I’m not surprised that someone didn’t learn how to use the t:slim effectively, how to determine the settings and set them once. I’ve seen lots of VCRs, ovens, cars with the wrong time flashing on their clock displays.
It’s a pity that you had to spend all your time constantly fiddling with settings that could have been roughly estimated in a few weeks, and refined once a month if you had learned how to interpret the data uploaded to Tandems site. It’s shameful that no one taught you how to use CGM data to tweak your lifestyle, or how to use it to systematically determine the pump settings.
I don’t blame you for that. The education we receive on using these pumps is awful. I received none.Luckily for me I didn’t expect any.
I’ve never had a teacher train me to use “tech”, especially diabetes tech, since I was first prescribed 26 units of beef NPH once a day and to eat less carbs if the tape I peed on turned dark.
I knew that if the FDA had approved equipment for home use and Medicare covered it as durable equipment, then there was a printed owners manual - and I knew how to read a manual even if it was badly written. To my surprise Dexcom and Tandem have very well written manuals.
Dexcom’s manual only assumes that the reader recognises that there’s a reaction of glucose to everything you do and feel and you can figure out what to do with that information just as you would with a BGM. “It ain’t rocket science”. I ordered the Dexcom manual and read it before using the G6,
Tandem’s manual explains what every setting and button does. All it assumes is the reader understands basic insulin management terms and principles. Tandem incorporated the entire Dexcom manual in the Basal-IQ and Control-IQ manuals, which I downloaded and now have in my phone and laptop .
I spent a day reading the manuals and making post-it notes with questions I had before I took the laughably terse online tutorial. I thought it was a good investment of my time to learn everything I could about a machine that would be attached to me for 5 years.
I was surprised and disappointed to find that a $5000 “smart” pump had fewer settings than my non-tech wife knows how to adjust on her phone, and more warnings than an arc welder. It’s just a scientific memory calculator with a single sensor feedback loop, a few more memory registers, a schedule that loads them and a precision pump it controls.
None of my usage questions were answered in the manual or tutorial. I figured them all out within a few weeks, helped by another book Think like a Pancreas, borrowed from my library.
I see differences between the Medtronics and Tandem pumps but only one of significance.
- The Tandem isn’t complex to set up. It has only 5 required settings: weight, approximate units/day, CF ICR, basal rate. Sleep schedule and detailed profile are optional, as are the alarm settings. Weight and TDD aren’t used after the Control-IQ algorithm has run for a day - unless you change them.
- I’ve never needed to read my pump screen in the direct sunlight. I have two hands and could shade it if I had to. I know the basic bolus menu well enough that I don’t need to read the software buttons. My phone screen continuously displays the glucose reading, a graph and 24 hour rolling metrics. I can read it in direct sunlight.
- The t:slim does have the square bolus feature. It’s called Extended bolus. Set the initial bolus to zero and during the interval chosen it will deliver a constant flow. It’s linked to the bolus calculator and the feature is shown every time you give a bolus.
- Extended bolus can also be used to adjust bolus delivery speed. Set the initial bolus to zerom the duration to a one or more minutes.
I know that few people have the patience to read a 175 page (350 half -pages) manual in one day, but not to do it in 1461 days?
- The touch screen is not as sensitive as my phone, tablet or laptop. The touchscreen "buttons are smaller.
- “Way less” isn’t a number. Waste as a percentage depends on fill and use.
- It normally takes me about 5 minutes to fill a new reservoir, (less if I fill 2 or 3 cartridge at once) 3 minutes to swap one out and have the pump fill the infusion set. A $20 fixture is available on Amazon to hold the cartridge and syringe in perfect alignment for filling.
- I have a flat LiIon 5000mah battery bank ($12) with a retractable cable ($1.25) that I carry in my emergency/backup kit. I can charge my pump while wearing it.
- The Medtronics infusion set cannula - IF it lasts longer in my body would save me about 10 minutes per week changing infusion sets.
- I’d need to have a lower TDD and for the cannula to work for 5 days for the choice of whether to change the reservoir, infusion set or both to be an advantage.
- I know what my pumps’ settings are. (I determined them by delaying one meal a day, eating a controlled diet and calculating the results.) The only person who reviews them is my endo, (who barely understands how Control-IQ works) and they get them from a Tandem report I made available to them.
- I have a nice silicone case that protects 60% of the pump front and most of the sides and back, with a stainless steel belt clip - $15 total.
- The bolus calculation/control target has no significance. My level and trend are important. I don’t care that my A1C is around 5.2. I care about my 24 hour TIR, average and SD each day - stats which none of the currently available pumps directly provide.