Trouble with my tandem sets?

Hey everyone, I have been on my new new tandem x2 and my dexcom g6. Both have been a little bit of a learning curve coming from an old minimed revel pump and cgm.
I having a hard time I think w infusion sets not sure.

So a few times it’s happened, today being one of those days where my sugar goes high and nothing I do will fix it.
I eat the same breakfast almost everyday usually I take around 4 units but today it didn’t come down. Then I corrected several times and before I knew it I had put 18 units in me for this one meal. This makes no sense. I just started a new set today with a longer cannula just to see if this is the issue but it was only a few hours later I got the trouble. I chose a spot on my side near my back because I hardly ever use those places. I never had absorption issues with my mm pump and I really don’t get why this is

Maybe your cannula is kinked? Unfortunately only way to know is to pull the set. But that has happened on occasion to me and its not enough for the occlusion alarm to alert.

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I changed from a Medtronic paradigm pump to Control IQ.

My biggest problem was getting use to Tandem supplies. Took me an hour to change my insulin the first time. And my BG was high too. I came to realize that getting all the air out of the cartridge is not as easy as it seems. And I now blame that for my highs. I looked at many YouTube videos. If they are not done by Tandem they could be problems. I finally got it and now my BG is back to normal and don’t have these highs all day. Pretty sure I didn’t follow their methodology of filling the cartridge properly. It sure is different than the simplicity of Medtronic.

I had exactly same problem, started tslim 5 weeks ago. In some cases, there was insulin under patch when I removed the inf set, other cases not.

I think I had a combination of some infusion set and some air in cartridge problems when I filled with insulin. Miss the medtronic reservoir where you could easily see and remove bubbles.

I called tandem support, and now experimenting with samples of 6 vs 9mm XC sets, auto 90 and autosoft 30 (silhouette, slanted insert). So far mixed results, but less times when I had numbers like yours!

I meet with endo soon and hope to get input on what she recommends.

But I MISS quick-sets !!!
Hate the plastic springy thingys.

I tried a couple of TruSteel infusion sets. They are so much easier to insert than the XC but gave up on them as they seem real cheap and I ruined a couple of them just with their tape sticking to things. I do miss quick-sets but have finally gotten the plastic infusion sets to work and I am fine. I keep my Control IQ on sleep mode all day and I am finally doing great. Took a month though.

I started with 24 hr sleep mode but currently trying non-sleep during day, to see how aggressively it corrects highs.
I learned to check T:connect for black drop that notates a correction bolus ! In my first case I didn’t notice black drop (IQ), followed by blue drop for my insulin correction I did 3 minutes later.

I need to pay attention before manually doing correction

I think I’m doing it right. I pull air out of the cartridge and primed it. I followed the tandem video. However air would make sense. I pulled the set out and it was not bent. But this has happened a few times already not just on one set. I got a few steel ones as samples I might try.

I refuse to try them, didn’t work for me with minimed!

I don’t like control IQ for correcting highs. Correcting highs by increasing your basal takes much too long to get your blood sugar down. But control IQ is excellent has it keeps you from going too low. so my job is to keep me from going high and I do this by jacking up my basil 30% all day long. That’s I keep myself from going too high in control IQ keeps me from going too low. It’s working fine for me.

I just always suggest doing back to the start. Rewatch all the videos and see if everything is set correctly.
I know I am very fortunate in that most things work just like it should. But I will say before I switched from Basal IQ to Control IQ, I worked at getting my basal, carb and correction numbers nailed down. My feeling is the less the system as to work the better. I also haven’t tweaked the insulin duration, the weight or daily average insulin doses. I just put in what I am at and use and went with their recommendations for duration and target.
My biggest problem early on with my first Tandem after almost 25 years with Minimed/Medtronic was occlusion. Never had that before but talking with my rep, a change to metal infusion sets and have not looked back.

So I guess my unprofessional opinion is look at numbers. See where you are set and see if they are where they should be. And as with all things, give it time. No medication works right away and most side effects will pass. All technology is hard to grasp when making changes but my site changes are now my new normal. Sure they are different from Medtronic but a couple extra minutes every 3 days are not a problem for me.
I am super happy to see you using the mobile app and here is hoping dosing from it will happen soon. I just started using it a few months ago and have learned to check so I don’t bolus for a high number it the works, when I check I see that the system has already done one. That is one thing I did not see in your photo. The system doing the bolus should be black and one you do is blue. Which leads me to think something is not right with settings because there is no black bolus drop, and there should be some to take care of those highs.

Thanks for that info.
I am sure my basal rates are spot on as most nights I draw a flat line. My trouble seems to be when bolusing. I think I’m not getting the correct dose. I have been taking about 4 units per meal give or take for 30 years. I just need to find out if I’m getting air or if it’s just not pushing insulin out.

With sleep mode off, the control-IQ will do BOLUS to correct a high bg. But does not bolus during sleep mode.

Check the screen shot in this thread for black blood drop, hidden mostly behind my bolus (blue drop)

I haven’t seen it mentioned here yet. I think a lot of bad inserts/kinked cannulas are caused by being too rough in removing the blue needle cover. It can pull the cannula right off the introducer needle. I always spin the blue cover until it feels loose, then you gently lift it off the needle without it tugging on the cannula. Leave the adhesive backing in place until the blue cover is off. I then press down on the covered adhesive tape, just to make sure the infusion set is as far down the introducer needle as possible,. When you remove the adhesive backing, again don’t pull it straight up. You want to minimize any possibility of lifting the set up. Instead, pull the paper down and around the UFO.

Those are long, detailed explanations of what really takes ZERO thought or effort once you do it and realize what I mean. I’m just OCD, and I was always freakishly gentle with them.

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The only time I experience this is when I’m pumping Fiasp and the reservoir level drops below 50u. Then, like you, all is well except when I try to bolus. No response at all. Plug in a new reservoir and all is well. Really have no logical explanation for this. Have you tried changing to a new insulin vial/lot number?

It has been horribly hot here lately and I thought of that. I changed my site Friday morning at 8 am. I had an early lunch at 1130 and that’s when it happened. But after it came into range, it has been fine. I have narrowed this down to a problem only w bolus not with basal. On my old animas pump I could see the insulin travel through the tubing. On my mm I could watch the syringe move. I’m kind of blind on this one, my go to troubleshooting tool is not useful.
This morning I bolused 5 units while disconnected. I saw nothing come out. I primed and then a got a bolus. Then I had to bolus connected and it was good. I just don’t know if I have a pump issue or a tubing issue. It still makes no sense how basal is good but bolus is not.

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That’s exactly the same thing I saw when FIASP stopped working at low reservoir volume. I’m mystified! The X2 is not approved for use with anything other than Humalog or Novolog so they didn’t have an answer.

I would call tandem. They’re pretty liberal about sending new pumps.

If you like the Autosoft30 but not the auto injector they do make a manually inserted Silhouette type set, it is exactly the same as the Silhouette with the exception of the connector at the pump. Its called the VariSoft.


I use the m annual sets. And I have never had an issue with them on minimed. I’m thinking it’s not the sets at this point

I started with the t:slim X2 three weeks ago, first pump for me. I was able to upgrade to Control-IQ last Friday. Most of my issues with highs and lows have been solved and I’m very happy with it now.

I started with the steel infusion sets and am very pleased with them. I don’t much like the idea of replacing them every second day as opposed to all the other infusion sets at 3 days. I’ll get over that.

I’ve been a type 2 for some 20 odd years and insulin dependent for the last 10 years. Finally getting a C Peptide reading that qualified me for a pump is the best thing to happen to me in the 10 years of insulin use.



I also find the varisoft sets (manual insertion at a shallow angle) work for me, while the autosoft (spring loaded and 90 degree angle) did not - not enough fat apparently, and they just don’t work.
My bigger concern using a Tandem pump is that I did have a situation where my pump was not putting any insulin out even though it was pumping (I disconnected the tubing and told it to load the tubing, watching for insulin coming from the cartridge - nothing came out. I tried 2 more cartridges with same result, called Tandem and they told me I must have had a “bad box”. It did not seem like I was the first person with this problem. They sent me a replacement box of cartridges, everything works fine now, and this issue aside I really like the pump. But my concern is that the only way to tell there was a malfunction was by seeing my BG climb and climb despite repeated boluses. Good that I keep a pen with Fiasp and another with Humalog in the fridge. I suggest all pump users keep a ‘loaded’ pen with them when away from home, just in case.