I’ve recently switched from Medtronic to Tslim and Im noticing that my carb ratio of 1:10 which worked perfectly on my Medtronic, doesn’t seem to work as well on my Tslim. Of course I am using a different infusion set but its still the same 6 mm length cannula. I was just wondering if anyone else has noticed a change of settings that worked great on the previous pump but needed some significant tweaking when switching to Tslim. I seem to get much higher spikes after eating and almost always have to do some corrections to get back down below 120. I was wondering if the Tslim being a micro delivery system might be having something to do with this. Other than that I am really loving the new pump, it’s just kind of bothering me why ratios and settings that worked so great are producing totally different results on a new pump.
My daughter has only ever used the OmniPod system, so I can’t speak from personal (parental) experience. But I know of others who have had to adjust many, most, or all of their pump settings when switching from one brand of pump to another.
Pump setting adjustments … the fun just never stops. 
I have a tslim but I have never used another pump so I couldn’t say. My bg is constantly changing and I sometimes- pretty often truth be told- have big drops and spikes. I frequently have no clue what is up with it- really most of the time- I don’t know if the pump has anything to do with it. I think maybe it may have to do with digestion/activity and body cycles and just my fluctuating metabolism and insulin needs. I can drop a lot when I sleep. Sometimes spikes seem like they could be due to not absorbing the insulin.
Mine usually stays pretty stable. It seems to be more a carb factor/correction factor. I dropped my correction factor to 1/25…was 1/30 and carb factor to 1/8…was 1/10. Hoping that makes a difference. Basal rates seem to overall be pretty good, just only when I’m eating that things get a bit wonky. Of course with D who the heck knows, could just be me and everything deciding it wants to get weird. I’ll see what happens with these changes.
I changed yesterday from mm to tslim BUT this morning the tslim malfunctioned so waiting on next day delivery-- hope this is just a one time incident😰
I was able to obtain a refund on the Tslim, We (hubby, nurse and I ) determined that it is probably the bladder cartridge system that just simply does not work for everyone. I liked the pump, I liked the trainer and customer service but, I had BG that climbed at the point that the bladder had >20 units in it. I’m only on a .50 hourly basal, and we think the fact that not much insulin is going through (I dont get occlusion alarms for days, which is something that will happen with low doses…) plus the fact that the bladder doesnt ever fully empty, had something to do with this.They suggest you change the cartridge every three days no matter what the vial insert says (it says insulin is approved for six days in a pump). That may help you get mileage out of everything. If you do searches, you will find people have had to increase doses (mine were climbing) and having similar issues. Not everyone, but some. I did much better returning to my Revel (and now a nice new Revel) and everything went back to normal. The problem was, so much was in question (basal, infusion site, cartridge issues) you could never pinpoint the real trouble. Having a 550 because the cartridge wasnt working for me, was not acceptable. My A1C was a 10 on that pump. I appreciated the good service they provided, but I did document things well enough to manage a refund and I am very thankful for it.
I too have had many concerns about the tslim. I switched in Mach from the Omnipod, which I was on for only 8 months. I had the MM for over 20 years. I have never been able to get my BS right with the tslim. I’m on the dexcom and between it and the tslim, I have had nothing but alarms from the hi and lows. I changed back to the Omni pod and I really like the freedom it provides from tubes but I hate the PDM. I wish MM would update their pumps. I had better control and felt I could trust it. I just don’t like the bulky shape. I have also tried the new basal insulin Tresiba and Humalog for meals and seemed to do well with this, but, it is a hard switch if you are use to the convenience of pumps. You just got to feel you can trust your pump.
Overall it is working really good for me my tSlim that is. I think if you are on a low daily basal rate, it might not be the right pump for you because of the delivery system, but my basal rate is high enough, that shouldn’t be problematic at all. I think it’s really just a matter of tweaking a few settings that work better with this system. Overall though I haven’t had any major issues. I’ll give it a few days with changing my carb ration and my correction factor and see how that works. Medtronic has been the only pump I’ve used, I just didn’t expect having to tweak settings so much. But I like it too much to switch back to Medtronic.
Yikes, yes I understand your frustration. Luckily my highs have been NOTHING like that. I’m staying pretty good after eating initially but as that four hour mark starts approaching, I’m getting an increase in my blood glucose level, that seems to take a correction or two to bring back down. Not HIGH HIGH just stubborn. I usually can handle carbs pretty well too, but that was on my Medtronic. Higher carved foods are seeming to be a bit more problematic with my Tslim. Hopeful adjusted the carb factor and correction factor fixes it. My guess its the way the delivery system is set up.
To their credit, they acknowledged my documented problems, and they moved everything along to get me a refund. Everything was handled with no problems, and I surely am doing much better now. Possibly being on CGM might have caught some of the issues as they were happening, but I cant afford the technology so for me, there were no early warning signs of no delivery. I think a chart I found stated it would take 19 hours to detect a no delivery, or occlusion for a person on the low daily doses that I am on. Makes sense. The pump doesnt know nothing is going through, for quite some time.
I had used a minimed for 15 years, and switched to tslim, the ratio is different, but not enought to notice. and also I did find out something. on minimed the infusion sets although they are different, the tubing is the same. whereas the tubing is a little differnet on the new infusion sets. but it still comes out 1=1. I think it is just the absorbtion that your body is doing. I remember I did 11 to 1 for 8 years, then bam, now it is 15 to 1 but the basal rate is higher.
Maybe so, and Im sure the fact Im nearing the age of all sorts of hormonal changes doesn’t help matters either. I know literally overnight once I hit 40, I seemed to be getting a little more resistance versus the sensitivity I’ve enjoyed for many years. My basal rate really went up almost over night once i hit 40 and hasn’t really budged. for the longest time I was under a unit an hour…then overnight depending on the time of day I’m anywhere from 1.15 to 1.35.
For me, it isn’t what pimp I am using, I usually have 6-8 different carb:insluin ratios throughout the day. And these can change depending on whether or not it is summer (when I eat much less - never hungry and usually only eat when at a fasting bg and yet I need to up the insulin), and of course with weight changes - by even a few lbs one way of the other. I really don’t mind. Pumping allows me to really dial iin my treatment regimen to reflect my needs.
I agree pumping, even with the occasional frustrations of having to tweak all your settings is worth it by how customized you can make your treatment. Hoping finally got my settings tweaked. So far so good today with he changes I’ve made.
@kitkat2, how has everything been with the changes and the ratios? Just found out I was approved for the pump today and I am excited to start on the tslim, but I’m just a little concerned with the issues you were having. I have read quite a few people had the same issues, where they require way more insulin compared to any other pump, or MDI.
Hey, it is all actually going much better. I did have to change my carb ratio and my sensitivity factor a little. I think my problems is a combination of things. Every since hitting 40’s I think hormones have become an issue and also probably just needing the slight tweaking in my pump settings because of the change. While I did have to make some tweaks I can’t say that I require WAY more insulin than I did on my Medtronic. Overall I have been happy with the switch.
I switched after 12 years with MM to t:slim this year and my A1Cs dropped from the 8s to the 6s. I did make some basal adjustments, but I attribute most of the improvement to having the Dexcom sensor. Granted I had the older MM sensor that had to be changed every three days but it was always giving me alarms and was rarely accurate and so I never used it. I’ve been using the integrated Dexcom nonstop since January and the heightened awareness has made the difference in my case.
The biggest challenge I’ve had on the t:slim is non-delivery alarms, which were happening most often when doing large boluses. I missed the ability to manually change the bolus amount (MM would calculate the bolus but then I could increase or decrease it however I wanted, I can’t find a way with the t:slim to do this), since some of the bolus gets delivered before the non-delivery alarm. But the hack I discovered, that worked most of the time, was to keep my pump out of my pocket with the cord untangled until the bolus had been delivered. I’ve since switched to a low carb diet and have only had one non-delivery alarm.
@Pipli you can change the bolus amount by simply tapping the units displayed. It should open a screen where you can edit the amount.
As to the question of differences in pump settings, in going from the Ping to the T:slim we had to reduce all settings. I think for some the T:slim delivery is much more efficient.
@tiaE thanks! I had no idea, but this will be helpful for those rare occasions.