Dexcom/omnipod vs. Medtronic 770g/guardian

Hi there,

I’ve had a omnipod for over 4 years now. I love it! I also love my dexcom. BUT, i have 2 kids now and I find it so hard to focus my attention on keeping my blood sugars in a steady line. This is why I started thinking about getting the medtronic. I hated the idea of tubing, also the calibrations with the guardian is one of the reasons I didnt go with it at the beginning. That being said, I want to live a long healthy life with my family, and feel as if the medtronic couls help with my blood sugar control. Any insight to those who use one vs the other? I live in Canada so these are my only two options.


1 Like

Hi @KeelyBurns13 and welcome to the forum. Which Omnipod system are you using? I’m getting ready to try the Omnipod 5 which uses a loop system. I’ve been on Tandem which I’m happy with, so can’t give you any comparison with Medtronic.

I’m using the original Omnipod. We dont have the 5 here in Canada yet. BUT, i also realized that im way behind with all the technology and tandem actually is available in Canada now! Do you use your tandem with the control IQ? How do you like it?

@KeelyBurns13 Welcome Keely to the JDRF TypeOneNation Community Forum! Here you will find members who have used just about every diabetes device ever made and will offer personal experiences, not medical professional advice.

I haven’t used the MiniMed 77G with Guardian, but I currently use the Dexcom / Tandem with Control IQ [CIQ] algorithm, the most advanced iAIDs - interoperable Automated Insulin Delivery system. So advanced that US FDA had to create a new category to classify this system. The new MiniMed 780G with improved Guardian is intended to fit into this category and, if it hasn’t yet, will probably be approved. With CIQ, the theory is that a user ONLY NEED to correctly count carbs eaten and the system will do the rest. That is a “perfect world” dream, which you know from your life with diabetes management doesn’t happen - especially with two young children.

My CIQ experience has been good, Time-in-Range [TIR] since initial approval and release of the software is about 90%; and this is after 6 1/2 decades using insulin to live. But it does take work on my part, for instance having relatively good basal rates programmed into a variety of Profiles to which I change depending on planned activities, good Insulin: Carb ratios for all meal times, and most importantly accurate sensitivity / correction factors. In my opinion, the insulin correction factor is most important in that basal insulin flow is automatically adjusted based on this rate that user puts in a profile, and it is also used to calculate “automatic correction bolus”.

I haven’t had any [well, very rare] issues with tubbing and I lead an active life. You may find one of these two automated systems will help you, but remember these are not magic devices.

Thanks, Dennis! This is really insightful. To be honest i was thinking it was some sort of magical device, but it’s good to know the reality. Thanks for all that info! Really appreciate you taking the time.

1 Like

I was on CIQ with Tandem, and it is not a miracle device (so far nothing risks a working human body). The key is having good background programming - basal rates, carb ratios, and other factors so it can adjust as necessary.
I say “was” because my Tandem warranty is running out and I decided to give Omnipod 5 a try before committing to another Tandem. I like Tandem and CIQ - it just seemed like a logical time to check out the pods. I literally just started yesterday afternoon, and it take two or three pods for the system to learn your body so I can’t say much just yet. I am enjoying being tubeless though! I was used to tubing but this is nice.

Im assuming you have access to the omnipod 5? We only have the original or dash here, so no way of looping. But maybe I should wait and see if it will be coming out soon, and then just upgrade to the new omnipod5! Thanks for all this info.

A couple of questions, Dorie. Didn’t you tell us, about a year ago, that with your Tandem advisor that you switched off CIQ so that you could have different [other than 110] meal-bolus target, and some insulin duration other than 5 hours? With CIQ toggled on, these settings remain at 110 and 5 hours.

And, how does the Omnipod “learn your body”? Don’t you throw out each Pod after three days - and throw out the built-in computer chip that governs a single Pod? Or did you mean it would take a couple of Pods for you to adjust your management techniques. I’ve occasionally thought that I might try Pods but the minimum 85 units required to start a Pod is much more than the total insulin I use in 3 days - I don’t like wasting insulin.

My Tandem manufacturer warranty expires in January, but Medicare requires manufacturers to extend services, and replacement, for at least one additional year; you may also have this extension.

You brought up something I’ve been trying to find. What range will the tandem let you go between? Right now, I try to keep my bgs between 4.5mmol and 7.0mmol. I can do this since I dont use a looped system right now. Would that range be too low for tandem?

Keely @KeelyBurns13, do you really maintain glucose levels in this very narrow range 24 hours every day - 5.4 - 7.0 mmol/L [81 - 126 mg/dl]? I needed to adjust my thinking a bit to understand as I usually think in mg/dl; the Tandem CIQ range table I’m posting is in mg/dl. Or is this range your meal-time target?

The values accepted by the Tandem estimated bolus calculator are virtually unlimited, and the CIQ [Control IQ algorithm] will always attempt to correct your BG to 110 mg/dl - 6.1 mmol/L. The general aim of the Tandem calculator is to have your BGL average 120 mg/dl / 6.7 mmol/L every day, which should provide a 6.0% 90-day HbA1c.

The automatic CIQ basal thresholds and correction-bolus table is below. There are three operating modes for the Tandem - Normal, Sleep, Exercise.

I hope this helps. My overtime “in range” 70-180 mg/dl / 3.9 - 10 mmol/L has been at least 90% and my 90-day lab tested HbA1c has ranged from 5.3% to 5.8% with CIQ.

I used to be amazing with keeping my bgs in range. But since havung 2 little ones running around, my range is higher, but id love to get back to an A1C of 5.5%. That’s the ideal. Thanks again for all the helpful information!

1 Like

Hi @Dennis . I did work with an adviser a while ago although I don’t recall how much time has passed. Don’t recall turning off CIQ although I may have, but ultimately we got some settings that worked pretty well - unfortunately I don’t recall the details.
The best I can explain Auto Mode at the moment is to say that its adaptive technology uses the background settings you input (basal rates, carb ratio, etc) as a starting point and adjusts that based on how your body responds: like CIQ it adjusts if you’re running low or high “in the moment” but if it detects repeated patterns it adjusts to a new rate. That’s the best I can describe it and I’m sure Insulet can do a much better job of explaining it. That said, here’s what’s in the user manual - bold text is my highlight:

Adaptive basal rate
Insulin delivery, in units per hour, that is calculated by SmartAdjustTM technology to aim your glucose to your target. This amount changes over time based on your insulin delivery history.

You do change pods every 3 days (I’ll change mine tomorrow evening) but the app saves insulin delivery history and this is carried over from one pod to the next. It can take 2 or 3 pods for the system to learn, and during that time the adjustments. I’m told number of pods may vary depending on how good those initial setting are, and how vigilant the user is about recording food, activity, etc. And adjustments start out on the conservative side so as not to over-correct as the system is learning.
It really is a very interesting system. Of course old habits die hard: I felt around for my pump when I got out of bed this morning, and when I wanted to check my graph before I remembered I needed the PDM instead.
One very helpful feature: you can set a duration for Activity mode - I often forget to turn that off.
It seemed logical to try the Omnipod when my warranty was coming to an end, but there is no commitment so I understand insurances may allow you to try it out even if you use another pump. However I don’t know about Medicare, and given your low daily needs I understand it wouldn’t work for you: you’re not supposed to withdraw remaining insulin from a pod so that would be very wasteful for you. But who knows - maybe someone will come up with mini pods in the future (no, I haven’t heard anything - just spouting a thought).

Thanks Dorie @wadawabbit now I see how the Pod way gathers history for future adjustments. The app, not the pump device.
I solved the “insulin throwaway” concern by changing the catheter section regularly every three days, and the cartridge when it approaches empty - I just prepared a new cartridge which I’ll install in the morning, having replaced the cath yesterday. I’ve found my actual insulin is about 18 units while regularly eating 225 - 250 grams of carb. As I’ve aged, I have become more sensitive to insulin.

18 pretty day - I’m envious! I use about 40 myself but that said, I try not to compare.
Apologies for being unclear before. Later!