T:Slim x2 suspension low issues

I’m sorry but that’s incorrect, the minimum basal rate is 0.1 units/per hour. Yes, you can increment this at .001 (e.g. you could give 0.101 units/hr), but you can’t set it to deliver less than 0.1. You also can’t set a temp rate below 100% if your basal is already set to the minimum of 0.1 units/hr…if you want less than 0.1, your only option is 0.

What you can do is set up to 16 different ‘start’ times in your profile, so you could start at 0.1 units hr at 9pm, then at 9.15 pm switch to 0.0, then at 10pm back to 0.1 units etc. Unfortunately with only 16 start times you can’t program it to do this all night, but you could set it for half an hour at 0.1, 1.5 hours at 0 to approximate your 0.025 rate .

With my son in honeymoon period needing less than 0.1 units/hr, we’ve just ended up suspending (i.e. temp rate = 0%) basal delivery from when we go to bed until 6:30 am which is working OK at the moment (levelling off and waking up at about 5.5-6 mmol/L).

What about using normal saline as a diluent, to reduce insulin strength. My wife did that for about a year when she first began pumping. It worked.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3570861/

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Where did you get the normal saline and how did you make the dilutions? I currently dilute Fiasp with Humalog to eliminate issues I’m having using the neat product in my pump. I would rather dilute with normal saline and increase my basal/blouses to compensate. I’m using Humalog because it’s the only sterile fluid I have.

Ask your pharmacy. Don’t use the stuff for $8 a bottle at Walmart. it’s not supposed to be used for injection.

How did you make the dilutions? I fill an empty insulin vial using the syringe supplied with X2 cartridges.

dunno. she did it. an endo should know and help with technique questions.

When I originally brought up the topic with my endo/CDE they recommended preparing the mixture in the syringe prior to filling the cartridge. That’s a problem because the syringe volume is too large to draw the amount of Humalog I’m using (400uL/cartridge) accurately and reproducibly. That’s why I started preparing a larger volume in a vial and using that to fill multiple cartridges. I’ll ask them again.

I’m sure you know that sterile technique is as important as an accurate dilution ratio.

No, they’re equally important. I can’t base therapy on a varying insulin composition or a non-sterile fluid. I need both. That’s why I was asking how she did it. My main issue is finding better equipment/techniques to handle both.

How about drawing the saline first, then the insulin. that would keep your container of saline as sterile as the syringe needles u are using. (she just came home, and told me that’s how she used to do it). we both feel it would be a mistake to use a container over and over, such as an empty insulin vial. (she’s an OR RN). Doctors and nurses draw medication from a bottle, multiple times, using clean needles. However, there are “rules” that govern multi-use, ie, a vial is discarded after a single use, despite having plenty of medication left. Some in practice, it just depends. Think of how many times we insert a syringe into a bottle of insulin. Definitely more than once.

@Dave44 - Point well taken. I’m using the glassware/syringes once so I’m not concerned about sterility.

I was surprised to find this article describing how to dilute insulin and the readily available equipment.

@Dee_Meloche, this also discusses using diluted insulin for people with high insulin sensitivity.

According this this article, Lily doesn’t recommend using diluted humalog in Insulin pumps. I’ll try to find out why that’s the case.

https://www.diabetesdaily.com/blog/diluting-insulin-when-its-beneficial-and-how-to-do-it-591809/

I saw the comment about ordering from the mfgr. My wife used Humalog with no issues.

This feature was one huge reason I went with Tandem. I wanted something that turns back on as soon as my blood sugar starts ticking back up vs the Medtronic 670g that waits an hour or so before it kicks back on. In that timeframe after treating a low and than no insulin is just opening a can of worms that I do want to open.
I find this pump to be very smart and I love the fact that it predicts lows before they get that low. And when reviewing my reports it shuts off around 83 and turns back on at 94.
Have I had lows under the 55 urgent low threshold? Sure. It is usually when I am waiting for a low being treated taking it’s time to come up. But I must say, those darn rebound highs are not nearly as prevalent as they were before.
As with everything dealing with a pump, it takes time, energy and a focus. Pumps are not for everyone! And they all demand and need work and attention all the time. And this is where I say, every pump has its fans and haters. And I say again, it would be so darn cool if we could just order a pump with all the features we want, just like when you order a car!

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Have you tried getting a car with JUST the features you want? It’s no longer possible. There are huge packages that come with things you may not want, just to get something you do want. Being tall, I don’t want a sunroof but in order to get other things I want, I would have to get a sunroof. Toyota has gotten worse about that than back in 2012 when I got my Camry. I would rather order individual features and wait a few weeks for a car to come from the factory JUST the way I want it instead of settling for what is on the lot and for sure it will have something I don’t want.

Yeah, if you buy off the lot, but if you can wait, you can order. But like everything nowadays, cost, cost, cost and no one wants to wait. I remember my uncle buying a car every 2 years and he ordered it. Must be nice!

You cannot order just what u want. At least not at Toyota, or Honda. I’ve asked recently.

Except one time, I’ve kept vehicles for over 15 years. and that exception was 7 or 8 years.

Guess i’m Dating myself again. Oh to able to dream and get what you want/need!

Sadly, yes, you can no longer just the features you want. There are 3 or 4 trim levels and a couple of optional packages, in general. that’s about it. The 2020 Hylander (highest trim level with the electronics I want) comes with goofy oversized wheels so that there is very little air cushion in the tires. I think they will be 21". I asked if they will sell me the vehicle but keep those wheels/tires and let me get smaller wheels. they said,“no”. that would mean a huge expense to order all new wheels and tires and then have the hassle of trying to sell the original stuff. they just won’t work with customers on that sort of thing.

@Dave44, @Dee_Meloche

I spoke with Lilly today about ‘do it yourself’ dilutions. They will provide Humalog diluent and sterile empty vials free of charge and without a prescription. To get them send an e-mail to

Lilly_distributon@lilly.com

Request the 10mL diluent and empty 10mL vials using the following codes, and tell them how many of each you would like.

ND0800 - diluent
ND0801 - empty vials

Include your name and address, and the name and address of the pharmacy where you would like them sent. They won’t ship to a home address. Typical ship time is 3-6 days ARO. I ordered a supply today.

I also asked why Lilly doesn’t recommend using diluted Humalog in pumps. They won’t recommend it because it hasn’t been approved by the FDA. You can still do it, but it’s off label. You might want to speak with your endo first.

I called Novo hoping to get Fiasp diluent. It doesn’t exist as a product right now. I believe they have a program similar to Lilly for Novolog.

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Awesome! That should be a “sticky”. You might want to mention that where parents of T1’s post on forums and FB groups.

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