Hello All! My first and only insulin pump is the Medtronic minimed which is currently out of warranty. Next week (Monday) I am going to talk to my endo about getting a new pump. I’m leaning towards the T Slim and Dexcom. I currently do not use CGM, but have used Medtronic’s CGM in the past. For the past year my insurance was terrible so I haven’t been able to upgrade or purchase pump supplies so I’m very excited that I have good insurance now and can get back on track. Does anyone have any experience switching from Medtronic to Tandem? Any advice? Also, should I use Dexcom G5? Does anyone have any other pump/CGM preferences that I might have overlooked? When I first got my insulin pump there didn’t seem to be so many options!
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i am using the Animas Vibe with Dexcom G4 support. With my insurance, I didn’t have a better option, though. I might have otherwise considered the t:Slim/G4. I Have been using the Dexcom for almsot 3 years now, and the Vibe since August. So far, been happy enough with both, though I might have benefited from a larger reservoir, and perhaps a bit more granular settings in some areas.
Thanks Thas! I’m excited to try CGM again, I did like Medtronic’s when it worked. I’ve heard and read a lot of good things about Dexcom G4.
Dexcom G5 is arguably better than the G4…
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Some people like the pump/CGM integration that will allow them to avoid carrying a separate Dexcom receiver, using the pump as the CGM display. The Animas Vibe and T:Slim pumps offer that. Dexcom has been upgrading and improving the CGM accuracy relatively quickly over the last few years. To take advantage of expected upgrades going forward, it may be desirable to buy a separate pump and CGM.
The Vibe, for instance, is limited to the G4 Dexcom system. But this system is one significant software upgrade (the 505 update) behind the latest G4 software. They cannot upgrade to the Dexcom G5 or even the G4 Share. That may not seem like a big deal at the moment but Dexcom has the G6 system in the pipeline and when it comes out, the integrated pump/CGM users will be left behind.
Pump warranties last 4 years while the CGM warranty is only 1 year. Most insurance plans (US) will not allow device replacement until the warranty expires. I would recommend keeping the pump and CGM hardware separate so that you can enjoy the expected continued software improvements in the CGM in coming years. Just my 2 cents.
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i love my Dexcom G5 by far the best one. but as for the pump thing i can’t help out on i don’t have one sorry.
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Thanks for the advice, very helpful!
I use the accu-chek spirit combo and Dexcom CGM. Has worked well for me but we are all different. I do agree to keep pump and CGM separate.
I’m not sure I’d agree the Dex 5 is that much better than the 5. I know quite a few people who have reported they’d go back but are now stuck. The other advantage with the 4 is that you have two options Animas Vibe or Tandem Dex, whatever it’s called, that come integrated with pumps.I’m a big fan of that. I get decent results from Medtronic Enlite sensors. If you used the Sof Sensor Medtronic, with the big, wicked nasty harpoon needle, the Enlites 1) work better and 2) insert better. I did a very short run with Enlites and Dex 4 side by side and found the Enlite generally a bit more accurate than the Dex 4 but it was a short sample. I started thinking I’d take notes but that lasted about 2 days. I hate logging.
I like the Tandem Dex combo a lot. My local buddies @Phyl arranged a meeting with @Wiffy and I and the Tslim salesperson about a year ago and I thought it looked really neat but I’m sort of a “don’t upset the applecart” guy and decided to pass.
The main marketable appeal of the Dex5 seems to be no receiver but when I used the Dex, the receiver was very unintrusive, easier to use than my phone as it has no distractions “ooh, email!” and fits very easily in all of my gear. I am somewhat skeptical that the Dex5 is significantly better, although I have been skeptical of the general assertion that the Dex is much better than the Enlites, based on my N=1 sample. I’ve run into a few other Enlite partisans who have mentioned “yeah, it works fine for me…” so it may be a YMMV thing? I definitely prefer the fact that Dex lasts for 3ish weeks. That is very handy!
I also agree there are a lot of interesting things in terms of new equipment rumors on the horizon. The FDA process is so convoluted that the companies can only talk in very vague terms about what might happen and it makes it very hard to be super enthusiastic about any product because you could be surprised by a newer or better one at almost any time! Good luck with your search!!
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I agree @acidrock23. I usually do keep the receiver and do not find it particularly intrusive, plus with Share, I can have a phone app, too (eat my cake and have it too!). I have been running the Dexcom receiver with the newer 505 software side-by-side with a receiver that has not been upgraded from the begging – first with a secondary receiver, and now with the Animas Vibe. I see very little difference in accuracy – the two algorithms are almost always within 5 points of each other or 5 minutes, if BGs are changing at a moderate pace. The newer, 505 software tends to err on the side of lows – presumably for more just-in-case hypo-alerts. As I run my BG somewhat closer to the low end, those extra false alerts can get annoying at times – the older firmware is somewhat less… “paternal?”
For now, I have no inclination or incentive to upgrade to the G5, and I do not feel deprived.
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I had previously used Medtronic’s sof sensors - ouch! I think my main debate right now is between Dexcom G4 and G5 - either will be an improvement from the nothing I’m using now. I used to have very good control and definitely need to get back to lower numbers.
It would be interesting to try the G4 and G5. My understanding is that the main knock on the 5 is that the range of the transmitter is much more limited. One of the things that I liked about the 4 was that I could leave it downstairs (admittedly because it seemed prone to get stuck on fake lows after I went running…) when I was asleep. This is of particular concern to parents who are not enamored of leaving their kids with their phones at night but have to to make the receiver “catch” and “Share” the info. This may or may not be a concern for you. If you have your phone all the time, it may be no big deal. I also like having my diabetes data off of my phone as my phone has other crap going on with it.
I have had the T:Slim G4 (insulin pump with integrated Dexcom G4) since early December. At first, I had several issues with it and ended up needing to have the pump replaced 2 times. Once because of a rare occurance where the toggle between letters & numbers wouldn’t work, thus, I couldn’t input the Dexcom transmitter I.D. The second replacement was due to receiving data error alerts that had already occurred before I even received the pump. The third pump I received is what I am currently using. One thing to note if you are wanting to use CGM and pump integration is that there is NOT a range of 20 feet if you use the pump as the receiver. Dexcom’s receiver has a range of 20 feet so assumed that was the case when using the T:Slim G4 as the receiver. I was wrong. I contacted Tandem Tech support 3 times about this issue and I read the user guide and found out that if someone wants to use the pump as the CGM receiver, then the transmitter need to be on the same side of the body with very little interference. For example; If I wear the sensor/transmitter on the back side of my left arm, the pump/receiver needs to be on my back left side in order to receive consistent readings. This is because, and I’m relaying what Tandem & my Tandem CDE informed me, the pump casing is not plastic like the Dexcom receiver so connection through radio waves is more difficult, thus providing a much shorter range. It’s not a deal breaker for me, but I would have loved for them to tell me beforehand. In my opinion, I trust the Dexcon G4 receiver more than I would a pump receiver. Other than the distance ‘thing’, I love the T:Slim G4! If you or anyone else has any specific questions about the T:Slim G4, I will try and answer to the best of my knowledge from my own experience with the product!
Hi Nicole
I have been pumping for 29 years and have, for the most part, been a Medtronic fan. Up until now, anyway. I decided to try the new T-slim G4 when it first came out because of all the advancements the company is making. I am truly happy with the pump, I absolutely love the colored screen, and the CGM gives great results as long as it isn’t obstructed. No, the transmitter doesn’t reach 20 feet but how often are you that far away from your pump? And, yes, a pillow will block the signal but I try to either wear the pump or lay it by my side when I’m in bed. It is so thin you can roll over it without even knowing. My only issue is that it isn’t waterproof like Animas (not a fan). No big deal. I’d suggest going with the T-slim because the sensors are much more accurate than the Medtronic CGM.
Best of luck in your decision!
Rose
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The t:slim is rated @ IPX7, whereas the Animas is rated @ IPX8. In theory, this means the t:slim can be immersed for up to 30 minutes at depths up to 1 meter (3.3 feet). The Animas (again, in theory) can be immersed for up to 30 minutes at depths up to 3 meters (10 feet).
So, if I use the receiver or my iPhone for CGM instead of my pump (which is the route I’m leaning towards) I have to keep the device on me (within 20 feet). Do most people carry it on them 24/7? I was originally thinking having it in my purse or leaving it on my desk when at work but it sounds like this won’t work if I walk 20 feet or more from my desk. Does the CGM need to then be recalibrated? Also, are there obnoxious alarms or can they be muted/ put on vibrate? I know with Medtronic’s if I ignored my alarm (if I was in a meeting or something and had my pump in a not so accessible place) the alarms would get louder and louder. The waterproof aspect doesn’t matter to me as my current pump is not waterproof at all.
I don’t know about the t:slim, but the Vibe and the Dexcom receiver will simply restore the connection after several minutes, when they return in-range without the need for any additional calibrations and even for extended periods of loss in signal. I currently user both the receiver and the pump’s receiver, but at times, leave the separate receiver at home for hours at a time – it recovers quickly when I return.
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Correct. If you use the Dexcom receiver instead of the pump as the receiver(remember, the pump as the receiver has a much shorter range unlike the Dexcom receiver), the device needs to be within 20 feet to receive connection/signal. However, you can always be more than 20 feet away from the receiver and then return to the within 20 foot range and connection will be restored. I have left my Dexcom receiver at home and returned a few hours later, and after a few minutes my Dexcom receiver picks up the signal even though I was way more than 20 feet away! i have not used my phone as the receiver so I have no idea about the distance in relation to using the phone as the receiver.
@Thas comments are spot on about the Dexcom receiver!
and @rosieb comments about the T:Slim G4 are correct as well and exactly what I do as far as sleeping and maintaining somewhat constant connection.
With all of this said, if you decide on the Dexcom G4, I think you would absolutely love it, even if it’s not integrated into a pump! @Nicole4
Thanks everyone, I appreciate your advice/input!
I recently upgraded from a MiniMed pump and Dexcom G4 receiver to the t:slim/G4 integrated pump. The newest t:slim/G4 has worked out very well for me. I wanted an integrated system - insulin pump and Dexcom CGM. Before the upgrade I had a Dexcom G4 and a minimed pump which meant that I had a pump and Dexcom G4 receiver with me 24/7. Now I just carry one device the t:slim/G4. it is all that I was looking for. With the t:slim/G4 I no longer needed to carry around a dexcom receiver. I decided against the Dexcom G5 because in my work, sometimes I am not allowed to have my iPhone with me. If you want a Dexcom “G5”, just know that the G5 transmitter is not compatible with the t:slim/G4. You can simply get a non-integrated t:slim then get a Dexcom G5. The G4 transmitter does not transmit a Bluetooth signal to your iPhone and the G5 does not communicate with the integrated t:slim G4. Make sure you talk to a Tandem rep to get all your questions answered. I have heard that the G5 Transmitter has a shorter battery life and requires replacement sooner than a G4. That may not be an issue for you. If you are set on upgrading to the Tandem t:slim pump you have at least two options: t:slim/G4 integrated with Dexcom G4 or a t:slim non-integrated pump and add a Dexcom G5 with Bluetooth comm to your iPhone. Good luck