Tslim X2 questions

I’m currently on a Medtronic 630G and Dexcom G6. My MD really would like to see if I can get on the Tslim X2 and is even willing to change my T2 to a T1 if it helps. (My cpeptide is 0.7 and he said 0.8 or higher = T2 so I’m being treated as T1 anyway). Some questions:

  1. I’ve heard a lot of stories about occlusions and I’m not sure I like the way the tank is filled. The air thing sounds very confusing along with using a regular syringe vs. the reservoir the 630 has?

  2. I have UHC and when I called Tandem, they were under the impression that UHC had an exclusive contract with Medtronic. I asked her to humor me and check both DME side and my Express Scripts which handles everything diabetic for me. Is this true? EVERY UHC policy?

  3. When I was first trained on 630G, I couldn’t even use the pump until I was formally trained by their educator. Does Tslim have similar training?

  4. I think I’m about 2 years in on my 630G but it was purchased on a BCBS obamacare policy. Some say that they don’t always share, and DME on my policy says 3 years and I didn’t see an exception for diabetic pumps being 4. Any ideas? UHC obviously sees pump suplied, but not the pump order.

  5. My MD really wants the basal IQ to help me stop the lows automatically. Could this be a good reason for an over ride if needed?

  6. Any one come from a medtronic 630g or the like and come over to the Tslim and care to offer their opinion? He originally said the 670G but I refuse to give up Dexcom! He said Tslim was also a good pump and that would be fine.

Brad, I just started on the Tslim X2 in January & so far, other than the ‘infusion tubing’ seeming to always-be-in-the-way, the pump itself is great! I had 1 occlusion (which was my fault & during the ‘learning’ phase), & can honesty say it is Very Robust and I’ve really had no problems. I ‘avoided’ the ‘pump’ for over 2 decades because of stories I’d heard, but I’ve had none of the ‘anticipated’ problems & am glad my Endocrinologist finally ‘forced’ me onto the X2… (except for the “teather-cord”/ infusion tubing! :grinning: ) Filling the tank/reservoir is easy, (I ‘draw-out’ the air 1st with ‘empty’ syringe, then, ‘draw-up’ insulin into syringe & intro into reservoir). I even did a ‘destructive disassembly’ of a ‘used’ reservoir, & cant see ‘any’ weak/failure areas. Hope this is helpful!


@BradP, I second @Ti-1comments, and would add that I too have only ever had 1 or 2 occlusion - and they were my fault when I was a new user. Training-wise, if you can demonstrate ability, they will give you a green light. My trainer and I met on Skype for less than 10 minutes, and I was a new pump user. I now wonder why I waited so long to get a pump? Looking forward to the PLGS upgrade!

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I did the same in 1990s. All I heard was negative, and not that many folks with pumps back then. Finally decided to try it after meeting people in person who had more positive experiences mechanically, AND emphasised the convenience and quality of life positives that out weighed the minor inconveniences.

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I have had an older Tandem pump now for almost four years after being with MiniMed/Medtronic for over 20 years. I do like Tandem and can’t wait to get the X2 at the end of the year with predictive low suspend, G6 connection and the upgrade (with extra cost) for the IQ coming later.
As far as occlusions, I did have more than I ever had with Medtronic but I think it is because I don’t use a lot of insulin. And the problem was solved completely going back to metal infusion sets. No more kinking and no occlusion alarms.

@Sally7 - It has not yet been determined if there will be an additional charge to the customer or not for the Control-IQ / HCL which is forecast to be available in Summer of 2019.

All that has been stated so far is that all updates which are FDA approved in 2018 will be available to the customer at no additional charge.

One certainly hopes the same thing will be stated at some point in 2019. Obviously nothing is free. The software developers (and everybody else) who work on these updates need to be paid to feed their families. However I think the best model is to build these costs into the cost of the device when originally purchased. Attempting to charge the customer later for additional updates would most likely incur a pretty bad backlash. But just my opinion.

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If the product is substantially being improved with IQ, I don’t see how there would be a backlash. I mean there will always be a subset of people who want something for nothing, but I think most people will understand a pump with IQ is a completely different pump (Software)than the Tandem base model.

I think it is awesome they offered there most recent pump upgrade for free, but I don’t think we can expect them to eat the cost of substantial improvements going forward. Now if the update is only bug fixes of the current software, those should be free. My 2 cents.

I talked with a Tandem rep at the TCOYD One conference and health fair last evening. I asked if Tandem will charge for the 2019 update it plans. He said that Tandem will be completely switching algorithms and that it has (or will) purchase the rights to use this new algorithm.

In light of that, he said that existing owners of the X2 will probably need to pay an upgrade fee of about $200-$300. I realize that this is not a definitive source but the rationale seems logical to me following the complimentary 2018 upgrade that will start any day now.

I got to hold and look at the X2 pump. It is impressive in it’s size and features great visual clarity. I would likely choose this system if my Loop system were to permanently fail.

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Correct. Tandem is licensing the Control-IQ / HCL from TypeZero.

That has simply not been decided yet. At this point, anything you hear from any source is pure speculation.

Given that the clinical trial for the Control-IQ / HCL is not scheduled to completed until April 2019 and that Tandem is forecasting the Control-IQ / HCL to be available in Summer of 2019 then there does not seem to be a huge rush to determine the pricing aspect. Plenty of time.

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Ok so I called Tandem and they checked my insurance. She said that anyone on private pay UHC is not allowed to purchase their products so wouldn’t even run it, and my Express Scripts will pay for supplies only. She said the only chance I had was to have my employer see if they can petition UHC for a plan override and emailed me a template to give to my employer. Anyone heard of this? Why is this so difficult? It’s PRIVATE insurance, so I should get the choice of who I want to use for my pump! This is very frustrating!

Tandem is not going to be able to spend the time and effort required for a UHC appeal.

The customer (ie - you) is the one who needs to drive the appeal process.

IMHO, UHC expects the the vast majority of people will give up and not pursue an appeal.

There are numerous people on these forums who have successful done appeals and fully understand the process and the best way to approach it. However, it requires determination and persistence.

Just a side note @BradP, it seems like over the last 18 months or so that Tandem is pushing more and more billing/insurance out on 3rd party companies. Both of my insurance providers deal directly with Tandem for insured patients. But because I have 2 insurers I am forced to use a 3rd party. I get worse service and more billing headaches from the 3rd party than if I only had one insurance and dealt directly with Tandem. Go figure.

Here’s a tip on fast filling the X2 cartridge. I fill the syringe will my regular amount of insulin. Then I insert the syringe into the cartridge. I hold everything vertically, with the syringe above the cartridge. I pull out on the syringe plunger which draws air out of cartridge. The bubbles rise too the top of the syringe. Then I push down on the plunger to push insulin into cartridge. You can watch the end of the plunger and see that no air goes back into the cartridge, even with the plunger all the way down. There is space between the bottom of the plunger and the beginning of the needle where you can see a small amount or remaining insulin and the bubble sits above this. I’ve been doing this for 6 months and watching every time. Never has any air gone into the cartridge.


I find the cartridges easy and fast to fill. This is because I never had the other pumps so I don’t know enough to be bothered. I think the other features more than make up for this.
I would have big problems with a pump that only allowed basal changes instead of profiles. I wish it had about 10 of them instead of only 6.

Re: occlusions. I’ve had a pump for about 4 years now and had occlusions twice. Once was my fault and I found a kink and fixed it. The other time it was a defective cartridge and I had to put in a new one.

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