[wanderingmoose]

Hi,

Ack --> I misread your article and thought your child was 14 years old, not 4. I don't believe kids that young qualify for any of the auto-adjusting toolkits. The medtronic has a minimum age of 14 (I think). In any case, the best advice I can give is to get your child on something like medtronic's pump + cgm + smartguard as soon as you can. Ideally the minimum age limits will drop and the quality of the treatment will keep improving.

I left the no-longer-relevant-to-you comment below in case it would be interesting to others.

Good luck with everything.

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This is a different suggestion than you were talking about in your article, but:

If possible, I would highly suggest trying out the medtronic minimed 780g with guardian 4 or simplera using the "smartguard" feature. This is the first out of the box solution I've ever tried that almost (but not quite) felt like magic in terms of achieving good control that was mostly automated.

This setup provides 3 things not yet available in the dexcom associated systems: 1) auto adjusts your basal rate (via a weighted average or 6ish days) 2) aggressively adjusts basal rate to avoid lows 3) aggressively micro boluses to help prevent highs.

I have recently switched from a tandem x2 with dexcom g6 and g7 and used with xdrip+ android phone app (similar or same as the nightscout you mention, depending on where you get it.)

The dexcom cgm with the tandem auto correct would typically take (for me) 6 hours to correct a high from something like too low meal bolus. The medtronic usually takes less than 2 hours and doesn't peak nearly as high.

More importantly, the hypoglycemia prevention is a complete game changer. I have not had a severe low blood sugar since switching -- and this means avoiding the hypoglycemia followed by 24-48 hours of higher insulin resistance.

The out of the box systems are getting really good, and are advancing at a quick pace now (which until recently hasn't been the case). The quality of control I have now is much better than with xdrip+ and the auto controls available in the tandem x2.

I used to eyeball my android phone many times during the day to follow trends and try and catch highs or lows early. Now, I don't need to adjust basal rates. If I miss calculate the carb counting for a meal, the auto correct takes care of it. Now I only need to pay attention to longer trends relating to meals boluses and relying more on a1c values to double check that the control is really ok.

[grahar64]

We looked at the Medtronic 780g system, there are a bunch of problems for a four year old. Most obvious is the tube, it gets in the way, the omnipod is waterproof and just works. The next is inserting the guardian sensors used to be horrific (as I understand it they have an applicator now) but my son barely feels the dexcom G7 insertion.

AAPS is good, it could be better, but it has a complete set of features we need. Just need a phone

[amagrude]

In the US and EU, children that young are authorized to use CGM and Omnipod. It’s functionally equivalent to the tube based systems, expect that it only lasts 3 days. Ugh.

But the total automation of basal based on realtime CGM is a lifesaver.

[ahaseeb]

with Medtronic, I am always concerned about the tube as you've to carry it around and with kids, it becomes difficult, so we're opting for Omni Pod. I hope they make it tubeless some how and CGM + Pump in 1 system . With Med, you still have to manage the dose prior - no ?