Tandem t:slim X2 - Micro-Delivery Technology

In another thread, @meee had made mention of a feature that the Tandem pump has. It was surprising to hear as I almost never hear people speaking of it so assume most people are not aware of it.

It actually is extremely interesting. (Thanks for mentioning it @meee !!!)

So, I found a YouTube which would appear to be produced by Tandem that graphically explains and demonstrates the technology. This is very short, only 41 seconds but enough to show what it is.


Nice. My next appointment with the doc is in January. She’s mentioned a few times in the past year and a half that I’d be a good candidate for a pump and that it might reduce the amount of insulin I take.

I didn’t consider it an option in 2017 due to my crappy insurance plan. Now my new plan is genuinely a Cadillac plan and I only pay 10% for DME. I have been using a Dexcom 6 since mid-October and it’s been wonderful.

I am T2 on MDI, 5-6 injections a day between basal, bolus, an occasional correction dose, and Victoza. My last A1C was 5.9% with no hypos.

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Woah great!! Will watch it later, I have never seen a video about it as I recall. I researched very carefully and Tandem’s design which offered overdose protection is the only reason I am on a pump.

I think it makes things a-little harder in that the cartridge has to be changed more often and insulin can degrade more rapidly because it is a plastic bag inside. But it is worth the overdose protection. I wish they could change that too though😹

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Very cool

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@lumi73 my TDD dropped y almost 50% in the first 6 months after starting on a pump. Was 160ish combined daily, now 70 to 72 daily.


Looks interesting - but,

I have to go outside and scream every time I hear the word PROPRIETARY

I’m not sure I believe any of that. The hypothesis seems to be that a “conventional” pump can fail to deliver insulin because of a blockage then deliver the whole lot all at once.

Frankly, knowing what I do about the compressibility of liquids, that is total and utter marketing.

John Bowler jbowler@acm.org

@El_Ver That’s amazing! I average about 140 units TDD right now. I am definitely going to talk to her about it next visit.

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@El_Ver / @lumi73

I wonder if that has anything to do with smaller and more frequent dosing? Basal / Bolus / Extended / whatever.

In general we find that smaller boluses (FOR US) are more effective than larger boluses.

I have no idea how that would or would not translate to other people.

With the Tandem t:slim X2 in particular as compared to the Animas Ping (which was our experience prior) the bolus rate of delivery for the X2 is slower than the Ping. Watching the video above, one can easily imagine why this might be so. Although possibly the rate is intentionally slowed down without regard to the mechanism. Without insight to the development team it certainly is pure speculation.

In any event, we found the slower rate of delivery on the X2 to be more effective for us as compared to the rate of delivery on the Ping (which we had already selected the slower rate on the Ping).

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That’s how I understand it and it makes sense if you think about it. Taking a bolus 3x a day doesn’t have the same effect as having a small, constant supply of insulin which is what the healthy pancreas does. You are either compensating or playing catch up with MDI.

@Tim35 @lumi73 before switching to tresiba I dosed 2x daily with Lantus and 7 to. 8 x daily for food/corrections/etc. With tresiba it was 1x.daily.
With nph &. R is was 4x nph daily and r every 3 to. 4.hours. A mess

Which of course it is not to say or imply that MDI is bad.
More about choices.

Being able to have choices to pick the option that works best is ideal.

Tandem t:slim pump uses Micro-Delivery Technology to deliver insulin in a “fixed volume chamber” of 1/3 unit per stroke. During the delivery of the 1/3 unit insulin to the infusion line, the syringe also blocks the insulin flowing from the reservoir to the chamber. In the event of syringe failure/stuck, insulin cannot flow from the reservoir to the infusion line, therefore, it is safer. Medtronic MiniMed Pump uses “gear type” pump with complicated safeguarding system, however, not sure whether it fails “safe”, i.e. blocking insulin flow to the infusion line. The information above is obtained from the article below: “How Insulin Pumps Work” by Erika Gebel Berg, Diabetes Forecast, September 2014.

Humalog short acting insulin starts to release 15 minutes after injection and the insulin half-life is 60 to 90 minutes. Insulin dependent T2D has insulin resistance issue, which reduces the efficiency of insulin utilization, i.e. portion of insulin may be degraded before being utilized. Multiple micro-delivery of insulin seems a good idea. Dr. Bernstein suggests limit each pen insulin injection to 7 units for better efficiency. Wish all insulin infusion pump manufacturers disclose their proprietary designs for consideration.

When I am ready to use insulin infusion pump, I will consider a pump with “simplicity” design and more built-in “fail safe” features.

Another interesting article, entitled “Usability and Training Differences Between Two Personal Insulin Pumps” by Noel E. Schaeffer, et al, in Journal of Diabetes Science and Technology, Oct. 14, 2015.

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