Need to make a decision

The warrenty is almost up on my Vibe. Tslim2 or Medtronic. It kinda boils down to the cam right? IMHO there is no reason to have a pump that doesnt integrate with cgm. The auto off feature from Medtronic is attractive… but I trust Dexcom. What’s a T1 x 39 years to do?

Potentially you could wait until Tandem releases the PLGS update this Summer for the t:slim X2.

I see nothing wrong running a pump past its warranty. Animas makes/made durable pumps. We ran our Animas Ping two years past its warranty and still have it in a drawer as a backup device.

Based on the (post deployment) reviews of the Tandem with PLGS and the reviews of the Medtronic at the time, you should be able to make the decision you feel would work best for you.

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My Ping has lasted three years past its warranty and I’m still using it (I also have a backup pump or two in case it fails). I’ve been waiting for a pump integrated with Dexcom; I thought it would be the next Animas pump, but now waiting for the t:slim in Canada.

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Tandem has started to line up partners for Europe distribution.

Last week, Tandem announced it has entered into a distribution agreement with Rubin Medical to cover Sweden, Norway and Denmark for the Tandem t:slim X2 and related supplies.

Tandem has previously announced that Canada would be handled directly from Tandem’s US operations. As well, Tandem has announced that Canada would be priorities to be the first international launch.

It definitely sounds like Tandem is continuing to move towards international distribution of its pump.

@Jen - I am wondering and perhaps you would know. Would there be different approvals for Europe and Canada? Only asking from a medical device approval perspective - not anything related to funding, pricing or insurance.

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I’m getting into that same boat before too long… My added annoyance is that I use and like Apidra (and have quite a bit in reserve). Tandem pumps and Apidra are not friends… I’ve tried Omnipod in the past and wasn’t totally happy, but I’m not thrilled with what I read from Medtronics, so given the choice…

What I really want is to hold out until one of the up-and-coming devices breaks thru the US market – I may be asking for trouble that way, though…

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The remarks I’ve read about the Med-T CGM in use with the 670G are consistently favorable, competitive in accuracy with the Dex G4 & G5. It’s how the 670G employs that BG data that would give me pause. I would have hard time living with a system that only corrects to 150 (8.3) and otherwise targets 120 (6.7). But that’s me; I aim for and often reach targets lower than that. If you can honestly say that those targets will be an improvement for you then the 670G and its latest sensor may be valuable to you.

Based on the reviews I’ve read here (see @DrBB’s posts) and other places I would consider a few things. If your A1c is greater than 7% and you’re willing to work to learn a new system and keep an open mind then the Medtronic’s 670 is likely to be a good fit for you. If, however, you’re already in the 6% A1c range or lower, you may not get a lot of benefit from the 670.

If your comfort is with the Dexcom CGM tech, however, I think waiting for the Tandem with the predictive low glucose suspend or PLGS would have a better chance of making you happy.

If it were me, I’d likely stand pat with your current Vibe hardware and let the market evolve for another year or more before making your next pick. I would be very interested in Tandem’s next iteration after the PLGS improvement. There will also likely be offerings from Bigfoot and Beta Bionics appearing on the near horizon.

Good luck with your decision. While I understand a four-year commitment is a large one, I’m thinking your choice at that future time will be clearer.

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Which is why I may end up going to Omnipod if I have to stop using my Vibe before something ‘better’ is around – I can pay for the PDM out of pocket (or, actually, already own one!) and buy pods - no 4-year commitment there!

Bigfoot and Beta Bionics AP options are on one side of my thinking, Sooil’s Dana RS and smaller players like, perhaps Cellnovo, are on the other side.

Medtronic’s fixed 120 BG setting on the auto-mode features play into my concern (I think Bigfoot may end up with the same limitation, though). The Medtronics rep I spoke with said “they have ways to work around that” for people who want/need better control, but did not elaborate.

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I have a brand new Ping, but even if it lasts for years out, the cartridges wont be manufactured. I am also trying to consider what Omnipod would cost me, and having a hard time getting an answer. Tried to get in on the Animas trial offer to test out the system, but they botched my info and I never was able to grab that deal. Tslim didnt work for me, had to get a refund. Not liking that 630 g…

The pump would need to receive Health Canada approval (similar to FDA approval) to become available in Canada. The fact that it’s been approved in Europe means nothing … some things (Ping, Veo, Fiasp) are approved in Canada very quickly, others (Lantus, Dexcom, OmniPod) take many years to get here.

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That’s not 100% true. The Tandem reps told me that they’re not allowed to recommend Apidra because it was never tested in their pumps. Apidra was released after the medical studies were completed. Likewise, there’s no clinical data that suggests Apidra DOESN’T work So we’re left with anecdotal evidence to rely on. There are actually plenty of happy people using Apidra with Tandem, though there are others that claim they get occlusions. I may be wrong, but it looks like Apidra may crystalize in the tubing for those with very low insulin needs. So long as the insulin is actually moving, it doesn’t seem to be a problem. I haven’t been able to try though, my insurance won’t cover Apidra.

Would just hate for insulin interactions to be a deciding factor for anyone. I love my t:slim x2 and love supporting small companies who are trying to do better for us.

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I love my 670G and I was under6 when I got it. It has been a great pump for me.

Note, I am a Medtronic patient Ambassador. I am not paid (ok I got a shirt and mug) and my opinions are strictly mine. Trust me a shirt and mug is not worth an untruth on my part.

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Problem is that a local Tandem rep told me that they have specifically heard of problems with Apidra in the pump (not just that they can’t recommend it, but that is does not work). I cannot use Humalog at all (allergy). I can use Novolog, but get much better results with Apidra - so “insulin interactions” are a significant factor to me.

I’ve heard of people having problems with Apidra in other pumps as well, but I have never experienced those problems with the Animas Vibe. It could be that it works for me because I always keep the Vibe in the fastest insulin delivery mode – which won’t help for other pumps, as I believe that Animas’ fast mode is faster than any of the other pumps. I do not know.

Ok - And how has using the 670G impacted your numbers, if at all?

I am hoping that my doctor will let me upgrade my pump at my appointment in April. I am reasonably happy with the Medtronic Paradigm 530 that I have now, but not with the Enlite sensors that it uses for CGM. I don’t know if the 670G has better sensors that are more reliable and accurate or not. The new auto adjust feature of the 670G implies that it does, although it would take a while to convince me. I have never used any non-Medtronic pumps or CGM, so it is hard to know whether I should try to switch to a different pump & CGM (assuming I even have the choice). Is there anybody that has experience using the Enlite sensors AND any other CGM? I would like to hear from somebody that has had hands-on experience with both.

For what it’s worth, I used Apidra in my Cozmo (Tandom bought the Cozmo patents from Smiths Medical, so delivery is probably the same speed) without problems. In fact, it clogged the tubing less than Humalog did. I then used a Ping with Apidra for years without problems. But I’ll be using Fiasp in my next pump (which I’m hoping will be the t:slim), so I won’t have any experience there, although I do have some Apidra in the fridge, so could try it.

My endo asked me a year or two ago if I’d experienced any problems with Apidra clogging in the tubing. I said I hadn’t. He said that Apidra isn’t recommended for pumps because it can clog the tubing (he seemed to be talking about all pumps, not just my Ping), but that in his experience asking patients, few had ever had this problem.

I love my 670g and I especially love the Guardian sensor.

I am a Medtronic ambassador. My opinions are my own. They did not pay me to say nice things. OK, they sent me a shirt and a cup but even I am more expensive than that.

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I was an Apridra user because Humalog causes welts and soreness at the infusion site. I switched to the Tslim X2 in early December and the trainer told me Apidra causes occlusion alarms. Well, less than 24 hours in I was getting occlusion alarms with the Apidra. I could clear them but it was annoying, especially in the middle of the night. I use over 40 units a day basal plus my boluses so the insulin is always moving. Since I switched to Humalog I have not had one occlusion alarm. Too bad but I would not put Apidra in my Tandem. I never had that problem when I was on Omnipod.

Just moved to Apidra and Day 2 the t:slim says “Go to Medtronic!”

So that’s what I’m doing on recommendation of my Endo who’s extremely well regarded and whose daughter is a senior engineer at Dexcom.