Making the transition from Omnipod to Tandem X2

I am a little nervous. My endo suggested it. My A1c fluctuates in the 7.2 to 7.7.
I want to get to 6.5 and am having a hard time getting there. Part of the problem is that I tend to underdose due to the fear of going too low. I think TandemX2 will be good for this. Any thoughts?

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@typ1, the Tandem x2 is perfect for this. It is absolutely geared to preventing lows and bringing A1c to the 6.5% range. However, trying to get below that 6.5% takes a LOT of work and I find it to be very problematic. So, in your case, it will do exactly what you wish it to do. Go for it!


I just made the transition from MDI to T:Slim with Control IQ. I mentioned in another post that I am a bit skeptical of automatic systems, but have been pleasantly surprised by how well C-IQ works.

I use the sleep, normal and exercise modes. And have not used to quick bolus function. When doing a premeal bolus, if BG is above or below 110 it will suggest a decrease or increase of the bolus. This also works for a correction bolus.

Yesterday I under bolused for lunch. An hour and half before dinner my BG was ramping up, and showing no insulin on board. I did a correction does at the suggested amount. And was in a better place for the evening meal.

I received excellent training from a Tandem tech. She gave me some samples of infusion sets, because the ones the supplier sent were 9mm straight AutoSoft 90. Her thinking was that I should have a 6mm. She also gave me a box of TruSteel 6mm. I think I’m going to go with those. I have had no problems with 3 so far.

Good luck to you with the transition. I did a lot of thinking about whether to go with Medtronic, OmniPod or T:Slim. Each have pros and cons. I was convince I would clumsily bang the pods into stuff, but then was concerned about the tubing doing the same. The big plus for the Tandem over the other two is Control IQ.

Anyway, you get a 30 day trial period.

Introduction to T:Slim

Dexcom G6

Filling and loading a cartridge

Infusion sets


Thank you for your input.

Thanks so much!

typ1, I wish I had saw this post 11 days ago as I would have informed you to be mindful of one thing with the Tandem x2. If your sugar goes below 70mg/dl, the Tandem x2 will stop delivering insulin which is good… you would think. But lets say your sugar is at 65mg/dl and it creeps up to 66mg/dl. The Tandem x2 will start delivering insulin when it is not above 70mg/dl. This has happened to me and my sugar kept going down which is worrisome because if I was sleep or unconscious (GOD forbid) and could not respond to the alerts it could lead to a bad situation. Tandem x2 should not start delivering insulin until your sugar has at least gotten above 75mg/dl. Tandem reps couldn’t help me as the program of the x2 is set like that. Just saying be mindful of that as it still is a good pump.


I’ve noticed that it will suspend if dropping BG is reported by Dexcom. If it starts to go back up, it does resume basal but initially at a very low rate, like 0.124 u/ hr (not sure how it decides exactly ho much but anyway . .) at that rate it would take me 8 hours to get one unit infused and I cannot fathom how that would drive my glucose down more.


Good Day MBW, the 0.124/hr insulin resume rate you posted maybe what you or you’re doctor set it at so your body might respond differently as that amount is a pretty low dosage.

I might also add I have tested and watched my Tandem x2 which had suspended delivery go up one point from 59mg/dl to 60mg/dl and my x2 motor immediately began giving me my 1 unit per hour dosage causing my glucose to drop even further. This is a bad thing if you are a heavy sleeper.

Tandem needs to correct that and only allow the x2 to begin delivering insulin once it is above 70mg/dl. Just my opinion.

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I don’t have this issue with my tandem x2. It does the opposite and suspends more than I like.

It should be looking at your trend and where you will be in 15 min rather than the actual number.

You might need to adjust your correction factor, I suspect that is set too high for your body’s needs.


If this is true, then you must be using the first generation Basal-IQ. And like all first generation systems, it needed improvement. This aggressive resumption was a common complaint with that very first system and has been rectified with Control-IQ, so upgrading to the newer system will fix this. It’s free and available in most countries now.

Control-IQ works as @MBW described. It’s based on where Dexcom predicts you will be 30 minutes in the future. It may indeed resume insulin delivery while you’re still low, but only if you’re trending up and predicted to be over 70 in the next 30 minutes. (Even if you can’t see it, because Dexcom smoothes the data points based on the previous 2, to make pretty graphs, but it knows more than it shows.). When it does resume basal delivery, it will do so at a reduced rate until you’re predicted to be back to target in the next 30 minutes. And that rate is indeed TINY when you’re still low, unless maybe if you were trending double up or something…

And like @Timothy pointed out, it’s still not a perfect system. It sometimes withholds basal for way too long because the Dexcom prediction hasn’t turned around fast enough. I usually have to give a correction bolus after a long suspension, to avoid a wicked rebound. That rebound would be way worse if it didn’t resume basal at the first opportunity.


Ditto !!!


I also think that the problem is that insulin doesn’t work fast enough to compensate for long insulin suspensions.

Lately I have not been using Control IQ except for times when I want and need the protection from Lows. For example hiking or long car trips.

Otherwise I am finding that my BG is more stable without the constant adjustments of my basal, especially the suspensions. I also appreciate having 80-112 back in my life without reducing my insulin. I am also happy to be able to use temp basal rates. I have given up trying to find the perfect settings for Control IQ because I don’t think that my insulin or the Control IQ algorithm is nimble enough to do what I want it to do.

I think that for most people with Diabetes, Control IQ allows for big improvements in their D-numbers. I am not anti-Control IQ by any means. But lately I do better mentally and number-wise without it.