Welp, I done it. Byram just sent me the confirmation. Tandem X2 should be here this week, barring a couple of minor snags. One is that my C-peptide test doesn’t specifically note it was taken fasting, which it was, so my Endo just needs to attest to that. T’other is that I just had my 90-day order for Medtronic sets and reservoirs filled. So to avoid having to wait 3 months to start I have to return two of the ones I received so Medicare will ok sending two for the Tandem. Didn’t want to return all three because that would leave me using my emergency reserve if something goes haywire with the deal. Kinda like buying the new house before you’ve sold the old one. Awkward.
Something I didn’t expect: the online transaction receipt says the pump is a rental and Medical is the owner of record. Kinda odd considering they only pay 80% of the cost. Does United Health own the 20% they’re paying for? Just another Medicare weirdness I guess…
Also I realized that at no point did I actually specify Basal IQ or CIQ. When I called back they said my Endo had prescribed CIQ, from which there is no downgrade, so I guess that’s what I’m going with. Didn’t sound like BIQ was going to be all that much use to me anyway.
Hoo boy, learning a new pump, yeesh. Guess I’m giving AID a second chance. My Paradigm has now started being flaky about reservoir/inset changes. The one I did yesterday refused to retract the screw plunger, just wouldn’t respond to the button, until it finally did. So I’m not super excited about having to go through the whole learning curve again, but any misgivings I have are overridden by necessity.
I switched from Med 523, 3 years ago, with no regrets. The cartridge fill is a bit awkward at first, but can now fill and insert to pump in about same time as 523.
I started with a Med 506,7,8 I think, also 511, 512, 522, 523 before switching to Tandem X2.
I do use 24x7 sleep mode that works well most of the time. A1C slightly lower (mid 5s), TIR about the same, and consistent after initial ramp up.
Just know that your sensetivity and carb ratio will be different. I don’t know why but mine were when I switched over. , but not sure they were right on my paradigmAlso my basal rates needed to be higher than before. If you have any questions, ask I went from paradigm 2 years ago it takes some time tho to get it right
Yeah, always the way with a new device. I think of those parameters not so much as some objective value, but just dials you have to fiddle with to get your pump to do what you want. On my 670G I had my DIA dialed all the way down to 2 hrs, far as it would go. I’m sure the actual, scientifically accurate duration was far higher, but that had nothing to do with it—2 hrs was just the number I needed to put in to make the algorithm more aggressive.
You can negotiate with Tandem to get just BIQ or both or none. I have refused both in the past. Currently I am using BIQ and find it useful. It mostly is a protection from over bolusing close to bedtime. I know that I have to adjust bolus if it a day one of the cannula or day two or day three. Adsorption goes down with age of cannula.
Actually, all you have to change is the cannula. The latest version of the tandem pump software has got a setting for cannuka fill that that can go down to a fraction of a unit.
If uncertsin which Tandem software to buy get I suggest Basal IQ. It would save your doctor the effort of prescribing twice once for the oump and later for the software upgrade if you wanted to start in manual mode.
imo It’s worth doing their online course/test just to get familiar with the operation of the pump,
If you want manual mode you can turn basal IQ off. If you want some night time protection while you’re getting your profile squared away you can turn it on. Once you’re satisfied that you’ve got your profile and settings nailed you have the option of grtting another Rx, taking the online course and upgrading to Control IQ.
TA DA. Took some doing to get it here—backordered, then they shipped the wrong one and told me to refuse it and the correct one would come in a few days, only FedEx actually stopped it before it got here and the correct one came on the day originally scheduled for the incorrect one, which made me think it was the incorrect one, so I refused it, and both of 'em ended up back at Byram and they had to reissue the whole ship order and lots of confusing back-and-forth and waiting for people to call back who didn’t and and and…
But ANYWAY…
Hello new companion, not quite equal in significance to these other two, but still a pretty big deal.
Well time to celebrate!
I did that exact same transition 2 years ago.
It took a couple of months to get it working the way I wanted, so there might be some frustration for you too.
My old basal rates did not translate. My carb ratio also had to be altered correction factor was the same I think.
You can’t see into the cartridge which will drive you nuts for a little while.
If I was just starting it, like you, I would do basal testing for as long as you can go fasting. I mucked w it for a month before deciding I needed to just figure out my basal rates. After that control IQ started working beautifully.
Very helpful comment! Been looking for some expectations-management, and of course all the sales people are going to say bright and cheery things. But my memories of switching from MDI to a pump (my old Paradigm! sigh…), and again when I tried the AID 670G thing, warn me that it’s ALWAYS gonna take a while. So I’ve been working hard at anticipating that, but it’s great to have it reinforced with some specifics. Such as…
And gods have I been lazy about THAT these last several years. One of the reasons I’ve been reluctant to get into this whole pump replacement thing. Kinda like facing the task of cleaning out your attic. Thing is, settings drift is all too easy to ignore because CGM is such a crutch. You can catch and counter pretty much any miscalculation, so "Close enough for government work, as they say. Plus after years of living with a CGM you develop a pretty strong sense of what to expect. Even when I’m displeased by a reading, I’m rarely surprised by it. So yeah, if I’m going to give this thing a fair chance I’m going to have to exercise some discipline around all that stuff. Or just say screw it and run on manual the way I’ve been doing… But I think I’m curious enough to see if I can get it to do what it’s designed for.
The difference between the Medtronic algorithm and tandem, is that you set hard numbers for basal in tandem. And the algorithm makes adjustments to it from there, but the settings set the tone. That’s why basal testing is going to make or break the experience.
All I did for mine , and I do it from time to time when I change my diet or activity levels.
I just fast 24 hours and look to see what my pump has delivered per hour. If it’s reducing in an hour slot, I just pull it down, if it’s giving me more, I go with that.
I also set a weekend schedule thst I manually set for when I’m more active. The truth is the regular schedule works fine because it makes adjustments but I do it anyway.
Of course you need some numbers to start, so you can just estimate so if you usually use 25 units, basal, then set it up for 1 unit per hour and see how it goes. It doesn’t need to be complicated.
If you are using the sleep mode, it will not auto bolus for when you need a bigger correction. Many people run in sleep mode all the time to mimic what the Basal control used to do.
I always bolus before auto bolus get a chance.
But the nice thing about the tandem is you can override anything it’s doing, so if it suggests a 5 unit bolus, you can just change it to 4 or 6 or whatever you want.
Yes, that’s one of the things that attracted me—seems very sensible. And that you can override what it suggests. So much of my experience with the 670G was that, under the guise of doing everything for you, it made it so you couldn’t do anything yourself. Felt like taking control out of your hands and then not doing a very good job of controlling things itself. Backseat driver takes the wheel kinda thing.
I’ve been Omnipod for 3 years and it is so much better than having to deal with tubed pump. Pump change is much faster and all I need is the little pump pack and my vial if insulin. I also loop and my A1C has dropped a full point.
Each of the choices has pros and cons. I preferred the tandem because it allowed me to run the show all while keeping the algorithm running. But sometimes it’s other things that suit others. I couldn’t get the pods to work well for me because they insert at a 90 degree angle and at the time I was very lean and it would crush the cannula when it butted up against muscle. And worst of all you can’t see it, you can’t tell if it’s in or out and you can’t see if the site is inflamed. I never tried the algorithm with Medtronic. But I was so frustrated with their cgm that I moved on.
I think the Tandem Mobi will address a lot of my issues with the T2. It will be tubed but also a patch pump attached to you. So sort of hybrid. Also it has a cartridge that you can see into looking more like the syringe model that Medtronic has, but I have no idea how it functions.
I’m only 2 years into my T2 so even if mobi came out today, I wouldn’t likely get one for a while.
