Former Medtronic User with Tandem Tslim

I had used the minimed pump for 20+ years and recently needed to update my pump and start using sensors (yes I resisted the sensor for far too long!). I went with the Tslim with Dexcom sensor primarily because of the size of the Tslim, the current minimed was even larger than my version and I like to be discreet and keep it hidden.

I have been horribly frustrated with the Tslim - my blood sugars have been all over the map. I have never had so many high readings, even though I didn’t have a sensor previously I still tested 5x a day. And when I’m high, it seems to take an extremely long time and ridiculous amount of insulin to bring me back down. Anyone else have this issue?

The clip is also useless, the clip comes off clothing very easily - i never had that issue with the minimed. And recently the clip came off and I broke a piece of the casing trying to reinstall it. Of course that isn’t covered by Tandem even though I’ve only had the pump for 4 months. I very much wish I stuck with Minimed and dealt with the size.

Doesn’t seem like just changing from one type of pump to another should cause this–they all do basically the same thing, so if you’re basal and other settings are the same, you should be getting the same results. One thing that makes it tricky is that the change also coincides with using a CGM for the first time. You say you tested 5x/day, but even so, speaking from my own experience, my BG awareness went way up when I started using a CGM, particularly around how high and how long my post-prandial spikes tended to be. I was pretty surprised at what I was seeing once I started getting a continuous picture.

But leaving aside the CGM acclimation question, your description sounds like a problem with the pump. I’ve never used a Tandem, but from what I’ve seen people post who do use them, the process for filling the reservoir requires some vigilance to avoid air bubbles. Voids in the insulin flow can certainly cause some of the effects you describe.

There are some, myself included, who could not use the Tandem pump. My BG would go high every three days, to about 500 and stay there. Documented info with them and they did provided a refund, even shortly past the 30 days. There are some blog writers and others who described the same problem. Some of us think it is due to the bladder system reservoir and/or low basals. They had me tossing sets out over and over, but in the end my documentation proved it was not the sets. There are not too many of us who had this problem, but there are some. I liked the pump, the service was great, but the whole experience went bad from about day three to 45 days later.

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Thank you, it’s nice to hear I’m not crazy (which is the implication when I’ve tried to explain what’s going on). And i agree i’m certainly more aware of my BS readings, but I would have had highs previously that would likely have been worse since I wasn’t treating them as regularly and that wasn’t the case.

Unfortunately I’ve had the pump now for 90 days so not sure I could get a refund, I probably should have been more diligent in documenting the issues I’ve been having. I will reread the fill instructions for the reservoir just to be sure I’m not missing something. Thanks again for your comments.

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My daughter switched to t:slim from the Ping. The transition was a real challenge. T:slim delivery is very different from the Ping. The endo orders were for the same settings she had on the Ping. We ended up changing everything…ISF, carb ratios, basals & even DIA. It took almost a month to get it all sorted.

@tiaE
Ditto. Ping to X2.
We did not adjust the DIA. At first. That was a mistake.
I believe the IOB calculations between the two pumps are different which is why the DIA needs to be changed between them. We ended up having the DIA about 1-1/2 hrs longer on the X2 as opposed to the Ping.

In terms of the Endo, it is a little different for us in that we tell our Endo what settings we are using.

I hope you don’t have that problem. Don’t give up! But yes, too far out with no documentation may not work. But if they keep having you toss out sets, ask for help and tips and just anything!!

Thank you! That may be helpful, I work with a diabetes educator and will check with her on that.

@Tim35
The endo gave the trainer a written order with the settings we reported from our visit 2 months prior. It’s a requirement due to the agreement between the clinic & the pump company reps, a liability issue. I started making insulin adjustments 2 weeks after dx, when we couldn’t adhere to the excessively high carb meal plan supposedly required by the prescribed regimen which included NPH.

A search of commentary by t:slim users who have switched from other pumps yields quite a few results stating the need for quite different settings on the t:slim for many. Personally, I believe it’s due to the difference in the way it delivers insulin.

I would call tech support until the issues are resolved, whether by adjusting settings, replacing the pump, or returning it.

Seems a bit strange but I really see no problem with that.

But you did not sign such an agreement no?

Certainly everybody has to decide how best to handle their own situation. If in your situation that means only doing what the Endo/Trainer dictates then that is what it is. Nobody is exactly in your shoes.

(sorry if I misunderstood your post)

You absolutely misunderstood, as well as continue to make assumptions, but no worries.:grinning:

By all means please elaborate.

I have just transitioned from an Animas ping to a Tandem T-Slim X2 pump. I love the pump interface, but I am having a lot of problems.

A whole lot of Occlusion alarms for no visible reason. Like over 12 in just under 3 weeks. During bolus & several hours later.

Like others my BG is way higher than it was with the Animas, and my TDD is about 20% higher, even though I am using identical settings to those on the Ping. I am just getting ready to increase everything.

Like others have said I think it has something to do with the Tandem delivery method, it doesn’t seem to push the insulin out as hard as the Animas??

I am feeling very frustrated. But no going back as the Animas is way out of warranty & I hate the idea of Medtronic. So I am watching for suggestions here

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When I switched over from an Animas to a T:Slim we had to make all sorts of adjustments. Once I got the basal under control and then adjusted the carb:insulin ratios my increase in insulin was rather modest 2-3% range.

I can see where different technology could lead to changes in your dosages. The variations in the pump calibrations can lead to a difference between actual dose and measured dose to cause some small issues as well.

I was thinking about switching from my Revel Medtronic pump to the X2 in the future but this thread makes me wonder if this we would be a good move.

I was a MiniMed/ Medtronic user for a very long time. Made the switch to Tandem just over 3 years ago. I also had more occlusion alarms than I ever had with Medtronic. My problem was a low basal rate. But all my alarms went away when I switched from Teflon infusion sets back to metal. Since switching to metal, I have had no alarms. I have an older Tandem, not the new X2. I have been holding out for a possible new AP type pump. But the launch of them keeps getting pushed back. So I may go with a X2 and get the newer versions of it through downloads. When the G6 gets approved with use of Tandem, it’s just a download not having to wait for a new pump. Sorry you are having problems with your Tandem. I love my with the infusion set change.

Hi Don, I was the original instigator of this thread. Here are the things I would caution you to think about…

  1. Expect to go through a readjustment period with both basal and bolus changes. I’m probably using 10-15% more insulin overall with the Tandem then i did with the Medtronic. I truly believe there is something different with the delivery, somehow the insulin is not being absorbed the same way. That said, over time it’s gotten better with the adjustments.
  2. You will have more steps when changing your catheter & loading your pump. Not necessarily difficult, just more pieces to use (the reservoir is not part of the syringe).
  3. It’s nice to have a clip which can be adjusted to wear the pump vertically or horizontally, but the clip isn’t as secure. The Medtronic clip had a lip at the bottom which held more securely, the Tslim does not and I find it slips off my clothing more frequently. The clip is also attached to the casing, so you have to remove the casing to change the clip direction which in my case resulted in breaking off a piece of the case and having to order a new one. Not expensive but frustrating when it’s still a new device.
  4. I did not have the occlusion issue many have noted, but several have responded that was an issue.
  5. If you’re using a sensor you will likely need to wear the pump on the same side as your sensor. Myself and others had noted you will frequently get “lost signal” alerts if you have them on opposite sides of your body.

That’s about all I have for you, good luck with your decision!

Hi, sorry to necro an old thread but this is the one thing I’ve found that sounds exactly what I’ve been experiencing with my tslim x2 I’ve had for about two months. I’ve already adjusted my basals higher, but perhaps not enough.

Did you end up sticking with the tslim? If so is it still problematic, particularly with getting down high blood sugars. I feel like I bolus 5x for a high and it won’t go down for half the day or worse.

I’m so defeated by this. I too don’t like what the new Medtronic brings regarding size and I won’t touch their cgm with a 10 foot pole ever again. Never thought getting rid of my old out of warranty paradigm would lead to such stress.