I Am a Tslim Pumper Now

I have been connected to my tslim since yesterday. I find that for my basals in the evening and overnight that I need to put 0 units in some time segments. When I was on my 630 l needed .025 in the evening and .050 through the night. The tslim only does .01 at the smallest. I alternate every other hour between .01 and 0. Anyone else have basal rates that low?

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Wow, your basal rates are extremely low. Are you still in honeymoon stage?

I set mine to 0.5U per hour, and only use this one basal profile. However, I do use overrides that will temporarily give ZB or a lower rate for exercise. I’m not on Tandem though. I use OmniPod and Loop autobolus, so really Loop is in control of how much basal I actually get. It is almost always less than 0.5U.

No, I have been type1 since I was 19. I am now 54. I weigh 90 lbs and I am 5ft tall. I am very small. Maybe that has something to do with it.

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I know some kids using omnipods have to do similar, but think its rare for adults to have basals that low…

Have you had c-peptide tested to see if you may be producing some insulin from pancreas?

Good luck with Tandem, I hope to get mine next week.

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I’m also five foot, though i do have a few lbs on you, I’m 120 (thankfully in the right places! Lol), but I take wayyyyyyyy more insulin. Usually my basal runs 30-40 units a day. Hard to put a finger on it, since Control-IQ is changing it all the time. It’s also like 75-80% of my total daily dose. I really don’t think that’s “typical” of hardly any adults, no matter how petite you are. Good for you, though!

I took more insulin than that when I was first diagnosed at 8 years old and 34lbs. I didn’t have a honeymoon, because I was a late diagnosis. I can still remember the crabby Nurse Ratchet barking at me “3 water, 8 milk!”, when I was practicing my injections on the rotten orange. The “8 milk” being an NPH basal substitute, given twice a day.

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I am 6’3 and I weigh 198. My basal rates are between 0.75 and 1.2. And have always been the same for 33 years. My total insulin is around 35 units a day. Same as when I was on injections.
I ordered a tslim and g6 today, I am currently on a mm 723. I’m so ready for a little more automation.


Yes, Loop Autobolus is similar. I just checked Tidepool, and it shows for THIS past two weeks, my avg TDD is 18U, 66% Bolus, 34% Basal. I vary a lot though. Some days TDD is 14U, other days over 30U but typically I am under 20U. I do exercise a lot (run) and I know that plays a huge part in insulin sensitivity. Loop Autobolus is definitely doing a good job bolusing corrections for me.

I will start tslim x2 next week, also switching from medtronic 723. Used medtronic for over 24 years, starting with 506 I think.

506-507-508-511-512-522-523. Final pump is 723 as replacement to dead 523 2 years ago, and no 5xx available. It was a good run with them, especially after adding dexcom (Seven, G4,G6) to replace sof-sensor. What an evolution!

(Some were no charge upgrades to newer models under warranty.).

Good luck. My order took forever to get through insurance and long delay from DME supplier, but I had only one choice.

I have kaiser insurance and they told me to expect a week to get the pump and sensor direct from tandem and Dexcom. So I’m surprised to hear how long you wait.
I have one box of infusion sets left and 4 boxes of sensors. Maybe I’ll need those I was thinking I would give them away.

I think DME struggling with COVID adaptation and work from home for some. So phone calls and emails constantly lost or handed off. At one point DME waiting for Tandem response, but Tandem didn’t get message, so sat idle for over a week. Then insurance required a C-peptide test to make sure I was type 1. (Not medicare).

If you need a pump I fail to see why they care what type u are. Insurance is crazy. Although I have not had much trouble with my insurance.

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Until now, I thought only medicare required c-peptide below a certain level. My previous plans didn’t. It could be they screwed up and miscommunicated between dme and insurance. I was surprised, but gave them what they asked for.

I agree, I have never heard of anyone who is an adult type 1 and not in a honeymoon having such a low basal rate. It makes me wonder if it is really mody? Some mody don’t need any insulin and some lower than usual I think. I have forgotten now.

One of my students had mody, when diagnosed he seemed like a type 1. Weight loss etc. But he doesn’t need any insulin. He just has to watch his diet.

I am petite, a bit taller and about 127. When diagnosed in dka basal was 30 units in the icu, I had lost 20-25 lbs then. It dropped rapidly to 9 when I was home. Now it is higher at 10-13. I constantly do basal temp rates adding in when I need more and shutting off for lows etc.

At one point I had lost some weight due to digestive issues and bg was crashing all the time. It was a nightmare, I was terrified to eat. It is easier for me to manage bg/ insulin when I have more weight.

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I have been trying to figure out my night basal. Before my tslim my 9pm-11pm basal was.025 on my 630. Last night I went below 5.0mmol at 1030pm and again at 142am. I get up and take a drink of juice as the threshold of 4.4mmol when the tslim suspends is when it thinks you are going to go below that number in 30 min. That is a bit too low for me. It would keep me in the 4mmol range all night I’m afraid. So I reduced my 9,10,11p basal to 0. It is such a small amount it might not even matter. I think I had a little more variation with my 630. I don’t know, I want this to work for me so I will continue on. My daytime rates aren’t a problem. Only evening and night are right now. I use my phone to alert me through the night. It has more options. It is also easier to look at during the night.

No I haven’t had that test. I don’t think I am making my own insulin. When I was on my Animas 2020 I had a similar rate. It was always like that in the evening hours.

Your in Canada, right? Meaning you’re still on Basal-IQ? Basal-IQ was pretty good, but yes, I still had lows with it. Control-IQ is sooo much better at preventing lows. Hopefully you can get the full update soon.

Try increasing your correction factor (higher number) and see if that helps.

I think someone else mentioned it, but you can also get the dilution solution from the pharmacy. You just mix it together with your insulin 50/50 to cut the potency in half, so you can deliver a larger volume that makes the pump happy.

Both these algorithms reduce basal to prevent lows. It’s “ON or OFF” with Basal-IQ and progressive reduction with Control IQ. But with so little basal to start with (zero in some segments), and the pumping resolution of the t-slim (little capability for a progressive reduction), I’m not sure either will be particularly effective.

I agree with @Robyn_H and others - diluting insulin so your basal flow rates are higher is your best bet.

Correct. I was looking at my dexcom clarity report for the last 3 days that I have been on this system. My graph bar for the hours through the night are mostly all red, meaning low. I might give it a few more days and if my numbers aren’t higher I will give my educator a call for an appointment. I have until the 22nd of July to see if this pump will work for me. I might be stuck with the medtronic pump. I know they are supposed to be making the 780 that will have bluetooth in it so I can connect anybody’s cgm system to it.

I wasn’t all that familiar with MODY, and was reading up on it this morning. You do sound like the poster child for MODY. Is that your official diagnosis, or are you being treated as type 1? Your profile says Type 1 or LADA, but I don’t know, maybe MODY wasn’t an option.

I’m honestly wondering if you need any insulin at all, let alone a pump? What are your insulin:carb ratio and correction factor(s)? What do your BGs do without the insulin? How much do you bolus and do you do so for every meal? What were you doing before you were put on a pump? Have you ever tried any of the non-insulin MODY treatments, like an oral sulfonylurea med?

You take so little, and seemingly go low so easily… So as an outsider, I’m kinda wondering why you’re bothering to take it at all?

Personally, unless you’ve already explored all the other options (there are 11 types of MODY, most of which are treated differently) and know for sure you need insulin, I wouldn’t want all the expense and strings of a pump at all. I think the X2 is the best pump on the market by far, but I kinda feel like you’re an exceptional circumstance and should maybe be looking to return it while you’re still eligible to get you’re money refunded. Unless, of course, you really do think a pump is the best treatment for you and it makes your life better. You can’t wait too long to decide, though, the return window is NARROW!

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What are you basal rates? You could extend the time of 0 (zero) blocks, decrease time at non-zero.

What were cgm reading during red times? Did you confirm any with bg meter checks?