Decision Fatigue-670G or Tandem X2


#1

Hello,

My current pump expires in about 4 weeks and I’m researching to determine which route I should go. Whether to go with the (known entity) 670G closed loop OR go without a closed loop with the Tandem X2–knowing it is possible in the future it might offer a closed loop option. I’ve composed the following random questions, broken by setup and would love anyone’s input; especially if they’ve recently made this exact decision.

Tandem X2 with Dexcom G5

  1. It sounds like getting these approved would be working through both the CGM and the pump approvals independently? I wonder if I chose this route if I should start the CGM approval process sooner to ensure I don’t end up with no CGM approval but a pump approval?

  2. I have read that the pump and CGM may have trouble seeing each other but that the phone to CGM connection is relatively stable; does this seem to be the case? I used to get so irritated with the Enlite sensor on one side of my body not being able to talk to the pump in my pocket on the other side!

  3. If you have this integration and you go to bolus for a meal; are you able to just use the number on the pump from the last CGM reading or does it make you do a finger stick?

  4. If you used Medtronic pumps and went to Tandem can you share what makes it better? I’ve played with the app version of the pump, etc., and like the touch screen but without actually using it I find it hard to make sure I’m not liking it better only because it looks cooler.

  5. Stupid question, but is having the ability to see BGs on your phone as cool/useful as it sounds?

  6. Have you ever felt “caught in the middle” between the two companies? It sounds like they work very well together but I could easily see it being an area for challenges.

670G

  1. Is it a two step approval process to get approval for both the CGM and the pump for insurances?

  2. I’ve read a lot on the auto-mode and it seems to work great for some and be quite a work in progress for the others. Does anyone regret going this route vs sticking with pure pump and CGM (Dexcom I’d assume) setups prior?

  3. Do you have any trouble with the Guardian sensors being able to be “seen” by the pump?

  4. What about the guardian sensors staying stuck on? I used to run into feeling like I needed duct tape to keep the enlite sensors on with various different attempts made; with the Dexcom sensors I never had that issue.

For either setup–other areas I should be thinking about? I hate to commit to another 4 years with any vendor without knowing for sure I’m making the right choice. Turning down the ability to go closed loop also seems a very hard decision to go against :slight_smile:

Travis


#2

Hi Travis. I used the Tandem Tslim shortly after my diagnosis almost two years ago. It was fine. Delivered whatever insulin rates it was set to deliver. Two troubles for me were 1) being tethered by the tubing and 2) weak communication with the Dexcom CGM. I ditched the pump awhile ago and went to back MDI. Two months ago I added Afrezza. Now it is almost like I don’t have diabetes. I still inject Tresiba every morning. Rarely, I use the humalog pen for small corrections. Mostly, I inhale afrezza for meals. Afrezza acts quickly so I don’t have to plan meals and pre-bolus which is important for my lifestyle.

I will never go without a CGM and use Dexcom. When the G6 is ready I am on-board. The current Dexcom sensor adhesive sucks. I use my upper arm because it didn’t stay on my abdomen and was an irritant there as well. I can keep it going for nearly a month on my upper arm with a little adhesive help. It looks like the Dexcom G6 will be much more user friendly. I hope the adhesive is better.


#3

I love my 670G system. It is the best insulin delivery system I have had.


#4

Hi @Travis2,

I decided on the x2 for two reasons - The Medtronic has supply issues with the sensors due to manufacturing delays (Mother Nature strikes again!) and I already have a Dexcom DME. Depending on which pump you are migrating from Tandem has several “special” offers. They are actually super easy to work with - easier than Dexcom IMHO, and I felt that Dexcom was very supportive.

In the last month I have had exactly two 5 minute CGM dropouts. That’s actually less than I had when I was using a Dexcom G5 receiver. For me the Dexcom adhesive works very well, but YDMV. I do use SkinTac prior to applying the sensor, and generally I get 3.5 to 5 weeks per sensor when I supplement the original Dexcom sensor adhesive with a GrifGrips patch several weeks in.

Fingersticks are required for the CGM every 12 hours. Personally I fingerstick 4-5 times a day, not because I have to but because I am OCD about my BGs and I donate the info to Tidepool. I usually bolus straight from the CGM value, but I always have the opportunity to override the pump suggested bolus value prior to actually bolusing.

I have also read that many people here have had numerous occlusion alarms - I have had none.

BTW, my CDE was just told by her Tandem rep that PLGS was coming Q1/2018, not the anticipated Q2/2018. Woo-hoo!

You are welcome to PM me if you want any additional UX comments. Best of luck in your decision. Whichever way you go you are getting a great pump!


#5

Hi Travis

I’ve used the Tandem X2 since January along with a Dexcom G5. I chose Tandem because it can be updated as new capabilities come on board. I love the integration with the Dexcom. To answer some of your questions:

  1. Yes, you get the CGM and pump separately so it is a two-step approval process.
  2. Sometimes they have trouble seeing each other. I have found I have to keep the pump relatively near the CGM. I can have the CGM on one side of my abdomen and the pump on the other side in my front pocket and it works fine. If the pump is in my back pocket with the CGM on my abdomen it does not work.
  3. Yes, you can bolus directly off the G5 CGM so you can use the number on your pump and bolus.
  4. I’ve never had Medtronic so I can’t speak to that.
  5. Yes, it is fantastic to see you BG on your phone. I always have my phone with me so it’s a quick look. On the iPhone you can swipe left from the lock screen and there it is.

As far as occlusions, I used to have them. Using the new case Tandem just put out has stopped them all.

Good luck with your decision.


#6

Good for you Lauri, so many seem to ignore Afrezza, which is beyond me. Those who successfully titrate have similar results to you, yet the talk about this drug is minimal here on TU, it baffles me. There are now 412 members of the Afrezza group on Facebook and it seems to be growing rapidly, it was only 100 a year ago. I think its reaching a tipping point, where a lot more people associated with diabetes will know about it and understand what a great treatment it is.