@Luis3 Thanks. Yep, I know 3 days is recommended but those days roll around pretty fast and so far so good for my skin. No infection or lumps yet. I ordered XC based on reports. And I have a Tandem employee educator doing the training. I met with her once and she seemed real straight in answering my questions pre-buy. I’ll meet her at Endo office. I don’t have to calibrate my Dex. I do sometimes because it can be off, but it’s rare.
I will see how it goes. I am sure Medtronic would be glad to have me back if I don’t like it but… my date starts on pump receipt and that was yesterday. Thank you!!
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Nope. The dust cover comes on and off easily. It’s just held on by a fatter piece of rubber tucked into a hole. They fall off all the time on their own and Tandem will send you free replacements if you want. (Hence all the threads asking about if it affects the waterproof rating… Which, it doesn’t.) And in my experience, Tandem is pretty liberal about the warranty. They don’t ask a lot of questions. They’re not trying to find a loophole to screw you over. They just need to know the pump is indeed not working right, and if not, they’ll send you a new one overnight. Their business model is built on attracting new customers, and keeping them. They take patient satisfaction pretty seriously.
Please don’t regret your choice. I did MONTHS of research five years ago when choosing my first pump. I read all the user reviews I could find, the scientific studies, the MAUDE reports of “adverse events”, I studied the product pipelines and where companies were going, researched their partners if there were any, etc… I believed then that the T:slim X2 was the best pump on the market, and that was before there was any automation and back when Tandem was still the little guy with a questionable future. I still stand by that today. T:slim is the best available. Is it PERFECT? Absolutely not. Is it still pretty incredible despite a few flaws? Yes! It’s mostly that it’s very different than Medtronic pumps, so there’s going to be an adjustment period. And it’s still in it’s first generation of Control-IQ, where there is room for improvement, and there are updates coming this year to address some of those improvements. It’s going to continuously get better. I think Tandem has the most exciting future and product pipeline, too.
I personally LOVE change and new technology. I was a medical researcher professionally, so this is my bread and butter. Covid had been absolutely painful for me by stalling all device progress in it’s tracks. And I’m doubly frustrated because now that Medtronic has openly admitted to their investors that it’s time to consider divesting (selling off) their diabetes division, Tandem doesn’t consider Medtronic competition anymore. Without any peer pressure, they’re free to sit on their current product and milk it for all it’s worth. So now it’s 2022 and the next generation pump we were promised in 2020 still hasn’t even been filed with the FDA yet! (Supposedly they’re filing this summer, but we’ll know more May 4th.) And while I’m sure most aren’t nearly as excited about new tech as I am, there are lots of people in my boat… Out of warranty or nearing the end of warranty without anything new to choose. It makes it easier to focus on the flaws when you’re staring down another 4 year commitment to them. So there’s a steady shift from excitement to annoyance, hence why you’re seeing more complaints. And I think they’re are ALWAYS some complaints from new adopters, because it’s so different from what they’re used to and and settings need dialed in. It’s to be expected. The overwhelming majority of people wouldn’t give it up, though, after that settling in period. At least judging by Facebook satisfaction surveys, whatever those are worth. The complaints don’t change the fact that the X2 is still the best available, in my opinion… And getting even better with updates.
Note, I don’t have any major criticisms of Omnipod. It’s great for accuracy and safety. I just think it’s catering to a specific taste, which isn’t mine. I don’t want anything that bulky at the infusion site and I don’t like the lack of infusion set choices. How good the Omnipod 5 algorithm is remains to be seen. I know of some trial participants who switched to Tandem “for the better algorithm” and others who love the Omnipod 5. There’s a niggling little part of me that wants to try it.
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@Robyn_H Thank you so much. My perspective is a bit unique in that I don’t have a lot of “wait” time for those improvements as I am in the old old group. So I go with tslim for the night time safety but the 24/7 irritation with the silly bag (bag!) of insulin instead of a visible hard plastic syringe insulin container and it’s ‘adjustment’ to somewhat accurate readings of how much insulin is left. I know how much remains in the Medtronic 630 without question. I can pull the syringe out and look how close it is to a flat stop if I want, and do.
Anyway, I have the tslim in hand because I choose the safety, I hope, of it and the Dex communication. I don’t have to like it but there you go. I don’t like that the Medtronic (so easy to use) does not hook with the Dex.
Medtronic refused to make a user friendly cgm. Companies do not really do much to be user friendly. Only what they must do. The same is true for Tandem or they would have fixed their bag and usb port long ago. Whatever made them go with a bag to start with? Some crazy engineer got an IV in the hospital and thought, oh yeah, that is how insulin should be delivered! Idiot!
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I started and programmed my tslim myself. I had already been pumping for 20 years. It’s not rocket science.
I entered the info from my Medtronic’s pump and started using it. By the time my training happened, I had already been making adjustments for 2 weeks.
The training did teach me some tricks and tips, but really I didn’t need to learn how to fill the cartridge or put in an infusion set.
My doctor kinda yelled at me for doing that before I was trained, but you know what, I started pumping insulin when my trainer was in elementary school.
It’s something I was comfortable doing and I had my pump so I went with it.
If you are going to live a long time with diabetes, you need to be the kind of person who listens to your doctors advice, but will also take your own care into your own hands.
After 34 years I don’t have any real complications from diabetes. I have dupuytrens and frozen shoulder twice, but not sure that is directly related or not.
That being said I had a weird stubborn low today while hiking. I got double vision that lasted an hour even tho my sugar was hanging around 70.
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This is a common opinion, but it’s actually a good design to meet the demands people were asking for. When Tandem set out to build a better pump, people were asking for smaller, safer, and a more modern design. That plastic bag delivered on the first two points. It’s simple physics and fluid displacement laws.
Medtronic pumps are basically a glorified syringe. The pump mechanism hasn’t changed in forever. The only difference being that the pump pushes the plunger for you. It’s the need for the plunger mechanism that means the pump has to be so large, more than twice as long as the insulin reservoir, plus extra room for the housing and internal mechanisms. Think of how big a full syringe is when the plunger is pulled all the way back. It’s also the reason for the primary safety risk, being directly inline with the entire volume of insulin, and the possibility of any or all of that insulin being delivered in a malfunction.
To shrink the pump size, they had to get rid of the plunger mechanism. So great, we’ll withdraw the insulin instead of pushing it. This means we can use a tiny pump mechanism and draw the insulin into an isolated intermediary chamber in the process, solving both the size problem and the safety problem in one go.
But you can’t just draw fluid out of a solid, air-tight vessel, can you? You can’t displace fluid with a pressure gradient, at least not without extreme force. Think of an insulin vial. Before you can withdraw any insulin, you have inject an equal volume of air into the container, otherwise you can’t displace the liquid without creating a vacuum. And because you’ve injected that air, you have to turn the vial upside down, so that you’re not sucking air. That doesn’t work for an insulin pump that moves all around, though, does it? The only other way to withdraw the insulin without introducing air into the system is to change the volume of the container itself. That means a soft, flexible container that can collapse in on itself as fluid is removed… More like a Capri Sun juice box that voids it’s contents easily.
You knock the idea of an IV bag like it’s remediary, but those IV bags are still used because they’re the best possible solution for the physics problem.
It’s a GOOD design. The only problem is that it’s different. People coming from older pumps and even MDI are used to SEEING the insulin, now they can’t. But you still know exactly how much insulin the pump can deliver. That’s never in question. SEEING it doesn’t change that. In fact, Tandem gives you even more info. Tandem tells you the exact units it can deliver. Eyeballing the reservoirs is only accurate to 20 units.
There is never any point in time where you’ll question how much insulin the Tandem pump will be able to deliver, except IMMEDIATELY after a cartridge change, when it’s just not a concern. After delivering about 10 units worth of insulin, the sensors have done their job and the pump determines how much insulin is available to use. When the volume is very large, it does round off to the nearest 5 units, but displays in single unit accuracy as the volume depleted.
Every pump wastes some insulin. It’s the nature of the beast, they just can’t access every last drop. There are 15-20 units of unusable insulin left in every cartridge after the display reads zero A lot of the complaints you see actually stern from people discovering there was MORE insulin in the cartridge than the pump screen said there was. But it’s in the manual and documentation, the pump can’t use that insulin, so it’s not registered on the displayed volume.
Now that you’re in the Tandem ecosystem, you’ll learn that they really do care about user satisfaction. They send out surveys often, and they use the feedback to implement changes. Unfortunately, since we’re talking about medical devices subject to years of design, product testing, clinical trials and FDA review… It’s a slow process to roll out the changes. They just can’t start shipping out pumps with different components than they were approved for.
Since people want to see the insulin, their next pump will let you do just that. They entered into a patent sharing agreement with Medtronic a few years ago, and I assume the cartridge/reservoir design for the next pump is something they got out of that agreement. I’m frankly a little disappointed in this choice. I worry about the sacrifices that had to be made to revert back to old technology here. But the people asked for it, so they delivered.
They also listened about the USB complaints and they’re entirely doing away with cables. Their next pumps will be charged wirelessly, and software updates will be wireless as well (just like updating your cell phone).
The ability to bolus from our cell phones has consistently been the most requested feature for years, so they prioritized this. It’s the first big Tandem feature to get FDA approval since Covid made a mess of everything. Unfortunately, IOS and Android have cracked down on security a lot harder since the Mobile Bolus platform was submitted for FDA approval a year or so ago, and they’re having a hard time getting the new versions of IOS and Android to play nice with the software, so we’re back to waiting… But they are desperately trying!
In the five years I’ve been with Tandem, I have been interviewed 4 times by them for more indepth product review. Twice in regards to a clinical trial Tandem invited certain patients to participate in (those whom had uploaded data both before and after pump automation was introduced), and twice as a follow-up to a survey. I was also once called by a group from their actual design team, after a tech support call of mine got passed on to higher ups. The wanted to understand how I was using the pump that brought me to my problem. As a new user, I was having problems with another round of lows after a low event, because the pump was ignoring insulin on board (greyed out and disregarded) and delivering for all the carbs I treated my low with, not just the excess. Turns out I was a freak for bolusing when low (hey, I know that i over-treat when sugar is my salvation from my current misery, and the sugar is going to kick in long before all the insulin does), and thus my behavior wasn’t anticipated. They were happy to learn from my experience with it.
Basically, I’ve been really impressed with how Tandem does business. THAT is the primary reason why they’ve grown so big, so fast.
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@Robyn_H Excellent explaination. 
And thanks for the video.
In my experience the only inaccuracy in cartridge measuring has been on new cartridges. After you pump some it will be quite accurate. I have often sucked out the insulin from a cartridge when swapping them for various reasons (almost out of insulin, or my site failed when there was still a lot left in it, etc) and the amount I have gotten out is usually very close to what the pump is saying. Obviously you can’t get ALL of it back out, but pretty close. I have also sucked remaining insulin out when it has had less than 10 units in it and it was still pretty accurate. I have not experienced it having way more left in it than what the read out says.
Another thing that hasn’t been mentioned by anyone in regards to the cartridge design is that it allows for more precise dosage. With my low insulin sensitivity that doesn’t affect me much, but for those that are more sensitive it gives better control.
I think you mentioned worrying about not making it 4 days, but even I with my higher insulin needs have been able to go 4 days multiple times when I haven’t had to change my site due to premature failure. If my site doesn’t fail and I don’t eat too many carbs going 4 days is not a problem. I use the 22in tubing (I think that is what it is) and when priming it only takes about 13-15 units on average, so you shouldn’t be using too much for priming really.
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