Hey Talonrider  

Believe it or not, after 20 years of kicking and screaming that I was never going on the pump, in February I took my last needle in 48 years!

Up here in Canada, a lot of the provinces have weighed out the cost of a insulin pump compared to the cost of decreasing health, and support and care over the years of having diabetes (since we have universal healthcare). So in my province, there is two pumps offered and all your supplies including any test strips are entirely covered by the provincial pump program. The only thing I need to buy is the CGM (Continuous Glucose Monitor) and my Insulin, Humalog as well.

After reviewing the two available pumps, the Omnipod, and the Medtonic, I went with the Medtronic. It has from what I read, the best AutoMode program where you are now experiencing something like it with the Tandems version in conjunction with the Dexcom G6 CGM. I'll be 100% honest, the Medtronic CGM's need to be scraped and go back to the drawing table, or, make a software version update that the meter so it will work with the Dexcom G6. One friend up here actually bought a Tandem pump and is letting the AutoMode make his adjustments for him with the G6 CGM.

So I've taken some advice from you over the years, and let me know hopefully offer you some  

AutoMode is the greatest thing. Up here, we use the international, mmol/L. So a good BG is between 4 and 8. Luckily when we started measuring BG up here about 40 years ago with test strips but no meters to read them, we were on the American and German and a few other countries measurements, which use the mg/dL. I still cringe when I hear someone saying they maintain around 120 . To us, that would only be 6.7 . You are very high and should get to the hospital ASAP at 120  

So back to AutoMode, at first I was not totally onboard with a computer, as in the meter, deciding my diabetes management. After 48 years of doing not too bad myself, I wasn't about to trust some computer. Do I sound like my father ? I do remember the first week of AutoMode, it was a nightmare. Much like you described. With Medtronic the first week I think, might be two, AutoMode is learning all your patterns and such. For example, when on manual, I have six different parameters for when in the day I need to have certain amount of basal insulin and then what amount of bolus insulin to carb ratio for when I eat. Over that week it is a nightmare checking your blood manually (I cheated and used a leftover Libre flash glucose monitor). The first week actually on the AutoMode was a bit hectic with all the alarms and getting waken up and such. I totally know what you mean in that it tells you are too low, and then you eat and an hour later you are being waken up because you are too high  All I can say is that it does get better as the computer learns your body's patterns. After the first couple of weeks things took a huge swing for the better. Most weeks I'm 90-95% in target every day of the week! This has reflected in my A1C's and also some other testing and health effects too!

From what my friend on the actual Tandem pump has said, it's AutoMode is comparable to the Medtronic. The bonus is the Tandem works with the G6 and no finger pricks! Like I said, I do not like the Medtronic CGM and think it is outdated and poorly designed. Also needing to do a minimum of 2-3 finger pricks a day pisses me off when the technology is out there not to with the G6 or the Libre. One thing that has happened recently is we have all got the new Medtronic 770G pumps, which they can download updates or even new software to the pump via wifi. I really, really, really hope they just say, okay it will be too expensive to redesign our CGM to get it out of the 90's and lets scrap making CGM's and work out a deal with Dexcom to utilize the G6.

One last thing, if the program is like the Medtronic, the pump learns your patterns and does not use 'user entered' values. So you don't decide the basal, you don't decide the bolus either. With the Medtronic, if you miss a test for a long period of time, or you have taken too much or too little basal insulin, it requires a finger prick and if not, it kicks you out of AutoMode and back to manual mode. Manual mode is where the user defined entries are defaulted too. One advantage I've heard of the Tandem is that it doesn't kick you out of AutoMode like the Medtronic does. 

I know you wrote this blog a few months ago, so curious if things have leveled out for you now, or are you still going crazy  

Hope it is the former