I have recently been diagnosed with gastroparesis and my endo thinks that switching to R insulin might help as its action is slower than humalog or novolog which are the only insulins approved for use in the t-slim. Anyone using R in the t-slim?
No experience with R, but you could also do an extended bolus and/or a temporarily increased basal rate to accomplish something similar.
You can use it in the Tslim if needed. Your endo can go over it with you and if you are worried, you can call Tandem and ask them about it.
There is a setting in your Tslim for insulin duration. For Humalog you set it to 4 hours. For the R you would just set it to 6.
Hope this helps. :)
So I called tslim and got the “we can’t really recommend or not” on using R insulin in the tslim. Wouldn’t even commit to possible warranty issues.
No offense Mario but you seem quite confidant in your reply. Do you have experience with using R insulin in the tslim? I’m curious mostly about your comment on changing the insulin duration setting, seems logical but more experimenting at this point would not be fun as I have been doing just that until my recent gastroparesis diagnosis.
Is R buffered? Novolog and Humalog are buffered, and that's why they're recommended for the t:slim. Apidra is not, and that's why it tends to crystallize and form occlusions and is not recommended. That's my impression, anyway.
Sorry if I came off as being over-confident or arrogant at all. It was not my intention.
I was mainly talking about the technical ability of the pump itself to utilize the longer acting insulin by way of its insulin duration setting in the menu system.
So while it seems like a fall back answer, I would still talk to your endo about it and have them ask about the specifics.
Companies like Dexcom and Tandem (or Medtronic or many others) can not give hard information to their customers since it could be considered "Medical Advice" and they are not covered to do that.
They can however, speak to your endocrinologist about the questions you have and leave it to their discretion.
As Niccolo points out though, I am not 100% sure on whether R is a buffered insulin or not and also whether it would cause occlusions or difficulties for the pump system in the T-Slim.
I hope this helps to clarify and I am sorry I can't give advice based on personal experience with R in this pump.
Wishing you the best,
- Mario
Thanks Mario I have asked my endo to call tslim. I will post their response
The pump was only trialed for FDA approval with Novolog and Humalog so by law they can only recommend those two insulins. There have been no trials using R insulin in the pump so they can't say 'yes it will work'...because if it doesn't and something bad happens to you, you can sue them for OKing an off-label use of their product. Does that make sense?
This is interesting because Apidra is the only insulin I've used in the T-slim. I'll call my doctor tomorrow and ask because I have had a couple of occlusions. Thanks for the info.
What's R insulin?
The key info is all in this thread, your doctor will either be aware of this info also, or perhaps more likely based on my experience, not well informed.
R = Regular insulin U100
So I tried R for about 2 weeks. Didn’t work for me because it virtually eliminates the correction bolus as its too slow. No occlusions or any other problems but I did notice that I had to significantly reduce my basal rates and their timing. I’m back to humalog and carefully planned extended boluses.
I also was Dx with Gastroparesis in July 2014. At first didn’t have so many highs after eating, only with certain foods, but now I am getting a lot of highs with everything. Started using the Tslim 1.5 weeks ago, love it, before had the Ping for 6 years. I am also new to tuDiabetes, joined today.
How long do you do the extended boluses, is it the same for all foods and in addition to the extended bolus do you take any medication for the Gastroparesis?