Transition from omnipod to tslim?

Type 1 and LADA
1

I think I’m gonna transition from Omnipod (old model RF pods) to t:slim when they do the forced upgrade to a cell phone controller. But, I need to talk through this.

I think I can still use my Dexcom on tslim. I imagine that t:slim runs on RF, not bluetooth communications. I don’t want a tubed pump or their buttonless controller. But, they have a more mature closed loop algorithm and if I’m gonna get pushed off a traditional controller anyway, I might as well us the pump with a more tested algorithm. I think I can run open loop on t:slim.

I’m just trying to think through this because I am a long term omnipod user and I use them because I trust their hardware. But, with all the upgrades, I’m gonna be using untested stuff anyway, so I might as well change tech stacks, I guess.

I have a year until forced transition and need to start thinking out loud about it because you all check my perspective. I need to talk to @Tim35, but he’s not on the forum anymore. :grimacing:

2

The T:Slim X2 with C-IQ communicates with Dexcom using Bluetooth. Technically Bluetooth is RF. I am 2 months into my 2nd year with this pump having transitioned from MDI. I considered the 3 pump types avaiable, Medtronic, Tandem and OmniPod. The OmniPod 5 was not available and I wanted the closed loop tech. I was already using Dexcom G6 so that kind of clinched the deal

There is no perfect system, tat includes MDI. I weighed the pros and cons as best I understood them. I liked the idea of patch pumps, but was convinced I would clumsily scrap them off when using the outer thigh and arm sites. I thought the tubing would be a pain, but it has not. One pro I did not consider until actually infusing - not all infusion sets are right for me. This means that if the Pod cannulas were uncomfortable, I would be stuck - ( :rofl:, I love a pun).

Every tube pump user has to find how to wear the pump and sleep with it. My big concern was bicycle and exercising with the pump. I bought a couple of SPI belts which seemed like a good idea, but the pump tended to flip with the display towards my body. This is only a problem because evidently the Bluetooth antenna is on that side. Connection the the Dexcom would be lost.

I went with some mildly elastic bands called invisible belts. I wear they under my cloths with the pump clicked to it. Any excess tubing I tuck under the belt. This way I cannot hang the tubing on a doorknob or whatever.

Some women are known to put the pump in their bra. That just sounds uncomfortable to me. But when the pump lights up it is an interesting phenomenon :bulb: .

I am not trying to sell you on this or any pump.

As a T2DM with constantly changing insulin resistance I find the C-IQ to be overly conservative. Sleep mode whille sleeping works great for me, no hypers or hypos. I find myself doing small corrections to lower my average BG. But, hey that’s me. I would drive a vehicle with a 6 speed manual transmission with a clutch if I could find one. Part of me thinks I am smarter than any machine. :crazy_face:

There is a simulation app of the pump. It’s OK, but I would suggest that you use the training videos before you make a 5 year decision.

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I just let my pump dangle or I put it under my pillow. I’m actually looking forward to the mobi because it’s small and uses the same infusion sets and sticks to your skin or you can use it like a standard tuned pump if you like soit will be more versatile also very small with no screen and 100% controlled with a phone ap. Well except w a bolus button in case your phone was lost

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I let my pump run wild at night. It is fun to find it in the morning. Hey where is pumpie today? LOL

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The one thing I have loved from the beginning about Control-IQ is the safety especially at night. I rarely ever go low anymore while I’m asleep. I get to sleep through the night most of the time and even when there is an alarm from low BG it’s a quick fix that I can immediately go back to sleep because the pump will have insulin off until I’m back in range. I know you have problems with severe night time lows @mohe0001 so even if you only used Control-IQ at night I think you would benefit.

You absolutely can run the pump in Manual mode but unless the Dexcom is having accuracy issues then you shouldn’t really need to as the pump really won’t make super drastic corrections on it’s own. In fact you can make it so it won’t give the larger correction boluses by running in sleep mode 24/7. It will still raise or lower/stop basal in sleep mode.

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I’ve not one that’s concerned about overnight lows. I wake up like a bat out of hell with low blood sugar. If anything, people would prefer that I passed out. :joy: I want to run this thing in open loop and I always have the option to change it here and there if desirable.

I’ve had a lot of problems with tubed pumps in the past. It’s a common point of hardware failure for me. That’s why I’m on Omnipod.

But, what I most want is to avoid running the PUMP off bluetooth. I can’t handle another point of failure in the hardware. Is the pump running off RF, like current Omnipod? Looks like they still run RF (industry standard to scientific, industrial, and medical devices). That’s a relief.

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I remember the days of hardware failure and they were not fun days. I couldn’t do the things that I do now. I’m no longer gonna be able to avoid those failures 100%. It’s good that I made the most of the opportunities afforded to me by reliable hardware while I was young. Things will be different now.

I’m also bummed about needing to dedicate a bunch of time and effort to diabetes via a change in tech. I have other things that I have earned the right to peruse, but se la vie. This is how its gonna be - all diabetes, all the time.

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I have contact information but your Messaging is blocked. Message me if you want the info.

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Thanks Willow4. Let me think this all over a little first. I’m trying to figure it out still. Plus, there’s new threats emerging all the time. These Super pigs are loose around town. I’ll never go xcountry skiing again. I’m ill prepared for fighting with “super” pigs.

Maybe in light of all this, its time to return to manual injection. I don’t know. All options seem unacceptable.

P.S. I don’t think the pigs attack humans. I don’t think they are like the wild pigs in the south.

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Maybe the source of my discomfort is that I can’t use a device that I can’t troubleshoot.

I can’t troubleshoot a device that has so many sources of failure. They should not be engineering in failure. Other industries don’t do that.

I’ve been watching a guy on a MT pump right now try to troubleshoot it and it looks terrible. I don’t want to do that. I don’t think there is a ultra reliable source of hardware for me anymore. I need to find the next, best option and determine if that is good enough.

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Really?! Where have you been? Manufacturers of everything have been building in obsolescence for decades now. Why hamper a cash cow?

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Actually this is consistent with the complexities of most everything in technology. I worked in telecommunications for nearly 40 years doing my best to isolate troubles in or out of my network. Then repair should be easy, but further troubleshooting has to be done, is it hardware, software, memory degradation, firmware, power fluctuations, or the dreaded faulty test equipment.

When it appears out of network - are those technicians competent or honest is their work - The joke phase, “Trouble leaving here fine.” Is not funny when there is a major service disruption.

I really want to know about how the guts of my Tandem pump works, what causes failures and so forth. The same is true for the Dexcom. I really want to know what causes the wackiness that occurs for some of us starting on day 7. My current sensor is at day 10 and was fine until the evening of day 9. I count 4 false lows, during which C-IQ was reducing basal to 0.0u. It didn’t cause me too elevated BG, but it could.

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I drive vehicles that have a myriad of sensors that may fail preventing the vehicle from operation. My last truck, a Ford F150 had a computer glitch that set some anti-theft sub=program in action. It required having the truck towed to the dealer to get it sorted.

I have a rough idea how the electrical grid works, but certainly not close to complete. I still use power in my home. It’s the same with communication via computer, smart phone and more. There are many points of failure, local or national. A maintenance procedure being done on a fiber optic terminal in NYC that goes wrong can deny service to millions of users. Then there is malicious destruction.

I had a hard and fast rule that I didn’t buy “A” models. That might be called Beta now. I wanted to wait until the bugs were worked out. The problem is everything is an “A” model. They put stuff out without proper testing.

So what’s to do? I go with it. I keep a careful eye on it, never completely relying.

In all the above, I left out a thing that is most important - most technology in today’s world has lousy support when things go wrong. They tend to answer, “We will send you a replacement.” With no explanation of why whatever happened. Does this ever get escalated to be addresssed?

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12

Medical devices are locked Dow for good reason, they don’t want you to be messing with it and possibly causing your own demise. I get why you want this but it’s not going to happen. The opposite is true, they are closing the loop holes. Take the tech as it’s presented or you can buy a do it yourself pump. I’ve seen them out there, where there are no safety limitations. For me the tslim works well enough. I can adjust it enough, and I really don’t mind the higher targets. Besides I found that an adjustment in diet in several times more effective than altering my insulin . I recently went all in with mastering diabetes and I have a much lower insulin requirement and my sugars are more level. I was at 98% in range this month and I’m using nearly half the insulin that I was before I started this WOE. It just took the better part of a year to commit to it fully. Chickpea pasta helped me get enough protein so I could give up animal protein completely.w elk it’s been a month and I’ve lost 5 lbs of fat and I feel better so I’m going to stick with it. It is the best adjunct to my tech that I could get in any other way.
Also less insulin means my sites last longer. I’ll keep doing it until it doesn’t work anymore.

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13

If you want total control, go with a DIY system. Many love them. It is not for me, but to each his own. Or as a HS buddy used to say to reach his own.

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Alright, you all. Not EVERYONE does this and they don’t need to do this. Omnipod was pretty solid hardware for a decade. If it worked for your physical body, the hardware was super reliable.

Now, they are engineering in sources of failure and that doesn’t sit right with me.

I’m not concerned about the higher target, closed loop just isn’t a viable for me. It doesn’t help me and it tends to cause more harm than good. In the interest of brevity, on this matter, today I shoveled snow that was waist deep for 2 hours. Closed loop isn’t robust enough to deal with stuff like that. You simply have to know what that does to you and work with it and its fine.

I dunno what to do. I won’t work with unreliable hardware. If that means MI, then that’s what it means. I’m not sure what the best option is. Luckily, I have one year to think it over.

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The key to using a pump is knowledge about how to get the most from the pump. There are no engineered sources of failure, the pump just do what you set them up to do. 99% of so-called failures are operator driven, if you learn the pump and be aware of how to properly set it up failure can most likely always be avoided. After 39+ yrs pumping I’ve only had one ue playing issue, all other I played a key role in.

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I’m an engineer and I understand discomfort with not being able to troubleshoot a system. It’s far easier to troubleshoot a tubed system than a patch system.

You can work backwards from the cannula detach point to determine whether the problem is the cannula, the infusion tubing, the cartridge or the pump. The pump itself has fairly good error messages with codes that allow Tandem support or an educated user to determine what can be done about it.

I’ve only had one problem with the pump software which was resolved by creating a copy of my profile changing to it,.powering off the pump and restarting it.

Tandem tslim is very easy to troubleshoot if your control is generally good and you are experienced in using the information from the Dexcom G6 to supervise your pump.

I’ve only had one source of issues with the Tandem pump since I’ve been using it, and it’s the same source of issues as with the G6 - my sites.

Where you are able to wear the pump limits the sites you are able to reach with a tubed infusion set. While the Tandem website lists multiple lengths for every annual type in practice they aren’t stocked by all suppliers.

I was started off with autosoft 90 26-in which barely reached my far upper abdomen with the pump on the right side of my belt. You think looking at a picture of a nude person 'that’s no big deal who’s more than 26 in wide" but that ignores a man routing the tubing through clothing to where the pump can be utilized.

In my case that wasn’t a long-term problem because the autosoft cannulas themselves weren’t working well with my available upper abdomen infusion sites.

Of the first 6 Autosoft sets, three of them didn’t deliver consistently after the initial startup period. For me that takes about four units "delivered’.

(That’s better than the 12 to 18 hours it takes for me to get reliable G6 readings, but it’s still inconvenient, because my control criteria is TOOR. My personal Target is Time Out Of Range under 5%. Worse than that is a very bad day for me.)

Being a pump novice and following the “when in doubt change it out”, lacking any kind of training on troubleshooting from the pump trainer, I replaced three infusion sets and cartridges, losing +100 units of usable insulin each time.

I contacted the Tandem trainer, who was more familiar than the doctors staff and more easily available and described the problems.

They suggested Trusteel cannulas, gave me a box with longer tubing to try. These worked so well that I contacted the supplier and they arranged to replace the other three cartons.

The first four Trusteel sets I used worked perfectly -much more consistently throughout a full three day period. When I had a problem with the fifth one I did a “hail Mary” and moved it to an adjacent site. It worked perfectly. That’s how I was able to determine that my problem was not infusion sets or sensor failures but impaired sites.

If you carry a cell phone and don’t use it with Tandems app, you’re missing two opportunities. The first is that that app will upload your readings automatically to your profile at Tandem. The second is that the app has a much clearer display of basal rates and boluses. Even if your phone is not one of the very few models that will be certified and allowed to do remote bolusing those two advantages are very useful.

I started using the Dexcom G6 before getting a pump and was PO’d to find that their apps wouldn’t work with my phone. This was very annoying because I didn’t have a PC or an Apple device that I could use to upload the Dexcom readings, and frankly the overpriced Dexcom reader is lame.

I found an app called xdrip+ that I have been using ever since. It provides a much better G7 display, more comprehensive realtime analysis features than either Dexcom or Tandem provides and has as many user-configurable alerts as you want to define.

For someone like me who is trying to change my lifestyle in a very systematic way to maximize my results, that is very useful, but it might be overkill for the average pump user. The app being free, you might want to try it.

I highly recommend the tsimulator to get familiar with the pumps menus, downloading copies of the owner’s manuals and reading through them at least once. Tandem has some cheat sheets on their site that cover different aspects of using each kind of infusion and the different aspects of using the pump. They also have YouTube videos on the infusion sets.

Before you are authorized to use a Tandem pump you have to go through an online tutorial. They are rather tedious if you have already read the manual and gone through the simulator but worthwhile for reinforcement. You’ll also have to go through a tutorial each time there is a significant change in the firmware of the pump - a feature update -before your authorization is extended to allow that software to be installed.

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Couple of examples of when the new omnipod model would fail. (Notice how inopportune these moments of BlueTooth communication failure are LIKLEY to be, compared with RF. Pumps are engineered to run off RF for a reason.)

1.) At the State Fair when there is a ton of police/radio/tv signal interference and you have to walk miles in the driving sun to leave.
2.) While responding to the 35-W bridge collapse to provide medical assistance to victims
3.) During the Minneapolis protests when huge crowds of people where moving spontaneously throughout the city and the police were actively blocking cell phone communications for crowd control.

While moments like these occasionally disrupt RF communication and cause pump failure, there’s no way BT doesn’t go down. BT is ‘flaky’ and unreliable. I recall @DrBB having failures from living in a crowded apartment complex.

I don’t know how much flexibility I currently have to rearrange my life to accommodate Omnipod failure (hardware otherwise). I should be troubleshooting diabetes, not this other crap. This other crap is THEIR job, not mine. They need to do THEIR job so I can be successful doing mine.

Maybe I’m just tired of accommodating the healthcare system and doing the work that they get paid to do. I’m the person with disability, not them. I am but one person. There are limits. All the time I dedicate to accommodating them take a huge toll on what I am able to do as individual. It’s not right. OmniPod 5 Nightmare

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My experience with Omnipod 5 correlates pretty well with @mohe0001…communication failures with the pod and/or pdm happen frequently. Sometimes a restart solves it. Once my PDM bricked and had to be replaced. Several times the pod had to be torn off and a new pod started. None of these failures were operator driven. Personally, I think they went cheap on the pdm/controller.

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I have found that the OmniPod 5s fail at a higher rate than the 4s. I have had multiple issues - where the pod communication failed during sleep, nothing could revive the communications, and the pod along with all the insulin was wasted. If you contact OmniPod, they are almost actively disinterested. If you complain, they will send replacement pods on their schedule, but they don’t seem to want to care how the failure happened. Not sure what company shill posted that he knows that 99% of failures are “operator driven”. Sounds like the sounds of his self-righteous brothers record collection have crowded out the possibility that this is a sketch product sold by a company for whom customer service is a low priority. YMMV.