Tandem T:Slim Review


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Recently I have acquired an insulin pump (Tandem T:slim) and it has made managing my diabetes so much easier. I essentially have insulin-on-demand now and no longer have to carry so many “diabetic supplies” such as my insulin pens (Humalog and Lantus) and extra pen needles. You no longer need to have two different types of insulin with a pump (fast acting and long acting) because you use fast acting insulin to compensate for the long acting insulin. It really has given me more control over my diabetes, therefore giving me more control over my life. I highly recommend any one who does not use an insulin pump to seriously consider getting one. Granted, they are not for every one but all I ask is you do not automatically rule it out.

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About a week ago my new t:slim pump arrived and I am absolutely loving it. Like I said it has really changed how I manage my diabetes. The t:slim has so many great features that really make it stand out and truly makes it a great pump.

Micro-Delivery System

First off Tandem has truly revolutionized the actual pumping technology of the insulin pump. They have developed a micro-delivery system to disperse the insulin in bursts rather than in one steady stream. Other pumps use a system that is essentially an electronic syringe whereas the t:slim uses an electronic syringe system with an addition of a device that separates the insulin into smaller doses. It was developed as a safety feature so you cannot not receive one big dose of insulin but rather several small ones. As an example say you need a bolus of 8 units, instead of getting all 8 at once the t:slim would give you 2u-2u-2u-2u over the course of a second. This video will display the micro-delivery system technology better:

Color Touch Screen

Another great feature of the t:slim is the color touch screen. The color screen makes the pump much more pleasant to look at while the touch screen makes it very user friendly. “But what if you accidentally hit the screen and administer a bolus to kill all other boluses?” Good question! The pump has a lock screen which you have to tap buttons in a sequential order to unlock, so it is nearly impossible that you will pocket bolus. On the screen itself, it displays graphics in the corners to let you know exactly how much battery life you have and how much insulin is left in the reservoir. Along the bottom of the screen, the pump shows you the Insulin on Board (IOB: the insulin still in your system) and well as the time remaining until the insulin is no longer in your system. This really gives you a good idea how much insulin to take and keeps you from “stacking” your insulin which can often lead to a low blood sugar disaster.

Bolus and Basal Insulin

The pump also has some unique features when it comes managing and using your insulin. You can set your basal rate down to the third decimal place. Mine right now (I am still fiddling with the numbers a little bit) is .487, which means that every hour I receive .487 units for a total of 11.7 units over 24 hours. The three decimal places really gives you a lot of control over your basal rates and provides greater accuracy when setting your rates. You can also setup temporary basal rates for times when you are sick/stressed, have low/high blood sugars, disconnecting for a couple hours, or anything that requires an altered basal rate.

In the course of making a profile (which stores all your info) you will input values for your insulin to carb ratio, a correction factor, and your ideal blood sugar level. The insulin to carb ratio means 1 unit of insulin counteracts X grams of carbs. The correction factor is a ratio that represents 1 unit of insulin lowers your blood sugar X mg/dL. When administering a bolus, the pump takes into account your current blood sugar level, the amount of carbs you are about to eat, the IOB, the correction factor, and the carb ratio to give you a projection/recommendation for a bolus amount to keep you at your target blood sugar level. Of course you can manually change the recommendation if you feel it is too much/not enough insulin. The pump also has a quick bolus feature which allows you set a desired insulin amount and can administer it with the touch of a button. You can also extend a bolus meaning you can administer X% of a bolus now and X% at a later time which is good for long periods of snacking or maybe even pizza.

Other Nice Features

  1. Water tight up to 3 ft for 30 minutes
  2. 300 unit insulin reservoir
  3. USB conectivity
  4. T:connect application to keep track of insulin usage and other diabetes data
  5. Alerts and reminders (re-test blood sugar after low/high, low insulin the reservoir, low battery, bolus not delivered, etc.)

This is just a brief overview of the Tandem t:slim’s more unique features. If you want to find out more about this pump you can check YouTube for more videos and you can also check out there website here. As I mentioned before the pump has been life changing and seriously recommend people to check out the t:slim and insulin pumps in general.

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June DSMA Blog Carnival


This post is my June entry in the DSMA Blog Carnival.  If you’d like to participate too, you can get all of the information at http://diabetessocmed.com/2013/june-dsma-blog-carnival-3/.  I participated in the May blog carnival so this will be my second attempt/second go at a DSMA Blog Carnival and hopefully you will enjoy this one as much as you liked my last one.

The prompt for June is:

Regardless of which type of diabetes you have – T1 T2 or T3 – you probably use one or more diabetes devices on a daily basis.   For this post, when we refer to devices we mean blood glucose meters, insulin pens or pumps, and all other diabetes medications.  This month we’re going to revisit the May 15th chat on Diabetes Devices and really think about what we use.  We’d like to know:

How do you select the diabetes devices you use?  To others looking into new or replacement devices, what would be your best advice to someone shopping around?

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I use the OneTouch Ultra 2 blood glucose meter and a OneTouch lancing device. They were the devices my doctor prescribed to me when I was first diagnosed, so I have not/did not shop around for any other glucose meters. I am unaware if there are other “better” ones out there, or if the one I have is top of the line, or if  there is even a big difference between glucose meters. That being said, I have zero complaints with the meter. It is very accurate (from what I can tell) and you do not need much blood for the test strips which is definitely a plus.The supplies might be a little pricey but I figure most all diabetes supplies are expensive.

Two other essential devices are my insulin pens. I have a pen of Humalog and a pen of Lantus and obviously as a type 1 diabetic, my insulin “devices” are very important to me. For those who don’t know, the Humalog is the insulin I use before meals to counteract the food I eat, and the Lantus I take once every day and it is my long acting (basal) insulin that keeps my blood sugar in check for 24 hour periods. Although within the next couple of days/weeks I will be getting the t:slim insulin pump so I will no longer be needing my pens except for emergencies if the pump breaks down or something. Now, I did shop around for other pumps (looked at brochures and watched videos) but the t:slim really stood out as the pump for me. The sales lady made it a point to address how the t:slim was designed by diabetics where as other pumps were designed by engineers with diabetics in mind. I think using a product that is for diabetics by diabetics speaks volumes about that product and how people with diabetes can benefit from it. I look forward to beginning my life as a pump user.

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Another device that I use and think very highly of is my Dexcom G4 CGM. For anyone who does not know, CGM stand for Continuous Glucose Monitoring. I wear a sensor in my abdomen which transmits my blood sugar levels every 5 min to the device shown above which plots it on a graph. It also tells me if my blood sugar is rising or falling too rapidly so I can react to it faster. I find this device almost invaluable and urge every person with diabetes to look into getting a CGM. The CGM has made me very much aware of my blood sugar trend and just how much food/insulin affects my blood sugar. And more importantly it made me aware that I was dipping low during the night and have since adjusted my basal insulin dose accordingly. I did a little research on other CGM’s but I felt Dexcom has the best system out and will have the best system in the years to come. Some of the brands of CGM take blood sugar readings every 20 minutes and have a start up time of 10 hours, while the g4 checks every 5 minutes and has a start up period of 2 hours. Those were big selling points for me. Although a potential negative I have found with wearing a CGM is that I feel naked and vulnerable if I have to go a long period of time with out it (which is not very often thank god).

My Diabetes Kit


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Since I have been diagnosed with type one diabetes, it has come to my attention that I must always be prepared for certain situations. What situations you may ask? Mainly low blood sugars and high blood sugars which can both directly damage my health. But what some people do not realize is that one thing , common to the region where I live, that can indirectly damage your health is the heat. I live in Texas. If there is one thing that everyone knows about Texas is that it is hot; like 3 digit temperatures hot. And as you may or may not know, insulin can spoil if left out in temperatures above 86 degrees Fahrenheit. So if a diabetic cannot use their insulin because it has spoiled, their sugars can get too high and they can get symptoms of hyperglycemia.

FRIO makes a carrying case for insulin pens and insulin vials (on the right in the picture above) which will help prevent spoiling. This case can keep your insulin at a steady temperature of 70 degrees even in direct heat so your insulin will not spoil. The case comes with two pieces: the actual case and the insert that is the cooling agent. The insert uses crystals that when soaked in water for 10 minutes chill to 70 degrees and become a gelatin. Then you just put your pens/vials (I have a Humalog and a Lantus pen shown above) in the gel insert and put the insert into the actual case. Now your insulin can be safely left in a car in the Texas heat without spoiling. The pen case needs to be soaked about every 2 days or so, so that the crystals remain a gel.

On the left hand side of the picture above is a travel case available here. This is an essential item to have if one travels or is on the go a lot. The case has two, zipper sealed panels seperated in the middle by a barrier and a handle for easy carrying. One of the panels is completely mesh because your FRIO pen case needs to evaporate out the moisture from the crystal/gel. The other side is perfect for all your diabetic essentials.

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These are the items that I have in my carrying case. I have my blood sugar testing unit (shown on the right side), complete with a vial of test strips, lancing device, extra lancets, and some alcohol swabs. On the left hand side of the picture I have my low blood sugar preventative/emergency kit, which contains: 1 pack of peanut butter and cheese sandwich crackers, 4 butterscotch candies, 1 tube of 10 fast acting glucose tablets, and 1 tube of fasting acting glucose gel. And in the green case at the top of the picture are the pen needles for insulin injections.

You never know what can happen when you are out and about or traveling, so I believe in always being prepared. I highly recommend assembling a kit like this one to help remedy/prevent bouts of high and low blood sugar. And if you are in a region that gets hot like I am, I also recommend picking up something that will keep you insulin cool and prevent it from spoiling..