670 G- the frustrating user experience

It’s now been about 9 months with my medtronic 670 G insulin pump. When it’s in automode, for the most part it’s pretty good. I’ve had less lows and less drastic spikes. I’ve also gotten better at pre-bolusing for my meals which has made a big difference.

In my current job, I’ve been thinking a lot about the users of our products. Thinking about the user’s needs and their experience using our product. I feel like I spend so much time thinking about other users that I forget that I too am a user. I am a user of the insulin pump product. Unlike the products I work on where we have to think about how we can engage the user and get them to come back, I have to use my insulin pump and continue using it (or I suppose switch to injections or switch companies). But there had to be people who thought about my experience using the pump, how to design the menus and buttons to make it as simple and intuitive as possible to use. And they needed to weigh the user’s needs and preferences against regulatory systems like the FDA and safety and compliance guidelines. It can be a hard line to walk. There’s a lot they did well, but yes, there is a lot of room for improvement.

There are certain features of this pump that continue to annoy and frustrate me. Maybe someone from medtronic will read this and can make recommendations for future versions.

Silencing alarms. To me, the point of silencing alerts is so that you do not hear or feel an alert. I understand the reasoning for not being able to silence low blood sugar alerts, that’s okay with me, but I would assume every other alert should not be vibrating if it’s on silent. This is not the case. From the user 670 G user manual:

“Alert Silence does not silence Auto Mode Exit, Auto Mode Exit
High SG, Auto Mode Off, and Low SG XX mg/dL (XX represents 50 mg/dL
or below) alerts. These are both based on set glucose thresholds and
cannot be silenced.”

Like I said, for safety reasons I understand why the Low alerts bypass the alert silence, but I don’t understand the auto mode exit. The pump is still working.

Automode exit. This brings up more frustrations with being kicked out of automode. For the most part, the reasons why you get kicked out of automode make sense. Although annoying, I do understand being kicked out when you’re over 300 for an hour or 250 for 3 hours. Being kicked out because you’re at your max basal delivery for 4 hours, I suppose I understand, probably good to check why the number isn’t coming down. But being kicked out for min delivery is an interesting one. I’ve been kicked out for running a blood sugar that was close to 85-90 for hours, I wasn’t requiring any basal insulin and so eventually it kicked me out, but my first thought was, why is having an amazing blood sugar kicking me out of the useful feature of the pump?

The sensor. I should be more specific about this one, really my biggest pet peeve with the sensor is that it only consistently works well for a few of the 7 days, and only lasting 7 days is annoying to begin with. But a more specific annoyance with the sensor is that I could have a sensor that is working really well on the 7th day and then the sensor expires. One would think that if the sensor was working fine before the expiration, that if you just restart the same sensor, it should work fine after. But it’s like the sensor sits there and goes “nah uh, don’t try to trick me, I know better” and will still tell you that it’s expired and needs to be replaced. A couple times I have gotten around this by disconnecting the sensor and charging it for a couple hours, and then reconnecting it as if it’s a new sensor. But even when this happens, it still doesn’t work as well as it did pre-expiration just a few hours earlier. Whether this issue is intentional or not, it makes me wonder if these companies could be designing a sensor that lasts significantly longer, but choose not to because it means we as patients and customers need to buy more sensors. Kind of how most electronics these days are not built to last, they’re built to last for a finite amount of time and then be replaced.

So any pump product designers and engineers and user experience people that stumble across this blog post, just a few things to keep in mind as you design and build your insulin pumps, especially as more and more turn to hybrid or fully closed loop systems. 🙂

3 thoughts on “670 G- the frustrating user experience

  1. Same issues here, the Sensor will expire many times a month after 3 to 4 days. The biggest problem I have is it not lasting all night with bed time calibration. It will wake me up sometimes 2 times a night. Calabrate properly, 4 times, then at bedtime, and it still wants a calibration after 4 hours. At first my Diabetic Doctor was like, this is not happening with other patients that I’m aware of, now after 9 months it seems to be very common and they are aware of the issues..Hopefully medtronic is working on it..

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    • Yes! That definitely happens to me too. I silence my alarms now overnight so it at least doesn’t wake me up but then the sensor isn’t working overnight if it’s waiting for a calibration. Yea that’s definitely a huge frustration and issue too!

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  2. I agree with Reva on most counts. Personally, I have not ever needed the low alarms, as I always – yes, always – am aware when my BG is dropping swiftly, and when I reach the 80 mark.
    Alarms: I would like the ability to silence all alarms, or be able to pick the alarms I do not want silenced (high BG would be my first choice). There are times when I cannot have the pump vibrating, or screaming. I end up turning off the sensor, which completely defeats the purpose of the 670G.
    Automode Exit: I hope the next pump has the ability to increase incrementally the insulin needed to bring down BG when higher than it should be. We do enter rates, which could be refined to tackle high BG. I agree with the minimum rate complaint – When my BG is 82 over night, is not dropping, for example, don’t wake me up and tell me to take my BG. Because when that happens, I turn off the sensor entirely…again the defeating the entire purpose. Not changing this reaction – I will not be able to get back to sleep, so I have to choose one unfortunate choice after another. I know the reasons why a BG might be needed – but please refine this! Frequent BGs needed interfere with my sleep and job. Often, when starting a new sensor, after caligrating the first time, I am told to BG for automode. But when I do, despite pump training saying not to do this, I then have to calibrate again, even as the pump is already calibrating
    The sensor: I spent literally MONTHS attempting to use every possible place on my body to insert. Only the back of my arm works okay – and even that is well less than perfect There are sensors that last only 4 or 5 days; few last the full amount. The BGs predicted are often 100 off what they should be by day 5 or 6. The biggest pain for me is that I have to have my wife insert the sensor. Neither one of us mind Nurse W. doing this, but if she is away, or I am away, I am stuck without a sensor. So my suggestion is either come up with a sensor that can be used in more than one area and be accurate, or figure out an insertion system that can be completed one-handed. The sensors need to last a lot longer, and be more versatile.
    Help line: Most folks I have spoken with have been knowledgeable and kind. The issue is, I do not have an hour to spend on all the attempts to make a sensor work, when the pump tells me to change the thing. I don’t often have time to call when a sensor stops working; if I wait, then too bad, not being replaced. Other issue is when i need a replacement, more times than not, I am told they are not in stock. Last time, I had two die on me, but never got any replacements. I guess it’s about efficiency and consistency.

    All the ideas, even the suggestions for the better, come from the incredibly technology that dozens of specialists take years to develop, so that we can liver full, independent lives. My life is very different, better in every way, with the use of the 670G. It is sad folks without the means do not have access to life-saving treatment like I do.

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