Jerked awake at stupid-o’clock by an alarm going off to warn me about low BG (pressure low, hate those), and I’m JUST drifting off again at like 5:15 when my phone gives me a nice loud beep beep beep, like OMG another BG armageddon on the way, please let me sleep… so I blearily lift my phone, don’t see… oh, there’s a notification from T:Connect app. Okay, open it up. “Your transmitter battery will expire in three weeks.” Are you kidding me? I need to know this NOW??? Anyway the Dexcom app itself already told me this way back yesterday morning when I changed sensors, something I usually do while, y’know, AWAKE. So I acknowledge the cursed thing, lie back down, starting to drift off again… BEEP BEEP BEEP. My pump this time. 5:45am, nothing obvious on the home screen: battery running out? occlusion? low reservoir? nuttin! Oh wait, what’s that yellow thing in the upper left corner. Sigh, tap 1, 2, 3 to get the story… Guess what? "Your transmitter will expire in threee weeeeeeeeeks!!!
Mein Gott, dudes. A lot of stuff I need to know about no matter the time of day, I get that, it’s just part of the drill. But the 3-week transmitter expiration notice? Isn’t there some way to tag certain codes as “Maybe we don’t need to jerk the poor schlub awake during REM sleep for this?” Uggh.
This is one of the many reasons I recently switched to the Omnipod 5. I was especially sick of Tandem’s “blood sugar over 200” alert. The one you can’t shut off with control IQ, where you’ve already acknowledged that your blood sugar is high but it tells you again every few hours once it hits 200 even if you’ve already taken action to correct. Bonus: since switching to Omnipod, my blood sugar has rarely been high anyway!
My latest favorite alarm is something like “your site has been in 3 days. Change it” when I know very well it was either in 1 or 2 days. And besides, I wear it 4 days but it warns me at day 1 or 2. I don’t have the words right. Can’t recall.
I’m near the end of my Tandem warranty and I’m curious what you attribute your doing so much better on the omnipod to? I’d assumed the algorithms were similar and that it was just a matter of whether one preferred a tubed or a stick-on pump. Does the Omnipod have a particular “special sauce” for you — algorithm, type of insulin used, absorption from infusion site?
It’s a combination of everything! First of all, the algorithm is quite a bit different from control IQ with tandem. Too much to summarize here but easy to find info online. Omnipod 5 has a “learning” element where it looks at your total daily insulin doses and makes adjustments to your basal delivery at every pod change. And it delivers microboluses every 5 minutes to correct highs instead of a bolus every 1 hour, and it also predicts glucose levels 60 minutes in advance vs 30 minutes out with tandem, and makes adjustments accordingly. Second, I’ve been able to use some new sites which has been helpful since I had so much scarring built up. Also, I really like the auto-insertion process where you just hit “start” and it inserts the cannula SO quickly and painlessly. I think it’s a lot less stressful for me vs the tandem infusion set process, less room for user error, and less traumatic to the flesh, leading to better absorption. Also, I find that I really trust the system, which has led me to check on my Dexcom less frequently vs constantly checking and perhaps overreacting and over correcting with tandem. Additionally, I like how quick it is to fill and insert the pod vs the cartridge and infusion set for tandem, and also how incredibly portable each pod is compared to having to carry around my autosoft xc and Tslim cartridges. I also only carry around supplies for 2 pod changes in my purse vs the 4-5 for tandem that I was carrying simply because I’d had so many bad infusion sites
I forgot to mention in my last reply, you may be able to try out the omnipod system right now even though you’re still under warranty with tandem. My local omnipod rep was able to set me up with a free intro kit which included the PDM and 10 pods! And refills go through pharmacy whereas my tandem supplies were DME. So because the pods are pharmacy I can still fill them to continue using them even though I’d recently reordered my tandem supplies
So, Tandem offers you the choice of scheduling a site change reminder in the reservoir change process, but it is optional—you can skip that step! I’m like you, I often push it to 4 days when I’m eating low-carb.
One of the things I miss about my old, dumb Paradigm pump is that you could set the Low Reservoir warning to alert you according to time remaining rather than units. It was an estimate based on your basal rate, so it couldn’t account for unscheduled stuff like boluses or corrections. But I used to set it to 12hrs, which generally prevented it yanking my leash at stupid-o’clock in the morning, and would give a pretty good idea of how long I had to work with. I’d use an injector for bolusing in that period if I wanted to put off changing the res. Especially handy to know if my reservoir was good for overnight! AID systems don’t offer this option b/c basals are adjusting in realtime, and I really suck at trying to translate “20 units remaining” into a time estimate, all other things being equal.
Not to open the door to a rabbit hole, but I’m not sure what you mean here. I see CIQ adjusting my basal delivery on a 5-minute basis when it needs to. I also see various claims about what “learning” means in terms of the actual coding of these algorithms (including Medt). It’s not AI, exactly. CIQ also tracks TDD and uses it to adjust accordingly.
But it sounds like Omnipod is working great for you, which is what matters.
I think there’s something of a grass-is-greener phenomenon with these things. After using Medtronic for a decade+ and trying out their early AID system and CGMs, I experienced Tandem as enormously liberating from all kinds of things that drove me nuts about MT. And I hear similar comments from people switching from Tandem to MT or Omnipod after years on one system. I think with any system that you’re living with 24/7/365, and that’s intimately connected with your whole metabolic system, the more time goes on, the more little things start to become big things. It’s like a romantic relationship in a way. Early on the little stuff is overwhelmed by the overall fizz of new good stuff, but after a while of living with each other the little stuff can start to be a big problem!
This is one of the reasons I quit my Dexcom and went back to the meter. The false lows were abominable in their frequency. Blood sugar isn’t the only important thing for overall health. So is sleep.
Yep, a lot of middle of the night warnings about when the transmitter or the battery will end! Sheesh.
And re my issue, wow, I guess I need to open my eyes to what is between the cartridge refill steps. Not time yet but I look forward to seeing something there to stop one of my “warnings”. Tandem engineers are real intent on awaking T1Ds from sleep.
You would think that they could at least delay the alarm if the pump is in sleep mode. I do know that some people stay in sleep mode 24/7, but the alarm could be delayed to daylight hours.
I can’t say why, but I think I’ve only been woken by one of those nuisance alarms once or twice in the last 6 or so years. (I don’t consider low blood sugar alarms nuisances.) Don’t know if this is the reason, but if an alarm can be turned off (like the time to change infusion sites alarm) I do turn it off. Also, with alarms for highs and lows you can give them a pretty long “sleep” period if you want.
To state a possibly obvious point: you can only clear an alarm from the pump itself. Dismissing it on your watch or on the app on your phone doesn’t clear it. I wish you could truly dismiss alarms on your watch or phone, but you can’t.
Since I use xDrip, I usually review several stats before bedtime, such as a pending sensor end or close to max transmitter days. Just habit since I starting using dexcom with xDrip. Usually ignore tandem pump screen, and glance at watch or xDrip screen or T:Connect app.
Home screen → Load, it the last thing on the list. There’s Change Cartridge, FillTubing, Fill Cannula, then Site Reminder. If it’s on, it will say ON. Tap it and there’s a Site Reminder switch to turn it on or off. There is also an Edit Reminder where you can change the frequency, 1, 2, or 3 days, and time for the reminder.
CIQ adjusts basal rate based in bG level and trend. It also applies correction boluses if needed. It is indeed once per hour. It delivers 60% of the a bolus calculated based on the current bG and IOB. When my bG is high, I bolus manually and let it calculate for 0 carbs. If it’s more than 1.0, I apply it. In sleep mode, correction bolus are disabled, and the target bG is lowered to, I think 120. During the day, I find correction boluses help more than the lower target, so I don’t use sleep mode during the day.
Tandem should give us more control over alarms and alerts. A Do Not Disturb option could silence non-critical alerts between specified hours. If my transmitter is going to expire in 30 minutes and it’s 2 am, I’d like to be woken up. But if it’s going to be 8 hrs, alert me when DND turns off. The same for past high bG alerts. Being able to set an expiration for some alerts, or turn them off altogether, would be good.
