May 16

Diabetes Blog Week: Day 4 – Accomplishments Big and Small

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Today’s topic: We don’t always realize it, but each one of us had come a long way since diabetes first came into our life. It doesn’t matter if it’s been 5 weeks, 5 years or 50 years, you’ve done something outstanding diabetes-wise. So today let’s share the greatest accomplishment you’ve made in terms of dealing with your (or your loved one’s) diabetes. No accomplishment is too big or too small – think about self-acceptance, something you’ve mastered (pump / exercise / diet / etc.), making a tough care decision (finding a new endo or support group / choosing to use or not use a technology / etc.).

In my five years of having diabetes, I believe my biggest accomplishment would honestly be just accepting the diagnosis, taking it in stride as I like to say.

If you know me, I’m a planner. I hate when things don’t go as planned. I love all the details, down to the last minute. If things change when I’m not expecting them to, I usually panic until I can adjust to the plan. “Go with the flow” is not a common phrase for me. (This would also be why I am mildly freaking out that my gift to my husband-to-be is a unplanned, go with the flow, road trip honeymoon next week. Luckily, I have had about 3 weeks to let it sink in and have been slowly planning every other aspect, like packing, food, and budget, that I can. //end digression)

So, personally for me, my biggest accomplishment was to accept, and not panic, after being diagnosed with diabetes. I pat myself on the back for that one!

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May 15

Diabetes Blog Week: Day 3 – Memories

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Today’s topic: Today we’re going to share our most memorable diabetes day. You can take this anywhere…. your or your loved one’s diagnosis, a bad low, a bad high, a big success, any day that you’d like to share. 

Honestly when I think back these past 5 years with diabetes, my most memorable time would be the days leading up to my diagnosis. I remember those days clear as day. Let me take you there:

I’m a senior in high school, focusing on what I need to do in the last month before graduation. I’m studying for AP exams, regular exams, writing papers, finishing deadlines as the editor of the yearbook, and just excited to finally be close to graduating.

  • I remember sitting in my English class wondering why I couldn’t see the board anymore
  • I remember thinking it probably wasn’t good that I couldn’t read the signs while driving
  • I remember asking to fill up my water bottle or go to the bathroom during classes
  • I remember being late to class for the same reasons
  • I remember sitting at work at night, my mouth drier than the desert, asking someone to bring me a water bottle. Then asking the same person to cover the phones a half hour later when I felt like my bladder would explode.
  • I remember my favorite jeans that normally fit “just right”, needing a belt
  • I remember throwing up the morning of my AP Calc Exam
  • I remember having to get out of the shower early because I felt like the world was spinning and I would faint
  • I remember having two study halls, back to back over the lunch hour, equally about a 2.5 hour break. I would drive home, eat the simplest meal and sleep. Sometimes even skip my next class because I was just too exhausted.
  • I remember coming home after school and sleeping until my mom woke me up for dinner.
  • I remember making a full pitcher of kool-aid and preceeding to drink said pitcher within an hour.
  • And then I remember playing Mario Kart with my mom and stepdad, pausing the game between rounds to grab water or use the bathroom. My mom asked how long I had been drinking so much water and using the bathroom that often. I told her a few weeks, and she looked at my stepdad and had a worried mom look on her face. She mentioned the word diabetes, stepdad mentioned that was what my grandpa died from, and we then researched WedMd the rest of the night.

We figured we were just psyching ourselves out when I said I had had all the symptoms.

I had a previous doctor appointment already set for that Tuesday (low iron count checkup from 3 months prior), so we figured we could just mention it to him at that time. We did, he did blood tests, and he said he’d contact my mom when the results came back.
I went to school on Wednesday as normal. Between English and AP Calc, I heard my name on the announcements to come down to the office. After telling my teacher, I went down to find a note to call my mom.
She told me on the phone I had to go to the doctors that afternoon because I had diabetes. I cried, and left school.
That afternoon I found out my blood sugar had been 419, and my A1C was 9.1%. The nurse gave me a shot of insulin (I believe Lantus) and told me I’d be attending classes through Children’s Hospital starting the next morning. I didn’t return to school for almost a week.

It was a whirlwind of a few weeks, but I can remember all the details. Memories that are only the beginning…

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May 14

Diabetes Blog Week: Day 2 – We, The Undersigned

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Today’s topic: Recently various petitions have been circulating the Diabetes Online Community, so today let’s pretend to write our own. Tell us who you would write the petition to – a person, an organization, even an object (animate or inanimate) – get creative!! What are you trying to change and what have you experienced that makes you want this change?

We, the undersigned, petition that all insurance companies form a group plan for the Diabetes Online Community. We pay one, reasonable, rate each year and we are allowed any medical supplies, prescriptions, glucose, anything needed to live, within that plan. No more co-pays, deductibles, out-of-pocket expenses, vacation overrides, calls to insurance company, etc. Nothing is questioned, unless a doctor prescription is needed. Everything is just given because insurance companies will trust that those of us living with diabetes or those caring for something with diabetes know what is best and will know what is needed. Who’s with me!?

My reason for this petition is I am going out-of-town next week (hello, honeymoon!) and I wanted to fill my prescription for insulin pens in case of a pump malfunction or a swimming, don’t-wanna-deal-with-pump, adventure. Well apparently, this means I couldn’t fill my regular 3-month prescription for insulin vials. The $1000+ bill Walgreens suggested, forced me to call my insurance company. So I called, went through the automated messages, entering member ID, birth date, before I got fed up and pressed ’0′. Took about 5 minutes, then the lovely automated message preceded to tell me that the office was closed and hung up on me. Tell me that before the automated BS please! So I called yesterday morning on my way to work. Decided to press ’0′ immediately. Still went through automated messages of entering member ID and birth date. Was on hold for 15 minutes before the lady picked up and told me I called the wrong number for my prescription plan. She could only help with medical insurance. (Last time I checked, prescriptions are under the definition of medical, but whatever.) I then called the prescription number that I found on the way bottom of the ID card. Luckily, I didn’t have to be put on hold, but still had to go through the roller coaster of verifying my information and was notified I was allowed one vacation override per medication a year. (So I can only go on vacation once a year? Hmm. Not looking forward to what will happen in July when I’m out-of-town again, but I will worry about that then.)
If only the insurance company could trust that I wouldn’t just go pay a co-pay for insulin pens for the hell of it. Like seriously? I think I know what prescriptions I need, thank you very much!

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May 13

Diabetes Blog Week: Day 1 – Share and Don’t Share

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It’s that time of year again: Diabetes Blog Week. Karen, from Bitter~Sweet is just so awesome to put this together for the Diabetes Online Community.

Today’s topic: Often our health care team only sees us for about 15 minutes several times a year, and they might not have a sense of what our lives are really like. Today, let’s pretend our medical team is reading our blogs. What do you wish they could see about your and/or your loved one’s daily life with diabetes? On the other hand, what do you hope they don’t see?

First, I will say I LOVE Dr. S. It’s why I drive an hour to see her. She gets it (she has T1 herself) and she’s so understanding and patient. So, Dr. S if you’re reading this, I want to say thank you!

So after sitting here for 5 minutes thinking about this topic, I had a hard time coming up with something I wished Dr. S would see. Why? Because what I wish she would see is the same as what I hope she doesn’t see. I want her to see that I don’t exercise and that I don’t watch what I eat because then I don’t have to tell her. My numbers look good, my A1C is good, so I know she’s figuring I’m doing good. And I am. I check my blood sugars, I give insulin for what I eat, but moderation is not a word that comes to mind when I think about the foods I eat. I wish she knew that, without me telling her, so that it could be addressed.

I, unfortunately  was told during my training after diagnosis that as long as I bolused insulin, I could eat whatever I wanted. My guess is the nurses training me through in the word moderation at some point, but I didn’t hear it. I didn’t want to. I was 18 and I didn’t want my life to change. I’ve stuck with that mentality and now I wish I could go back. If Dr. S knew that, and “bugged” me about it, I probably would get my butt in gear. But because she only knows what’s on paper and what I tell her, I continue and will probably keep continuing to do what I do.

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Apr 10

t:slim: Update

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I’ve been asked to write an updated review on my Tandem Diabetes t:slim insulin pump to help someone decide what pump they want to get their daughter.

So I’ve had the pump almost 6 months! So here’s my opinion 6 months in, with reference to my initial thoughts. Updates are in red.

Things I Love (6 months in)

Overall

I love this insulin pump because it fits ME. It’s touchscreen, rechargeable, and so 21st century. It fits in with my lifestyle of working and breathing in the technology world. I still agree with all of this, but I’ll say the “wow” factor has worn off significantly. It comes down to the fact that it’s still a machine that helps me live.

Battery

Love, love, LOVE the rechargeable battery. I even charged the pump on my way to work this morning! It works out perfectly because I have a 20 minute ride to work and it is recommended to “top-off” the battery daily. Depending on how I notice the battery life diminishing, I will determine how often I need to charge. I started it with a 100% full charge on Saturday morning and this morning it was at 85%. Not bad for something working 24/7! It takes one minute to charge one percent. When I got to work after charging it in my car, it was at 95% battery. (I didn’t plug it in until about half way to work). It’s still at 95% 4.5 hours later. If the battery stays this way for four years, I’ll be happy!

Battery is still great. I don’t even have to think about really charging it because when I do charge it, it’s enough until the next time I think about it. If that makes any sense. I’ve had it go down to about 20%. I was going to try to remember to charge it every morning when I’m in the shower, but that hasn’t happened. I’m not worried at all about the battery because I sit at a desk all day and could charge it at any point really. This summer though, when I go camping for 4 days without electricity, I will probably buy a solar portable charger. 

User Profiles

The user profiles allow the user to set their basal rate, correction factor, carb ratio, and target bg at different times. On my Medtronic insulin pump, these were in different areas and only basal rates could have multiple “profiles”. For instance, I can now have a target BG of 120 throughout the day, but at night have a higher target if I don’t want to fall low before bed. Having these all on the same screen and time dependent is awesome and I’m hoping it will help me utilize the features more. I already set up a different User Profile for weekends because I’ve been waking up low (since I sleep in). This is something I could have done on my Medtronic, since it’s only a basal rate change; however, it seemed much easier to do on the t:slim. Plus I was able to duplicate my everyday user profile, so I didn’t have to add in all the times and data twice. Setting this up was tedious, but only because I had to search all the screens on the Medtronic pump for the data.

LOVE LOVE LOVE the user profiles. I use these so much more than I did on the Medtronic. If I find I am running lower lately, I can quick copy (!!) a user profile, adjust the settings, and away I go! Then I still have my old basals and settings and I can easily go back! This would probably be one of the biggest things I’d miss if going back to Medtronic. I also use this for the weekends so I can sleep in without waking up low. LOVE! 

Carb Calculator

THIS IS AWESOME! Why? Because I guess my carbs. I round to make the math easy, not because I can’t do math, but because I’m too lazy to spend the extra time adding, especially when my meal is sitting in front of me. But now, I can add with the included calculator! Love this feature!

So while I still love the idea of this feature, I barely ever use it. I am still in the habit of guessing my carbs (old habits die hard right?), so I am hoping I’ll utilize this more. 

Alerts

Haven’t used this much yet. I have one set for tomorrow, but otherwise I haven’t played with them much. I do know I will love this feature though. You can set alerts to change your pump site, test your bg after eating and more. Since I haven’t used them, I don’t remember what they all are. I did set the change pump site and I did this because the insulin pump holds 300 units of insulin, much more than my Medtronic pump did. With my Medtronic pump, I would just change the insulin and infusion set once the insulin ran out (3-4 days depending); however, that will take much longer now. I did find out that even though the cartridge holds more insulin, it’s still recommended to change the cartridge every three days. Kinda sticks, I was hoping to get longer time out of them (less supplies, less to worry about), but the pump trainer said if I just fill the cartridge to my approximate usage for three days, I won’t waste insulin.

The only alert I have is set to tell me that it has been 3 hours since I last ate. This is so I can quick check my Dexcom and if I’m high, I’ll test and correct. So it’s useful, but I don’t use any of the other alerts.

The Cartridge

The main thing I love about the cartridge is how I put the insulin in. Included with the cartridge supplies are syringes that you fill with insulin from a vial, then insert the syringe into the cartridge to fill. Why I love this? It’s easier to use every drop of insulin from a vial. With Medtronic, the reservoir had an attachment that went onto a vial, then you pulled down the plunger to fill it with insulin. If there was only a small amount of insulin left in the vial, you’d have to take this off and put it onto a new vial. From my experience, this always caused more air bubbles and always was cumbersome. Plus, the plunger at the button of the reservoir could easily move or come out which seemed to cause air bubbles. With the t:slim, you just need to take a syringe out of the vial, stick it in the new vial and continue pulling in insulin. Kinda hard to explain, but for me, it works much better and I feel as though I’m not wasting precious insulin.

Cartridge is fine for me. I haven’t had any problems. I know a lot of people have complained or expressed frustrations with the time it takes to change a site. Well I’ll say this: I “cheat”. I reuse the tubing so I don’t have to fill it every time. I probably change the tubing whenever I change insulin vials. I will also say when I do change everything, including full tubing, I don’t notice the time because while it’s filling, I change my site. I also clean up all the garbage that is generated from changing sets. So the timing for me isn’t anything I’m concerned about. 

Differences

Alarm Clock

Such a simple feature in my book. I used this everyday on my Medtronic pump to remind me to take my medications. I figured I could use it also to remind me to switch my User Profile once the weekend is over. There is no alarm clock though and I’ve confirmed this with the pump trainer this morning (thought maybe it was hidden or something).

I still miss this. It stinks that something so simple isn’t included in the pump. 

Backwards Correction

By this I mean, when you’re blood sugar is below target and you’re bolusing for a meal, the insulin pump would subtract insulin to correct you back up to the target blood sugar. I haven’t decided if I miss this feature or not. I also have not entered an actual low blood sugar, meaning I don’t know if there’s a certain point that this feature does work. My thinking is this: if I’m low, I will treat with fact-acting carbohydrates. If I happen to bolus as well, it’s most likely after I’ve eaten those carbs and I wouldn’t need the less insulin. So in that sense it’s fine and I won’t miss it. However, if I’m border-line at 85 and my target is 120, the Medtronic pump would subtract insulin from my bolus to get me back up to 120. This will be different and something I need to decide if I will miss. I CAN always override the amount of insulin given; however, to me this is cumbersome.

Although I miss the idea of this, I haven’t had any problems with it not being there. Sometimes, depending on my Dexcom reading and what I’m eating, I will override the amount of insulin given, but this hasn’t been a major issue.

Tubing Location

Very minor, but the tubing comes out of the opposite side of the pump then with the Medtronic. So I keep looking at the pump upside-down because this is what I’m used it. I will obviously get used to this change, but it was a little weird at first. On this note too, I like that the connection is moved up the tubing and not right on the pump. It’s more out of the way, which I like.

I finally learned to look at the pump the correct way! The connection for the tubing can be a little bothersome when I keep the pump in my jeans pocket, but it hasn’t been anything major. 

Things I Hate Very Much Dislike

Pump Clip

It’s HUGE. Very much dislike. I did figure out this morning that the clip comes off and you have a case. I do like that. The pump can be “slippery” and has already managed to slip through my hands (hasn’t fallen on the floor – yet). The pump case has a rubbery texture that’s nice, but the clip…. the clip just is a big fat NO for me. I use the clip when wearing my sweatpants (aka PJs), so it’ll stay in my pocket or when I’m sleeping, I clip it to my waistband at my lower back. (I sleep on my stomach). But this clip gets caught on everything and it’s very easy to unclip, making me feel it’s not going to stay put. I’ve heard there’s a different clip and I’m going to look into this.

This was fixed when Tandem sent out the new case. I love the new case, in comparison to the old one, but I still wish they had something similar to the sport clip that came with my Medtronic. The new case holds a lot better and is a lot lot lot slimmer which is awesome. The reason I still wish they had a sport clip is because I have to disconnect anytime I want to put the clip on since the tubing has to feed through. Sometimes I just keep the bottom of the clip on when I’m lazy. This is more of just an inconvenience then anything. 

Software

I understand that the software is going through FDA approval, but I still dislike that I have no way to get my data off the pump. Luckily I will have data from my CGM (Hello Dexcom G4, it was delivered today!! More on that in a future post. Update: It was not delivered. Communication error. Will receive soon though and will post about it soon.) and I can grab data from my meter. I will have to record carbs and insulin amounts for two weeks prior to my appointment. The pump trainer also stated that she thought the software would go through by the end of the year. If that’s the case, I can wait. But data is a HUGE thing when it comes to diabetes management. I want my data!!

The software is now available. I think for about 2 or 3 weeks now. I tried it once, but I had a connection error, so I figured it was because so many people were on the server uploading their data. I haven’t tried it again, but I don’t have my doctor appointment until the end of the month and I’ve been busy (5 weeks until I get married!) so I just haven’t had a chance to sit down and play with it. I’ve heard it’s nice though. 

USB Cord

Someone else mentioned this in a review as well, but when given a outlet charger and a car charger for the pump,  I would have been appreciative of having two cords. For now, the cord remains in my purse (why not? I have a million other diabetes management supplies anyway). May need to request this or just order another.

While two cords would have been nice, it hasn’t been an issue because I have my phone and Dexcom that require the same cord. So I have more cords than I can possibly count. 

So that’s my initial thoughts. I plan to post details about the cartridge changing and about my experience actually getting the pump. I will also post in a few weeks about how I like the pump and answer any questions anyone may have. So if you’re considering the t:slim or if you’re just curious about the new technology, please ask away! I’m more than happy to detail any information and provide my opinions.

Those are my updates! As I stated initially, the “wow” and “newness” factor has worn off and the device has become just what it is: a medical device. Overall, I’m happy with the device and I have no problem with keeping it for the next 3.5 years. As always, feel free to ask questions. This post is directly a result of someone asking me to write it, so I’m more than happy to answer and help!

Notice

Please remember I am not a healthcare professional and I am only providing my personal opinions. I was not asked to write this review and was not given anything, monetary or otherwise, to write this review. Always ask your doctor about making any changes to your diabetes management.

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Dec 13

Dexcom G4: Compared to Medtronic CGMS

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Edit: As Scott pointed out in the comments, I mixed up transmitter and receiver, but I have changed this to read correctly now. Thanks Scott!
So I’ve had my Dexcom G4 for just over a month now and I love it! It’s scary accurate and I can wear a sensor longer than 7 days! Those two things put it on a pedestal, really. I thought I could compare some of the differences that I’ve noticed from the MM CGM. As always, if you have any questions, please ask!

  • Obvious: Dexcom G4 has a color screen and the MM CGM integrated with the pump
  • The Dexcom sensor comes as an all-in-one package. With the MM CGM, you used a seperate insertion device
  • Along the same lines, the insertion is different in the fact that with the MM CGM, it “plunged” into your skin and you didn’t have to physically force the needle in. This threw me off at first with the Dexcom. The insertion device looked the same, so I thought when I pressed down it would “plunge.” NOPE! I immediately felt the needle, and was freaked for a moment. The act of pushing the needle in myself is something I’m still getting used to. I can’t “force” myself to go quick (even though I know I should) and I miss the MM CGM insertion device
  • With the MM CGM, I could scroll backwards on the pump to see where my blood glucose was every 5 minutes. This I can not do with the Dexcom. I don’t miss this feature, but for some reason knowing I could have it bugs me
  • The transmitter attached to the sensor is big. And by big, I mean GIGANTIC compared to the MM transmitter. However, it hasn’t bothered me. I thought it would, but it hasn’t
  • Connecting the transmitter is a bit odd. With MM you just snapped it into place; however, it would be flimsy (ie. not attached to body) and I would cover it with medical tape. The Dexcom you have to snap into place with an attached piece, then you remove the attached piece once it’s secured, but it’s attached to your body then. I prefer this.
  • Also the transmiiter doesn’t need to be charged! Although, when it “dies” I have to order a new one from Dexcom. I’m not sure if that’s additional charge to my insurance (anyone verify?!) or what, but for now, I enjoy not having to charge it
  • The Dexcom has better alerts. I hated very much disliked the alert on the MM CGM (technically pump). *BEEP BEEP BEEP BEEP* I had nightmares from the beeping. Dexcom allows you to set it to ONLY vibrate which I love because I hate loud obnoxious noises (even my cellphone is on vibrate until I go to bed and need the alarm). The receiver stays on my desk at work and creates a LOUD vibrating sound that I’m pretty sure can be heard upstairs. Thus, I’m not worried about the alarms. The other choice I use, when out and about and my Dexcom is in my purse, I use the Attentive tune. It plays music after vibrating (no beeping!)

Notice

Please remember I am not a healthcare professional and I am only providing my personal opinions. Always ask your doctor about making any changes to your diabetes management.

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Dec 06

t:slim: Compared to Medtronic

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I have been asked by a few people to compare direct features of my Medtronic insulin pump (I had a MiniMed Paradigm® 522 for almost 4 years) to the t:slim insulin pump (have been using now for about 6 weeks). This post is to help those thinking of switching, determine if the features they want or need are available! These are only observations as I have seem them and as they applied to me. Consult technical specs for official information. And as always, if you have any questions – feel free to ask in the comments!

You can see all of the t:slim technical facts on their website:

http://www.tandemdiabetes.com/uploadedFiles/Content/Products/Downloads/tslim_technical_specifications.pdf 

I could not find a quick guide to the technical facts of the Paradigm 522 pump, probably since it’s not the most recent.

*Also please remember as much as some of these technical specs might be different, they may not even apply to you, so look for features that you would actually use and would apply to you! (For example, I will never use 1:300 insulin to carb ratio, but I love the more precise basal rates and bolus units from the t:slim)

 

  • The t:slim will “backwards correct” only under 70 mg/dL. This is not able to be customized. The MM will “backwards correct” with anything under the predefined range set by the user
  • The t:slim will bolus insulin in units as small as .01 (over .05 units), whereas the MM will bolus in .1 units
  • The t:slim offers basal rates of .001 units (over .01 units/hour), whereas the MM allows basal rates of .1 units
  • The t:slim holds 300 units. The MM that I used (522) held 176 units
  • The t:slim shows units left on the home screen, while the MM showed it in a status menu. The MM also showed time left (based on basal rates), the t:slim does not show this (which I miss!)
  • The t:slim allows for up to a 250% temp basal rate, while the MM offered up to 200%
  • The t:slim offers 1:1 to 1:300g ratios (.1 increments below 10 units), the MM offered 3-150 carbs/unit
  • The t:slim offers 15 minute increments for temp basal rates, while the MM offered half hour increments
  • The t:slim allows you change your target blood glucose based on the hour; however, you don’t set a range (again which I miss!), the MM allowed a target blood glucose range
  • The t:slim currently only offers one, very-bulky, clip, whereas the MM offered two types of clips and I loved the sports clip and miss it incredibly
  • The t:slim has a different way of entering your “profiles.” I believe I could explain this in a new post; but the gist of it is all your profiles are based on times and each profile has your Target BG, Basal Rate, Carb/Insulin Ratio, and Correction factor. It nice to have them all in one screen and it’s easy to copy and paste (yes on a pump!) if you need to adjust something. For example, I’m “testing” a new overnight basal rate; however, wanted to keep my “old” basal rate just in case. So I just copied the profile, changed what I needed, and I had both available to me.
  • The t:slim has a numeric pad for entering numbers (carbs, bg, etc.); whereas the MM you would scroll up or down for the number
  • The t:slim also has a built in calculator for adding carbs when bolusing
  • The MM would allow you to enter a blood glucose of 100, without carbs, and deliver 0 units; the t:slim will only allow entering of blood glucose when insulin will be given. Meaning, meters will need to be synced as well as the pump for accurate blood sugar numbers Update: As both Tom and Kathy pointed out to me in the comments, the t:slim does allow you to enter your BG, then back out of the screen and it will save it – even if you don’t deliver insulin. Great news! Thank you for correcting me, I appreciate it.
  • MM has software online; which worked fine for my needs and allowed my doctor to see my data. The t:slim has software (not yet approved; however) and I’m not sure how my doctor will see my data. Hoping the software is approved soon!

I will add more as I think of them, but these are the main differences that I noticed (besides the obvious like touch screen , etc.).

Notice

Please remember I am not a healthcare professional and I am only providing my personal opinions. I was not asked to write this review and was not given anything, monetary or otherwise, to write this review. Always ask your doctor about making any changes to your diabetes management.

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Dec 04

t:slim and dexcom posts coming soon!

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I’ve promised a few posts on my further thoughts of the t:slim and my overall thoughts on the Dexcom G4 systems; however, life has gotten in the way! So for that I apologize.

I am hoping to write the posts ASAP. I should have time this week; otherwise this weekend for sure.

Thanks for the understanding and the interest in reading my blog!

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Oct 31

t:slim: Follow-up & Cartridge Change Video

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So this is my follow-up on the t:slim insulin pump. You can also read my initial thoughts.

  • I still love the insulin pump (but still very much dislike the pump clip).
  • I found out from my pump trainer that the new clip should be available online by mid-November!
  • I’ve decided I miss having a range for my target BG. On the t:slim you put in only a number but EVERYTIME you aren’t at that exact number, the pump will alert that you are either higher or lower than your target. This gets annoying. Especially because Medtronic pump only alerted when I was lower than my range, not higher. So even when my BG is 121, I get an alert (my target is currently set at 120). I’m sure I’ll get used to this, but it’s annoying nonetheless.
  • I’m still getting used to changing the cartridge, but I added a video for your enjoyment to see how different it is.

If you have any questions, please feel free to ask!

And remember, I’m not a doctor and do not have any medical degree, so please follow your doctor’s instructions and advice for anything to do with your diabetes management. 

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Oct 29

t:slim: Initial Thoughts

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t:slim insulin pump

Friday I received my t:slim insulin pump! I wasn’t going to be home Friday night, so I decided I would hook it up Saturday morning. (I had prior permission from both my doctor and the Tandem Diabetes trainer to start without training). So I’ve been using the pump for just over 48 hours and I received my official training via Skype this morning.

The following is my initial thoughts regarding the insulin pump. I will go through more details on certain things in future posts. I noted these below.

Things I Love (so far)

Overall

I love this insulin pump because it fits ME. It’s touchscreen, rechargeable, and so 21st century. It fits in with my lifestyle of working and breathing in the technology world.

Battery

Love, love, LOVE the rechargeable battery. I even charged the pump on my way to work this morning! It works out perfectly because I have a 20 minute ride to work and it is recommended to “top-off” the battery daily. Depending on how I notice the battery life diminishing, I will determine how often I need to charge. I started it with a 100% full charge on Saturday morning and this morning it was at 85%. Not bad for something working 24/7! It takes one minute to charge one percent. When I got to work after charging it in my car, it was at 95% battery. (I didn’t plug it in until about half way to work). It’s still at 95% 4.5 hours later. If the battery stays this way for four years, I’ll be happy!

User Profiles

The user profiles allow the user to set their basal rate, correction factor, carb ratio, and target bg at different times. On my Medtronic insulin pump, these were in different areas and only basal rates could have multiple “profiles”. For instance, I can now have a target BG of 120 throughout the day, but at night have a higher target if I don’t want to fall low before bed. Having these all on the same screen and time dependent is awesome and I’m hoping it will help me utilize the features more. I already set up a different User Profile for weekends because I’ve been waking up low (since I sleep in). This is something I could have done on my Medtronic, since it’s only a basal rate change; however, it seemed much easier to do on the t:slim. Plus I was able to duplicate my everyday user profile, so I didn’t have to add in all the times and data twice. Setting this up was tedious, but only because I had to search all the screens on the Medtronic pump for the data.

Carb Calculator

THIS IS AWESOME! Why? Because I guess my carbs. I round to make the math easy, not because I can’t do math, but because I’m too lazy to spend the extra time adding, especially when my meal is sitting in front of me. But now, I can add with the included calculator! Love this feature!

Alerts

Haven’t used this much yet. I have one set for tomorrow, but otherwise I haven’t played with them much. I do know I will love this feature though. You can set alerts to change your pump site, test your bg after eating and more. Since I haven’t used them, I don’t remember what they all are. I did set the change pump site and I did this because the insulin pump holds 300 units of insulin, much more than my Medtronic pump did. With my Medtronic pump, I would just change the insulin and infusion set once the insulin ran out (3-4 days depending); however, that will take much longer now. I did find out that even though the cartridge holds more insulin, it’s still recommended to change the cartridge every three days. Kinda sticks, I was hoping to get longer time out of them (less supplies, less to worry about), but the pump trainer said if I just fill the cartridge to my approximate usage for three days, I won’t waste insulin.

The Cartridge

The main thing I love about the cartridge is how I put the insulin in. Included with the cartridge supplies are syringes that you fill with insulin from a vial, then insert the syringe into the cartridge to fill. Why I love this? It’s easier to use every drop of insulin from a vial. With Medtronic, the reservoir had an attachment that went onto a vial, then you pulled down the plunger to fill it with insulin. If there was only a small amount of insulin left in the vial, you’d have to take this off and put it onto a new vial. From my experience, this always caused more air bubbles and always was cumbersome. Plus, the plunger at the button of the reservoir could easily move or come out which seemed to cause air bubbles. With the t:slim, you just need to take a syringe out of the vial, stick it in the new vial and continue pulling in insulin. Kinda hard to explain, but for me, it works much better and I feel as though I’m not wasting precious insulin.

Differences

Alarm Clock

Such a simple feature in my book. I used this everyday on my Medtronic pump to remind me to take my medications. I figured I could use it also to remind me to switch my User Profile once the weekend is over. There is no alarm clock though and I’ve confirmed this with the pump trainer this morning (thought maybe it was hidden or something).

Backwards Correction

By this I mean, when you’re blood sugar is below target and you’re bolusing for a meal, the insulin pump would subtract insulin to correct you back up to the target blood sugar. I haven’t decided if I miss this feature or not. I also have not entered an actual low blood sugar, meaning I don’t know if there’s a certain point that this feature does work. My thinking is this: if I’m low, I will treat with fact-acting carbohydrates. If I happen to bolus as well, it’s most likely after I’ve eaten those carbs and I wouldn’t need the less insulin. So in that sense it’s fine and I won’t miss it. However, if I’m border-line at 85 and my target is 120, the Medtronic pump would subtract insulin from my bolus to get me back up to 120. This will be different and something I need to decide if I will miss. I CAN always override the amount of insulin given; however, to me this is cumbersome.

Tubing Location

Very minor, but the tubing comes out of the opposite side of the pump then with the Medtronic. So I keep looking at the pump upside-down because this is what I’m used it. I will obviously get used to this change, but it was a little weird at first. On this note too, I like that the connection is moved up the tubing and not right on the pump. It’s more out of the way, which I like.

Things I Hate Very Much Dislike

Pump Clip

It’s HUGE. Very much dislike. I did figure out this morning that the clip comes off and you have a case. I do like that. The pump can be “slippery” and has already managed to slip through my hands (hasn’t fallen on the floor – yet). The pump case has a rubbery texture that’s nice, but the clip…. the clip just is a big fat NO for me. I use the clip when wearing my sweatpants (aka PJs), so it’ll stay in my pocket or when I’m sleeping, I clip it to my waistband at my lower back. (I sleep on my stomach). But this clip gets caught on everything and it’s very easy to unclip, making me feel it’s not going to stay put. I’ve heard there’s a different clip and I’m going to look into this.

Software

I understand that the software is going through FDA approval, but I still dislike that I have no way to get my data off the pump. Luckily I will have data from my CGM (Hello Dexcom G4, it was delivered today!! More on that in a future post. Update: It was not delivered. Communication error. Will receive soon though and will post about it soon.) and I can grab data from my meter. I will have to record carbs and insulin amounts for two weeks prior to my appointment. The pump trainer also stated that she thought the software would go through by the end of the year. If that’s the case, I can wait. But data is a HUGE thing when it comes to diabetes management. I want my data!!

USB Cord

Someone else mentioned this in a review as well, but when given a outlet charger and a car charger for the pump,  I would have been appreciative of having two cords. For now, the cord remains in my purse (why not? I have a million other diabetes management supplies anyway). May need to request this or just order another.

So that’s my initial thoughts. I plan to post details about the cartridge changing and about my experience actually getting the pump. I will also post in a few weeks about how I like the pump and answer any questions anyone may have. So if you’re considering the t:slim or if you’re just curious about the new technology, please ask away! I’m more than happy to detail any information and provide my opinions.

Notice

Please remember I am not a healthcare professional and I am only providing my personal opinions. I was not asked to write this review and was not given anything, monetary or otherwise, to write this review. Always ask your doctor about making any changes to your diabetes management.

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