Review of the Medtronic 630G Insulin Pump

I am going to break with tradition and state my recommendation at the outset I love the Medtronic 630G. However, please read the entire story because it is worth knowing my full experience with the pump.  Because like with most things there are both good and some not so good parts to owning a new piece of technology.

Getting started

When the 630G arrived, there were all kinds of warnings about leaving the pump alone until you call the local trainer.  So I immediately picked it up and started messing with it.  I also called my local representative and explained that I had my new pump, but due to insurance issues, I could not start the sensor for another month.  The trainer suggested I proceed with pump only training and then tag on sensor training when I received it.    So a few days after receiving the pump I was in class.

The day of training went very well.  The trainer gets a high five for adapting the class to the learner’s level. She made sure it was valuable for me (I have used Medtronic pumps for 17 years) and my wife who seldom if ever touches my pump.

About 30 days later insurance released my sensors, so we took the sensor training in the same place with a different trainer.  The sensor trainer was incredibly good.  Since I relate everything to the Dexcom experience, she again took me where I was and helped me develop insights about how my new sensor and pump work together.

Wearing the pump

I love the color screen.  The operation of the pump is easy and straightforward if you are familiar with prior Medtronic pumps.  But and this is a big “but” there are some new features and ways of doing things so don’t blow off training and expect to run the pump well.   I have no doubt I could be running the pump based entirely on what I knew from using the 530G, but I doubt I could run it efficiently.

One thing that needs improvement is the belt clip.  For some reason, this pump has the clip that breaks easily.  In a little over six weeks mine has broken 2 times.    I am a belt clip veteran, so I knew how to piece it back together and keep going.  I wonder why Medtronic cannot solve this issue.  Veterans of the various Medtronic pumps over the past few years know this has been an ongoing concern.  Albeit one I thought was resolved in the 530G, since my last belt clip was approaching 3 years of use with no issues.  Medtronic will send a new belt clip every time the thing breaks.  In fact, if you call their help line for anything it tells you for a broken belt clip press one for replacement instructions.  So my first gripe: please this clip design does not work so let’s get it fixed.

What I love about the pump

It is a complex machine that is relatively simple to operate.  It does exactly what it is designed to do, and it works smoothly and efficiently.  I rate it at 5 times improved over the 530G.  The color screen is so much friendlier.  I love that it tells me when it is time to do a set change.  Not just in days but in hours and minutes on the final date.

For the first time in two generations of pumps, I think they have the pump/meter combination working well.  When I use the meter, I am given the chance to calibrate the sensor or not, but on the same screen, I can administer the bolus.  I do not have to wait for the pump to do the calibration before I can bolus.  I love that.  The menu options are clear, even if changing the Basal settings seems a little clumsy.  And the sensor integration (a future post) is so well done.

It took some getting used to, but I like the vertical orientation of the pump.  For me at least it allows for more information to be packed on the screen without opening a menu to get answers.  For instance, there is a battery indicator.  I can see with one glance how my battery is doing along with my sensor age, current sensor readings, and active insulin.

Fast delivery is a new option.  The pump has a quick bolus delivery mode.  You put in your bolus and almost instantaneously it is delivered.  The trainer suggested we not use this feature until we are familiar with the pump.  I have yet to turn this setting on.  I am not certain why I need to do that, especially with such a short cannula, but I bet it may be useful for the next generation 670 G.   At any rate, it can be turned on or off, I have just not gotten around to turning it on.

What I dislike about the pump

Nothing is perfect, and this pump is no exception.  First, let me say even with what I am going to tell you I still would buy this pump. But I feel the need to be truthful.  So here goes, I have used the pump for five weeks, and this is my third pump.  So let me explain.  Within a week the first pump had a non-delivery error.  I called Medtronic, and they replaced it with an overnight shipment.  That happened the first week of wearing it.

The second pump developed a critical error that reset my entire pump back to factory settings.  I called Medtronic, and they let me know the protocol was not to replace my pump until this particular issue occurred twice.  However, since I was feeling skittish about the pump, they replaced it without question.  Again I got the package overnight, and I was able to set up the new pump quickly.  After all, I was getting to be an expert.

Then less than a week after putting my third pump in service and while on a flight to Dallas the new pump also reset to factory settings with the same error codes as the second one.  When I got to my hotel, I called Medtronic, and I was very upset.  Once again they offered to replace the pump, but I was traveling, so an overnight shipment was difficult.  The supervisor assured me the pump was safe to use and that protocol was to replace the pump, on the second error like this.   After a 1 hour discussion, I decided to keep wearing the third pump.  I have not had any further issues.

I have not found others who experienced this type of failure, let alone two in a row.  I do not have any explanation as to how this happened.  With the third error, the question came up about going through airport screening.  Did I go through the scanner?  No, I always ask for and receive manual pat downs.  The last error occurred over a month ago, and I have had no other issues.

So am I unlucky?  Is there a pump issue?  I do not know.  What I do know is that Medtronic’s service was fantastic.   I received excellent telephone support and overnight delivery of two pumps.  Medtronic did not hesitate to offer a new pump for the second or third issue.  Not taking it for the third issue was my decision.   And as I said earlier there have been no further errors.

One other thing bothers me about the pump. One has to be very intentional to operate the pump.  To do anything with the menus, one must first select a button the pump displays.  I think of it as the human test.  Then to deliver a bolus one must set the bolus amount, press enter and then confirm the intention by pressing enter again.

I understand this is a safety feature and yes it will prevent accidentally delivering a bolus.  But I had a steep learning curve that meant I thought I had delivered several boluses only to discover later they had not been delivered because I did not press the second enter.  For me at least it took some doing to get into the rhythm of pressing two buttons to give a bolus (first world problems).

Overall

Despite the various issues I am thrilled with the 630G.  It operates in a cool way and I am looking forward to bridging over to the 670 G this summer.    I have to take the major errors in stride.  I honestly have no idea what happened.  The pumps were manufactured at different times so I do not think it was a particular component or code that led to the failures.  Maybe it was simply my bad luck?   I have stuck with it because of the experience of other members of the diabetes online community.  No one else I could find reported these major errors with the 630G.  Of course it could be happening that this particular pump is prone to such errors.  But I have now used it for six weeks without a new occurrence.    So yes, I am all in on the pump, I love the features and ease of use.  And I have my fingers crossed (not easy for a guy with RA) on the issue of long term reliability.

-30-

rick

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