A few questions

Diabetes Technology Insulin Pumps
1

Hi guys!

So, I am now 19 and becoming more independent with my diabetes. I was put on a medtronic MM one year after DX (got pump at 9 yrs). Then I went back onto shots until April 2012 when I got approved for the OmniPod.

Unfortunately the OmniPod seriously screwed me up emotionally and physically. I had SO many issues with it that my A1C shot way up. My main issue was that insulin was leaking from the hole where the actual cannula went into my skin. There were some days where I would literally have to change out the pod 2-4 times in one day. It got to the point where I never knew if I was actually getting the insulin that I bolused or basaled for. After talking (I actually got stern with Insulet - which never happens) with the omnipod people we decided it would be best for me to go off the pods and onto shots until the smaller pods came out, which was supposed to be in March of 2013. I still have not received the new pods and pdm and it is mid June. Needless to say, I think I have given them a fair shot and my own health and life is not worth waiting any longer for them to get their crap together. (sorry for my frustration coming thru - I am pretty angry with everything I put on the line for this pump).

So - I am now, under the "guidance" of my endo (in reality she just handed my brochures that didn't tell me anything I didn't already know) to beg the insurance for a new pump. I am looking at the medtronic MM with the CGM or the tslim with a dexcom. I have never used a CGM or dexcom, so that is completely new to me.

(I should mention.. some people find that the OmniPod works great for them. That is wonderful and I'm happy that they have found success with it. I am only frustrated with the experience that I have personally had and obviously my problem isn't that common. One praise I do have is the customer support thru omnipod/insulet is absolutely wonderful and the best I've found.)

I have a few questions...

1. What is the difference in priming the tubing for the tslim and the medtronic? I don't understand why the tslim would take so much longer than MM.

2. How are the alarms? My OmniPod alarms were not customizable and they were high pitched, loud, obnoxious alarms that weren't able to be disabled without turning off the pod.

3. Have you been happy with the battery? I have a pretty busy life going between classes and work and friends. During the day I wouldn't have more than 20ish min in the car or in a wall to charge up the pump.

4. How is Tandems customer support? If a set fails, will they replace it? Do they take your problems seriously?

5. I have heard some concern about air bubbles. Can someone expand on that please?

6. Can you use any type of insertion set with the tslim? I heard you can but I wasn't sure how that would work since it has different reservoirs, etc.

7. Last question.. Are you overall happy with your tslim? If not, why? If given the opportunity, would you switch?

I'm sorry for sooo many questions!! As you can tell I am really apprehensive about getting a new pump since my previous experience wasn't exactly the best. Any advice or suggestions would be wonderful!

2

Former podder here.

  1. OmniPod was my first pump…I’ll leave that answer to others.
  2. The alarms are customizable on/off, vibrate and or sound volume, too.
  3. Happy with charging. I usually charge while bathing. Not certain; but you might be

    able to charge from a computer. I have an iPad.
  4. Customer support is very very accommodating. Very friendly!
  5. I have not had any bubble issues. There are some discussions here regarding this.
  6. Any infusion set (leur lock) can be used.
  7. Love my t:slim!!! Not switching. By the way, it’s in the running for medical device

    For 2013. WOW! Just won!!!
3

1. I think the reason it takes longer to prime the t:slim than the Med. is that you have to fill the relatively large space in the connector and the luer lock. Also, the slim will prime for a while and then stop, while the Med. just keeps going.

2. I have my slim set to vibrate, because I don't like alarms. I could never hear them when I was on the Med. if there was any other noise going on -- from lectures, to music, to lots of conversation. I kept getting told by my friends, "Harriet the secretary is reminding you of something!" I'm not really sure about the slim alarms, because I learned to set it to vibrate while I was still on the Med.

3. Absolutely no problems with battery. I give it short charges while I'm reading myself to sleepiness in bed. And it really doesn't go down all that fast anyway.

4. Customer support with the slim hasn't been as good as it was with Med, but they may well be improving, because they're a new company and still training their staff. I had the tail come out of the connector twice, and the first time, they didn't offer to replace the cartridge (I should have asked them to, but I think it's good business smarts for them to offer!), but the second time, they did. And last night, I called because I didn't know how to do something, and the guy who helped me was very competent.

5. Seems like there is always an air bubble in the connector/luer lock, and I've tried VERY hard not to let it happen, but it always does. But I've never seen it enter the tubing itself, and haven't had any problems with air bubbles otherwise. I think the air bubble's name is George, and he's proving to you that there's insulin in there. :-P Never really had any problems with the Med. either.

6.Since the cartridge has a tail with a connector that connects with a luer lock, you can use any luer lock set. I started with the Inset (Animas), hated it, and went back to QuickSets, which are a Med. product, but they do make them with luer locks. I'm perfectly happy with them.

7. Yes, I'm overall happy. The reason I switched from Med. which I WASN'T unhappy with was because their CGM was grossly inaccurate for me -- missed a whole bunch of lows in the 40's and 50's that I didn't feel, and I can't afford that since I live alone. I'm MUCH happier with the Dex, and the reason I went with the slim is because they have a contract with Dex for integration. When, I don't know, but I'm hoping it's within my lifetime, LOL!

PS. I tried 2 fake Omnipods, and hated them. One was on the back of my arm, and left a huge bruise when I pried it off. The other was on my hip and drove me nuts when I'd pull my pants up and down. I don't think I'd even like the smaller Omnipod, and while some people seem to love it, to each his/her own.

4

HI! I recently received my new t-slim in the mail and I appreciate the person who asked the question and all the responses. I haven't started using it yet (waiting for training). I am super nervous about it and all these answers have made me feel better.

5

I also appreciate all the questions and any responses... I've been "window-shopping" for a pump, and after a demo of the t:slim from a company rep it came out in front. Still waiting for awhile before I start pumping. I've only been bolusing for a month, and I feel more comfortable getting to know my body a little better the manual way.

6

I've never used MM or Omnipod. I tried a demo pod when they first came out and hated wearing such a bulky thing. I used the Animas since 2005 and have always been happy with it. I switched from the Animas to tslim 2 months ago and it's grown on me. I'm pregnant and just hit my 3rd trimester when I switched so the fact that I couldn't see the cartridge and was having issues with the bubble in the luer lock made me really nervous. Plus it added another element to think about if I had high BG's. Another user recommended drawing out an empty syringe of air from the cartridge prior to filling with insulin and that's helped. My doctor (T1 who also used the tslim) said to get a pen with a rubber grip and use that to tap the air bubbles in the luer lock and prime out. No idea why, but this helps more than flicking the luer lock. I also use the Dexcom religiously since I'm pregnant and am very happy with it. I started wearing the sensor on my upper arm halfway thru my pregnancy and get better readings than I ever have on my stomach even prior to pregnancy. I usually get 2+ weeks from a sensor too.

1. I change my infusion site every other day, and cartridge every 2-3 days. I hated how long it took at first, but I've gotten a little faster. Still takes longer than changing out my Animas cartridge but I don't mind it now.
2. Alarms are customizable - I have all my alarms set to vibrate on my tslim and Dexcom.
3. Very happy with the battery! I'm terrible about remembering to charge, but it takes the same USB cable as my Dexcom. I have one plugged into my desk at work and one plugged in by my bed so between the two my devices stay charged. I usually let the tslim get to 50% battery before I charge it and takes maybe 15-20min to charge to 100%, if that.
4. I had initial issues with air bubbles in the luer lock and the Tandem rep came out twice to help and gave me extra cartridges/supplies. She said they would replace the pump if I was still having issues but I never needed to do that. Apparently many of their customer service reps are diabetic and on the pump so it's always nice to talk to someone who "gets it", but I haven't needed to call their 800 number for support yet.
5. Like I said, this was my biggest problem initially. I was doing everything right - insulin room temp, no air bubbles in the syringe prior to filling cartridge, etc. For some reason drawing air from the cartridge prior to filling helped tremendously. And wait til the tubing fills about 10 units and insulin hits the luer lock before tapping with a pen to push the bubbles through the tubing.
6. Any set with a luer lock. I've only ever used the Inset and it works great.
7. It took a while but it's grown on me. I love the IOB feature on the main screen, I love the rechargeable batter, the tconnect software is MUCH better than Animas software (my big reason for switching since I was fine with my Animas pump but hated the software and made it difficult for me to interpret and make the necessary changes). It's super easy to bolus and correct and the touchscreen is so nice. Now that I'm 34wks pregnant my insulin needs have almost tripled and I like that I can set my breakfast carb ratio to 4.6 instead of either 4 or 5.

You can always go through the process of ordering the tslim and once you have the training you have 30 days to make up your mind - don't like it, you can send it back! Good luck!
Jenni