@tedos, many of the skin barrier products have the same core ingredient, there is a rosin based one out there (the rosin based one is the unicorn) by Ferndale labs. Personally I react to most skin barrier formulations, and even some of the over patch adhesives. When I place things also seems to be an issue. My go to spots on my thighs will now only tolerate 2ish days for anything, CGM included when I used to run a CGM there for weeks. My abdomen was never happy with adhesives, and my arms are the most tolerant, even with an overpatch.
Regarding your ask re: TSlim occlusions - in 4 years I can count the occlusions I have had on less than one hand. I generally use either steel sets or 30° manually inserted sets (nylon).
I also don’t have much trouble with occlusion alarms, with my Minimed/Medtronic for about 24 years and Tandem for about 6 years. For me the problem when I switched from Medtronic to Tandem was the infusion set. That was when I finally just went metal and haven’t looked back.
I do find that rotation is key. There are some sites that aren’t as comfortable as I want but I still use them. I find the outside of my leg a little more painful the first day but it settles in, same with inside but I push through. That rotation thing was drilled into me back in the day. I find the back of the hips and all around the lower belt line is most comfortable.
Sorry to say, no perfect answer here. Just got to try and find the best infusion set and as many sites as you can use!
Many of the few occlusion alarms I get with 670G are due to a kink in the cannula. When I first started on pump, I got a lot of those until learned how to hold the inserter so the “plunger” wouldn’t bump my fingers or thumb.
Are you be chance using Apidra? My insurance stops FIASP coverage 1 July, so may be giving Apidra a try.
I don’t think my occlusions are due to the cannula kinking because everytime I pull it out to inspect it’s straight and insulin goes through if I use the plunger to test.
I’ve been using Apidra since day one. Initially I thought it’s the insulin not being compatible with the pump but then it doesn’t explain why the first 4 years I never gotten a single blockage alarm. I also checked with Apidra and they say it’s approved for pumping.
I am a huge fan of TandemIQ!!! It has made my life so much easier! Since switching to metal infusion sets, I have had no problems with occlusion alarms. Medtronic would have to do something pretty big and spectacular for me to switch back. While I never had any problems with customer service with Medtronic, I just feel they are not on the cutting edge. I mean in all the years I used their pumps, I had 3. Which shows how rarely they made big changes.
And for me, problems are usually infusion set issues not pump issues.
The thing for me is that I’m not using CGMS because on the Medtronic it was vastly unreliable and secondly, the cost is very expensive and not subsidised. I don’t intend to use it in the tandem either for these reasons.
With CGMS aside, is there anything that stands out on the Tslim? Does this one interface with the mobile phone such that when I bolus I can do it via my phone
@Sally7 sorry I have one more question, I just watched on YouTube a tutorial about filling the cartridge with insulin. The cartridge doesn’t seem to be see through like the reservoir on the Medtronic, how do you know whether air bubbles are present?
My insulin comes in a pen so I currently use an insulin pen to fill my reservoir, not a syringe.
I’m not fond of taking medications if I can avoid them, either, and believe there’s a risk/reward to evaluate for everything you take… but for me the anti-inflammatories aren’t optional. Between the two, though, the Natto-Serra is my favorite and I believe the safest. The side-effects are also potential benefits, like lowering blood pressure.
When it comes to infusion sets, you’ll usually see two names, Unomedical and Infusion Care; but they both come from the same company, ConvaTec, manufacturing with the same material. You might see minor proprietary differences, like in the connections, but for the most part infusion sets are similar across the board.
Not quite yet, but it’s in the works. The first version of the mobile app is being tested. The mobile platform is the cornerstone of the next pump they’re developing, which won’t have a display screen at all, and they’re rolli6 it out to X2 users first The most recent Control-IQ update snuck in a Bluetooth toggle option to allow the X2 to speak to your mobile. We’re just waiting for the app it connects to. The first iteration will only allow you to view information from the pump, though. Operating the pump via the app is a separate FDA filling, and isn’t expected until later this year.
I was on MM for 4 pumps. Switched to T slim when they chimed in what the Dexcom sensor. The MM sensor was challenging and unreliable for me. I loved the T slim for months and never thought I could live without a pump. Then, like you I experienced more and more infusion issues. ( T1 50 years) I changed infusion sets, tried only 2 days of wear, tried everything. My endo said…You have lost ability to absorb through pump.
I reluctantly went on MDI. Never imagined I would love it ! Have best control in years…because I KNOW I AM GETTING INSULIN1…The freedom is amazing . Showers, sleeping, exercise, etc! I cannot imagine going back to a pump. Now they have Smart pens that do almost same as pump with few limits. I am happy and no longer insane.
Keep us posted on what you do. Good luck!
Hello: When I was first on the T-slim the cartridge design really bothered me because it is like filling a darkened chamber, I like seeing the insulin once it is in. I have gotten used to it now and I do use a pen to fill it ( I mix Fiasp and Novolog and use the pen for the former, a vial for the latter). I think the main difference is that having the insulin at room temperature seems to work better (fewer air bubbles). Moreover, the way it pumps insulin into your body is much slower and therefore I find it irritates my site less. Lastly, a word about CGMs the Dexcom has by far been the biggest game changer in my diabetes management. I hope you can find a way to get one, Dexcom works much better than the Medtronic version.
@ASA thanks. How do you tell whether there are still air bubbles if the chamber is concealed? And can you elaborate please on how you fill the cartridge using a pen, is it still using a syringe but instead of vials you extract from the pen?
Hi there: you remove the air bubbles from the cartridge before filling it. The Tandem website shows how that is done, you essentially suck out the air bubbles with your syringe prior to filling it. Moreover, when you prime your tubing you just watch for the last of the bubbles to pass through.
Ah I see. The reason why I ask is for the Medtronic resovoirs I fill directly with the pen and without a syringe - I use the blue connector piece that comes with it which has a needle to piece the pen. There is no air bubble in the pen however when I fill the reservoir bubbles do form so I was thinking the same thing will happen with the syringe and you won’t be able to see it if the cartridge os concealed.
With the Tandem you take care of the bubbles within the syringe itself and then when you prime the tubing you can see a few bubbles at the beginning and then they stop as you continue priming. Overall, I do find that the pen does generate more bubbles than a vial I just try to fill it in tiny increments. If you are interested in the Tandem I would recommend going to their website. My Endo’s office is now openly recommending Tandem over the Medtronic model --first because of how it works with the Dexcom CGM and because of the Control IQ. I had an Animas pump previously so I can’t comment on the Medtronic pumps. I will say one of things I like about the Tandem is that when they come out with improvements it simply involves a software upload, you don’t have to physically change pumps.
Not exactly. Mine came shipped with a terrible One touch Verio IQ in the box, and when I complained about how awful it was, they sent me a second one that was worse. Complete random number generators. I don’t know if Tandem had anything to do with that, though, or if it was my durable medical equipment provider (thanks to our crazy insurance many people in the US have to go through a middleman to order supplies) that had the deal with the manufacturer. You can use any fingerstick meter you want, though. I kept using my trusty freestyle lite that I’ve used and loved for years. And now that I rarely test anymore, my test strip stash for them might outlive me.
I’m sure you already know that it does integrate with Dexcom G5 and G6 and will work with the G7 when it’s released.
For those not using a Dexcom, you can upload your glucose data from your meter into the t:connect portal. Some meters make that easier than others. Some have Bluetooth sharing or USB ports. Others, unfortunately like my freestyle lite, require a proprietary data cable than can be expensive. The t:connect application has some great analytical tools, should you choose to upload your data to it.
Thanks @Robyn_H, well medtronic gets a brownie point in this area then. My current medtronic pump came with a glucose meter and after every test, it automatically transfer the reading to the pump so you don’t have to input it. This was quite a nifty function.
Does anyone know whether there is a meter out there that can sync directly to the tslim?
Sorry, I didn’t know Medtronic pumps did that and what exactly you were looking for. The answer is no. The t:slim X2 does not directly sync to any manual glucose meter. So you’re right, that may be a pro for Medtronic if that’s an important feature for you. While I’m highly team Tandem, I fully accept that there are those whom are better suited to Medtronic.
I will say that I used the X2 for two and a half years without CGM, and I still think it’s an exceptional pump without that integration.
While no meter will automatically send a fingerstick result to the pump, it only takes moments to manually enter it with the touchscreen. You don’t have to keep scrolling until you find the right data point.
Have you tried the simulator app out yet? It will let you try out the interface to see for yourself.
I think the simulator app probably features a pump setup including CGM, though. The only difference if you never connect a CGM is that instead of a graph front and center on the screen, the “1,2,3” screen lock and the “bolus” and “options” buttons on the home screen all move up to a more prominent location in the center of the screen, instead of the bottom.
Personally I tend to “quick bolus” via holding/pressing the button on the side, so i rarely use the bolus wizard anyway.
