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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Pump Love


As you may or may not know, I bought an insulin pump and have been using it for less than a week now but I can already say that I love it. It has made my life so much easier. I no longer have to carry a separate case for my insulin pens and needles. The less I have to carry around the better. In fact, the only part of pumping that really worried me was being able to sleep with the pump clipped onto the waistband of my boxers and the hose getting tangled or pinned underneath me. But I have been sleeping fine with it and the hose/pump has not been bothersome at all. Which is good because lord knows I value my sleep.

The Tandem representative that came to my house was very helpful but ended up not wanting me to get hooked up to the pump. She requested some orders from my doctor for my basal rates, carb ratios and correction factors but the doc has yet to come through. So she did not want me to do anything with out the doctors consent. But me being an eager beaver decided to just hook myself up any way and use the numbers which I know to be accurate from my experiences. So I made the decision to bypass the doctor for now until I hear word and can cross reference our numbers.

But all that said, let me reiterate how much I am enjoying the pump and I definitely recommend the t:slim to people new to pumping or people who just want a new pump. Keep and eye out for a full review of the features of the T:slim in the coming days.

Finally!


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After a few months of waiting it is finally here, my new Tandem t:slim insulin pump! I am pumped (nice pun eh?). Unfortunately it took several months for me to actually get the pump but the wait is finally over. Last week I received confirmation that my health insurance provider deemed the pump to be “medically necessary” and have decided to cover some of the expenses. So here I am a week later with my brand new insulin pump and just in time for my birthday too!

The only down side is I have to wait until Friday before I can hook my self up. Well I guess I don’t have to wait but it is advised that I do. On Friday, the Tandem rep in my area is coming over to my house again to help me get setup with my basal rates and to train me on the pump. Talk about good customer service, eh? It’s not every day a company sends some one to your house to help you out. She has been nice enough to contact my doctor and endo to get my basal rate information so she can fully help get me started pumping.

I am really looking forward to start pumping as well as beginning my life as a complete diabetic cyborg! I have a feeling this pump will be a game changer!

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).

Pump Update


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As you know from a previous post of mine, I have been shopping around for an insulin pump to purchase. Everyone’s comments on said post were very helpful and I thank you all very much for your advice. A lot of your comments had to do with insurance coverage and until recently I had no idea what kind, if any, coverage my insurance provides for insulin pumps. I did some research and contacted my health insurance provider to discuss potential pump possibilities (see what I did there? 🙂 ). And to my pleasant surprise, they cover 80% of the cost of any insulin pump! Sure there is better coverage available but my insurance is not very good (cheap) so 80% is good enough in my opinion. In fact, I still have to call them twice a week to make sure they are working on getting the Dexcom system covered, which they barely are. They are so slow!

So all that being said, I have made the decision to get the Tandem t:slim pump. Tandem was accommodating enough to send a sales representative to my house to allow me to play around with the pump and ultimately hook myself up to it with a saline cartridge. And I must say I thoroughly enjoyed all aspects of the pump: the features, the size, the weight, the look; just about everything. The sale rep unfortunately was not able to give me a loaner pump to wear for a couple days, but I was able to wear the infusion set for a few days just make sure it was comfortable. And it is quite comfortable… or not uncomfortable, rather.

The infusion set I have been wearing is the Cleo 90 and it seems like a good set. I am not too sure of the differences in the infusion sets other then ones a steel needle opposed to a plastic/rubbery insertion. And one is at a 45 degree angle opposed to the 90 degree insertion that the Cleo is.

I have been in close contact with Tandem recently and so far they have superb customer service. They have a very nice and knowledge staff that is eager to help make people with diabetes lives easier/better.In fact a good few of the employees I have spoken to are diabetics or spouses of diabetics, so they know quite a bit about the D-lifestyle.

So, a few days ago I faxed them the required paper work and contacted my insurance provider to get the ball rolling so I can hopefully acquire the pump soon-ish.