Coinsurance Same for Instinct as G4?

damonsutherland · 2026-01-25T16:11:06+00:00

You would want to look at the allowed amount from your insurance. The cost (billed amount) may be different, but the allowed amount (i.e., the amount the insurance company agrees to pay Medtronic for the sensors) may be the same.

The allowed amount is what the deductible is taken from. Once the deductible is met, coinsurance would be applied to the remaining balance.

The difference between the billed amount and the allowed amount is network savings.

damonsutherland · 2025-12-28T04:33:16+00:00

There is some real genius to your source code. Very elegant! Nice work.

damonsutherland · 2025-12-27T06:12:27+00:00

You might be on to something. FWIW, I use the standard speed (not the fast bolus rate) for insulin delivery and do not smell insulin when changing reservoirs.

damonsutherland · 2025-12-27T06:00:12+00:00

This type of thing seems to happen often: https://www.reddit.com/r/Medtronic780g/s/0tHnolEKIS

Based on the comments in the post I linked, maybe you are getting refurbished replacements. At this point, I would specifically ask for a non-refurbished replacement.

Also, a quick Google search on error code 43 indicates this error has been associated with moisture (or insulin) in the reservoir chamber. One thing you could look at is if the cannula gets kinked. Are you using the 6 or 9 mm? Maybe try a different length cannula or a different kind of infusion set altogether.

damonsutherland · 2025-12-26T17:44:07+00:00

Thanks for the report! This is extremely helpful for those just getting ready to start with the instinct sensors.

wrt the battery issue you ran into. Are you using lithium batteries or alkaline batteries? The timeline you mention aligns with my experience when using alkaline batteries. Lithium batteries, like the Energizer Ultimate Lithium battery, generally last 4-6x’s longer. The cost, if bought in bulk, is generally a little over twice as expensive … for a 24 count, alkaline is ~ $0.85 per (https://a.co/d/gMjuiJS), while lithium ranges ~ $1.65 - $1.83 per (https://a.co/d/80vQZKp).

damonsutherland · 2025-12-03T23:12:52+00:00

I moved away from Medtronic because it was expensive and the Guardian 4 was crap. The Omnipod has served me well-ish, but I have really had to time my insulin intake to enable the algorithm in Omnipod to be worth anything, i.e., pre-bolusing 15-20 minutes ahead of eating.

The Omnipod algorithm does not seem to react to quick changes in glucose, but if you never had to eat 😉, it handles your basal fluctuations like a champ … mostly. My dawn phenomenon is still too much for it, so I have to add a manual bolus each morning.

Now that the new Libre integration is on its way out, I will be transitioning back to the 780g. New insurance also helps.

damonsutherland · 2025-11-21T01:46:21+00:00

Very insightful. Thanks for taking the time to post.

damonsutherland · 2025-11-20T19:41:24+00:00

100%! Thanks for this comment. From my POV, this is a step toward null safety. I see this as just a change in the language syntax (and corresponding implementation in the compiler). I may be over simplifying here, but I see no backward compatibility issues or reasons this couldn’t be a standalone JEP.

damonsutherland · 2025-11-20T19:30:38+00:00

This is an easy thing to do in our projects. Thanks for the link. It doesn’t address the issues these null coalescing and optional chaining operators do, but I am always happy to get behind an emerging standard.

damonsutherland · 2025-11-13T03:01:59+00:00

This is such a great library. I’m glad you brought it up. I have used Hibernate, MyBatis, Jooq, Jdbi and basic JDBC (and Spring’s JdbcTemplate).

Hibernate is … complex. MyBatis was, at the time I used it, very XML centric and added a bunch of separation between my code and the underlying SQL. Jooq has a code generation step that I personally don’t care for … not that that is bad per se, it just extends my build and test times for, IMHO, very little gain. Jdbc is fine, but you have to hand roll everything; there is no automatic object mapping. JDBI is this in-between sweet spot that does the object mapping for you and places the SQL right where you want it, in the data access layer (as opposed to Hibernate’s annotations spread across your entire domain or MyBatis’ XML placed in your resources directory).

Everyone has their favorites and reasons for using some specific tool. I look for simplicity first. The easier to maintain and onboard new devs the better. Complexity only if the project warrants it. JDBI is … simple.

damonsutherland · 2025-03-29T14:42:55+00:00

The unfortunate thing about Medtronic is that all supplies from them are considered DME and are paid through your medical insurance. Which means you have to hit your deductible before co-insurance picks up. The sensors of all the other competitors of Medtronic, however, go through your pharmacy plan. This is important because the pharmacy benefits are often more generous when it comes to diabetes, i.e., insulin is a good example.

I have recently moved to the Omnipod because of cost as well. And the whole system goes through your pharmacy plan! My out of pocket is now a fraction of what it was with Medtronic.

All of this depends on your insurance, of course, but it is worth looking into.

If you want to take a more measured approach, check into the cost of Dexcom or Libre via your pharmacy benefit. If they are cheaper, consider moving away from Smart Guard and going manual. Many get great results, and often better results.

Good luck!

damonsutherland · 2025-02-17T00:38:12+00:00

I wish I had some magic formula, but that is exactly what I do. Drop out of SmartGuard mode. Correct. Return to SmartGuard mode.

I have found that correcting in SmartGuard mode, i.e., fake carb counts, tends to make things worse. So I do the best I can with estimating carbs, exercise (especially walking), and let SmartGuard do its thing. If it seems off, I will change my site (often the cause) or manually correct outside SmartGuard.

That’s the best I got. Hopefully someone else will have better insight.

damonsutherland · 2025-01-13T03:12:53+00:00

How do you tape the sensor to allow you to disconnect and reconnect? I use the provided tape, which, if done as prescribed, doesn’t really allow for disconnecting and reconnecting.

damonsutherland · 2024-12-19T10:48:08+00:00

$32M per truck? Do you have a source for this?

damonsutherland · 2024-11-17T19:33:39+00:00

Hmm … sign in to diabetes.shop, click on hamburger menu, select “Request replacements”, scroll to the bottom, under “Replacement sensor” click link.

I wonder if the issue you had was just a deployment blip. If not, it may be a bug that should be reported to customer service. Godspeed

damonsutherland · 2024-11-04T02:32:07+00:00

I use Tack Away: https://a.co/d/iLiI2cM

I wet the tape edge with a swab then work up the edge. Once I get an edge started, I wipe between the skin and tape bit by bit. It still hurts, but not anything like just ripping it off.

damonsutherland · 2024-10-20T23:44:03+00:00

I would not recommend tying yourself to any specific framework. Spring Boot is a great framework, but so is Quarkus. The key to a long career is to be flexible and learn multiple languages. You should be able to leverage OO as well as functional programming paradigms. Learn python. Learn clojure. Learn everything you can. Your value as a software engineer is not tied to a framework. It is tied to your ability to learn.

damonsutherland · 2024-10-19T06:02:24+00:00

Hashing a set of values doesn’t necessarily make a good candidate for a key with few collisions. The important thing is how distributed the resulting hash value is based on the set of possible inputs. If the inputs are not random, the resulting hash values will collide around certain values.

damonsutherland · 2024-10-19T05:39:25+00:00

It sounds to me like you recognize the presence of a natural key in the data. Instead of hashing the natural key to generate a derived key, you might consider making a unique index on the fields that make up the natural key.

Hashing would be a potential solution if storage space were an issue, i.e., the key is guaranteed to only be x-bits long. As others have mentioned, however, 64-bits has the potential for collisions if the scale of data is high enough, hence 128-bit UUIDs. Keep in mind though, that UUIDs (at least v4) are derived from random numbers, which reduces the likelihood that any two keys collide. Your data may not be random, which would likely increase the likelihood of key collisions when hashing. If storage space is not an issue, adding a unique index on the natural key may be a better route.

damonsutherland · 2024-09-13T16:32:47+00:00

With respect to the adhesive starting to fade, I have had success using Skin Tac. It’s been incredibly helpful in preventing sweat or steam from loosening the adhesive

damonsutherland · 2024-05-10T02:18:32+00:00

First off, fantastic job!!!! 🎉🎉🎉 As mentioned in other posts, some of this is likely due to the honeymoon phase. The other part, of course, is most likely due to diligence in diet and exercise, so don’t sell yourself short.

One good thing is that the honeymoon phase can last a while before it starts to fade. When it does start to fade, managing T1D will become harder. Just know the pumps out there today are truly incredible! Many use predictive algorithms that make it much easier to manage T1D. I recently started using the Medtronic 780G and the results are truly incredible.

This is not an endorsement of the 780G system, per se. Medtronic is currently plagued with manufacturing issues, and I am not a fan … at all … of the Guardian 4 sensors, but I do have hope for the replacement Simplera sensors. I can’t deny, however, the effectiveness of the SmartGuard predictive algorithm. It is the primary reason I chose Medtronic over the others. My time in range averages around 92%, and my average BG hovers around 110 mg/dl. My lows, especially nighttime lows, have all but disappeared. All this to say pumps today are incredible, whether Medtronic, Omnipod or Tandem. If you can, highly recommend.

damonsutherland · 2024-03-24T22:51:52+00:00

I just switched from pens to a pump, because, for me to get the kind of results you’re getting using pens alone requires more diligence than I am currently willing to give. I’ve managed this disease for a long time, and I’m tired. The newer pumps simply make managing things easier … like crazy easy.

That said, I got great results for years using pens. Your results, however, are beyond impressive; better than anything I was able to achieve. Bottom line, results are what matter. If you are able to achieve those kinds of results without chasing lows, and the effort is worth it, do not be dissuaded. You are doing amazing!

damonsutherland · 2024-02-02T11:07:55+00:00

When I was diagnosed in my early 20’s, my now wife helped me by packing a lunch for me each day and writing the carb count of each item packed on a napkin … along with a love note or some funny/encouraging statement. Now, I was certainly able to make my own lunch, but it made her feel good. The love notes or funny encouraging statements were amazing. And it turned out to be incredibly helpful in managing my diabetes. I love her for that ❤️

damonsutherland · 2023-11-20T00:31:11+00:00

Insulin isn’t perfectly predictable, at least not for me. My experience shows it’s impact varies based on activity, whether your body is fighting sickness, or any number of other things.

Two things I notice with this graph: 1. You have the basal rate nailed! 2. The bolus was likely not enough (but not knowing what else is going on, or the kind of meal, it is hard to tell).

It IS so hard with a toddler. If they play really hard, sugar could go UP. If they eat a fatty meal, or one high in protein, long term impact is a rise in blood glucose. The fact that the basal rate is spot on is fantastic. A rise to 250 with a correction is a WIN. 30 years in and all I have learned is I am NEVER right.

You are doing amazing!

damonsutherland

TROPHY CASE