infusion sets I use them for over three days and they working well. As I said in latin america supplies are too expensive and scarce so I found a way to get the most of what I’m able to get.

[@TheBelllady]

65😮 been diagnosed T1 since 2013, diagnosed TD1.5? Since 2000. Growing up very athletic may have been my only salvation. Now I'm in pain all the time with additional Graves disease diagnosis after telling me I was a hosimotis disease. Causing my life to slow down so much, Gain wt. Have insulin resistance. Depression I really don't know what has kept me alive but my kids. Your just what 10 yr ahead of me?

[@mikeperritte]

The Medtronic sensor was always off for me so I couldn't use the sensor but my sister can. I have the same complaints on the cartridges for Tandem. The other complaint for Tandem is it doesn't allow reusing of the cartridges but sometimes its needed do to insurance not allowing for enough before the next shipment gets to you as with Medtronic you can reuse if needed but not recommended.

[@TheBelllady]

I'm having issues with day 3 on Omnipod? The cannula tends to come loose, gets a insulin pocket under the skin & readings get high so I'm carrying a syringe filled with insulin to get a reaction to the o5 bolus. 😢

[@harrywilcox8954]

I'm from the UK, my sensors always last the 7 days. I only wear it in the back of my arm. I wonder if the us ones have less quality control or whether it really is to do with body placement

[@La_Dra_Ped]

I change from tslim to Medtronic and my blood sugar become better and better, but the guardian sensor is a pain in the neck, I wish I can use Dexcom G7 with Medtronic, for me Guardian 4 is not as accurate as Dexcom G7. I wish Medtronic can be compatible with Dexcom G 7 in the future.

[@MonkeyboyBurke]

On a 780G with G4's, its great at maintaining a level, but does over run with its corrections now and again, especially when you have food intolerances. Cant wait for the new insulins to start being used in the pumps, like the faster acting ones, I saw a vid on the a new insulin thats being developed, NNC2215, it stops being active when the blood sugars are lower, amazing.

[@MorganTN]

16 min in - I feel he would have benefited from running his Tandem in Sleep Mode 24/7. That is what I do and it is night and day different from standard Control IQ.

[@janetdevault53]

Would you please explain Sleep Mode? I am planning to switch to a Tslim x2 very soon, so am trying to learn all I can before I decide.

[@vladinolive]

​@@janetdevault53sleeping mode have not allowed auto small bolus, high blood sugar is regulated by bazal ... sleeping mode have different settings for range

[@dwightl5863]

@@janetdevault53 I have been using the Tslim x2 with Control IQ for better than 4 years now. I always use the sleep mode when sleeping and when the settings are correct (Medical team will get it set up) I wake up with readings 90-110. When going to sleep with glucose in range it will be virtually straight line glucose readings all night. In sleep mode the the glucose range is reduced to 70-140 whereas in normal mode it's 70-180. Being you are resting, very little physical activity and not eating anything, it puts you in a tighter range. The Control IQ will change the basal rate throughout the night to keep you in range. It will not do a correction bolus. Wish it did personally because sometimes a meal will take longer to digest and raise your glucose levels. But setting Dexcom alarms can warn you of those highs and you can have the pump make the suggested correction bolus manually. It works very well for me and my nephew says it works great for him as well. Good luck with you new pump.

[@Glamdring196]

@@janetdevault53 I believe sleep mode adjusts your target range to be 112-120 so it’s a much tighter range than the default of 112-160. On the opposite end, exercise mode adjusts your range to be 140-160. I think the option for sleep mode is only available if you have a CGM integrated

[@russellseaton2014]

As the other person said, Sleep mode in Tandem tries to keep blood sugar at 115 roughly. It does this by adjusting basal insulin every 5 minutes. Whereas regular Control IQ tries for a blood sugar of about 120-160 roughly. So it is not as aggressive at adjusting basal insulin and tends to let blood sugars slide high. But regular Control IQ does give correction boluses when your blood sugar gets high. Every 1 or 2 hours or something like that. Sleep mode does not give any correction boluses. Sleep mode relies on the aggressive basal insulin to keep blood sugars under control. I use both regular Control IQ and Sleep mode. Oddly, I use Sleep mode all day long. And Control IQ at night when sleeping. Seems to work god for me. Control IQ with its automatic boluses when blood sugars get high happen automatically. And if you have your pump alarms set right, you can get the correction bolus and not get an alarm. So you can sleep at night. But during the day, I like getting alarms so I know to manually give a correction bolus and keep blood sugars down. I like the aggressive basal when I am awake.

[@marinakiell1069]

You should have actor Victor Garber on. He’s had T1D since I think since about the same time as Mike here. I think that they are about the same age. Maybe with your prior career having to do with Hollywood is your way in, so to speak.

[@thomasmcnulty8477]

i call medtronic when my censor fails before the 7 day range and they always send a replacement

[@michael91411]

I do the same thing and they are great about replacing them. Thing is, though, it shouldn't happen. That's why Justin wanted me to tell my story. :)

[@thomasmcnulty8477]

@@michael91411 I found interesting when you said the dextron and the guardian censor were so far apart in there readings ........I saw the same ting when I was wearing both .....so I only wear the guardian now

[@karenmielish-clausell]

there isnt anyway to wear a pump site for 7-10 days the site would cause an infection not to mention scar tissue

[@MrJak427]

I honestly think ypso pump would fix 99% of all the problems most on here are talking about but they made a HUGE mistake not using both android and iPhone what a stupid decision on their behalf. Almost as stupid as freestyle libre not releasing a watch widget when they released their update that didn’t require you to swipe. I actually tend to think freestyle are purposely sitting on their hands and doing slow releases to keep themselves relevant in the CGM market.

[@Dhufeeri]

Medtronic 780g algorithm is fantastic, nothing can beat it. but everything else are horrible and out of date.

[@michael91411]

They are indeed. That pump is the same basic design as my first, the 530. The sensors are the same design. Look at the Tandem for the big difference and ease of use. Thanks for watching, I hope you enjoyed it :)

[@russellseaton2014]

I used the Medtronic 530 and 670 pumps. Those pumps tried their hardest to make sure my blood sugars always ran high high high. So I switched to Tandem. And will never ever give Medtronic another chance. I find it hard to believe they changed their algorithm for the 780 enough to fix the grievous errors with the 670. Kind of like you would never ever believe a mean, evil, awful, horrible, terrible person instantly becomes a saint and helps people. No. That is exactly how I feel about Medtronic. They were rotten for diabetes control before, they will always be rotten for diabetes control. Never again Medtronic.