Monday, January 27, 2014

Review: Tandem t:slim Insulin Pump.

I wanted to give myself a few weeks of living with it before I shared my thoughts on the t:slim insulin pump I'm now wearing. I've had time to do several cartridge changes, program boluses of all flavors, experience some alarms and alerts, download my data a few times, and basically just see how this tech fits into my activities (and outfits).

You may not have the patience to read everything I'm going to write about this pump (I get that; do your thing), so here's the GIF short-hand. It's going to be about 90% this:




And the remaining 10% somewhere around this:




My insulin pump experience includes four years with a Cozmo, and four years with an Animas Ping, plus a few weeks of trying out the Asante Snap, so keep that in mind as my frame(s) of reference.

I realize no insulin pump is "perfect" and probably none will possess all of the things I like (and none of the things I don't), but the t:slim gets preeeeeetty close, for me.

Let's get the less favorable qualities out of the way first:
Nothing to see here; everything's normal

  • While it's advertised as a pump that can hold 300 units, I don't see a way to actually get to use all 300. When I tried to fill the t:slim's cartridge with a full 300 units (it may have been more like 302), it caused an error that rendered the cartridge - and its insulin - unusable. I called customer service when the error came up, and they said that particular message code appears when the cartridge has been overfilled, and that I wouldn't be able to use that cartridge. Whoops! (Sidenote: some suggested I could draw the insulin back out using the syringe I filled it with, but I hesitated to do so. I'd rather play it safe than use possibly contaminated insulin; that's just me though.) The t:slim still holds more than my Ping did, though, so I can live with it.
  • The tubing prime when starting a new cartridge - OH MY does this process seem ridiculous. Having grown used to the < 30 seconds a prime took with the Ping, and the .5 seconds it took to prime tubing with the Snap - this step feels painful. And not only does it take a long time - think minutes, not seconds - I was instructed to sit not only the pump, but the tubing upright during the prime to avoid air bubbles. Considering I use 43" tubing - it's a sight to behold, and a task I've assigned to my kitchen cabinet knobs. (See right.) 
  • When my t:slim was shipped to me, they asked what kind of infusion sets I wanted and we decided I'd try some Cleo sets. Unfortunately I had quite a few issues with using these - I've sent back the unopened boxes to swap back for Insets - among them, an airbubble that would get stuck where the "pigtail" meets the luer lock of the tubing. However when I switched back to Insets, I couldn't see that bubble anymore, so this may be a non-issue for me going forward.
  • There are what seem to me to be an exorbitant plethora (I like big words as much as I like GIFs, okay) of confirmation screens. I'm aware that this was due to FDA's concerns about a touch screen on a medical device (think about how many people butt-dial on their phones; now imagine butt-bolusing), but it's still a concern from a usability standpoint. It annoys me.
  • The "manual bolus" option - that is to say, a way of telling my pump to just administer a certain amount of insulin, not associating it with carbs or a BG - is non-existent on this pump. While there is a workaround that involves programming 1g of carb, and then overriding the units of insulin from there - it seems a silly thing to have omitted.
  • The lowest profile clip they offer, which is also the clip that now comes with the pump when you order it (the "t:clip"), is not as low-profile as I'd prefer. Again, I'm used to Animas' clip, which was so nice! And when clipped to the top of my pants, more of the Animas pump would be "below the line", so to speak, than the t:slim and its case.
  • And finally, the way it delivers insulin - with this "bladder" that I'm not able to see, within the cartridge - is something new to me. I'm going to need some time and an accumulation of good experiences before I can develop full trust in how reliable and accurate this is. 

There are a few other small things, but they may just be things I need time to get used to, rather than downsides of the pump itself. It's also worth mentioning that during my first few days with the t:slim, my blood sugars were running higher than I expected them to. But, once I switched back to Inset infusion sets from the Cleos, things seemed to even out for me. It could be coincidence and due to some other factor, but it happened, so it's worth noting.

Onward.

Here are my "Oh, HELL Yeah!" items:

  • It feels, looks, and behaves like an insulin pump in 2014 should. How I feel about the way I manage my diabetes plays an important role in my psychosocial health, for better or worse, and things like a touchscreen (no more scrolling - huzzah!) and data displayed in color (with graphics!) pleases my sensibilities. The screen is bright; the vibrate setting is noticeable but not too vibratey (technical term); the pump's "feel" is solid and sleek. This matters to me.
  • It has a vibrate option, instead of all audible alerts and alarms.
  • There's a touch bolus button, which allows me to program a bolus without ever needing to look at my pump screen - I use this often, and realized after trialing the Snap pump that this was a must-have for me.
  • The "basics" are all on my home screen, or just one tap away: things like my insulin on board (IOB) and time of my last bolus, current basal rate, battery life, insulin left in cartridge and current I:C ratio are all easy and quick to access. 
  • I can plug the pump into the wall, or the USB port on my laptop, or my car,  to charge it. That is so boss.
  • "Personal Profiles" include everything you might want to reset for that time of day - not just basal rates, but also I:C, correction factors, target BG, and more can be tailored in each individual profile.
  • Speaking of personal profiles, you can name the profiles whatever you want. Again, seems small - but being able to have a profile named "Eff Yeah Wknd" makes me smile.
  • I considered listing this as a negative, but I'm actually thinking it should be a plus: the t:slim seems more occlusion-sensitive than other pumps I've worn. This could be good as long as the alarms are actually truthful. 
  • It's water-tight. Excellent.
  • Delivery noises seem much quieter to me. I'm not talking about confirmation beeps, but the actual noise the piston makes when delivering a bolus or basal. Anyone who has used an Animas Ping and spent any amount of time in a library or super-quiet work environment (hey, that's me!) can attest to the loud noises it makes while delivering insulin, and that always bugged me. Sweet relief!
  • I hadn't realized this ahead of time, but the t:slim will alert you if you it thinks a bolus you're creating will cause you to go low. I love a device that can help me out like that.
  • The t:connect software (Mac-friendly - yay!) is very visual and easy to use, and I like not having to mess with a special cable/dongle in order to access my information. Downloading my Ping was always such a clunky process that it deterred me from doing it very often - t:slim is very plug-and-play with any micro-USB cord. My doctor hasn't tried to access my data yet (I've heard there's no provider version; that they'll need my password to access it, which doesn't seem right), but so far I like it for my own use.
  • I've found Tandem's team to be very responsive - customer service has been good, and my local reps have been very accessible, through emails, texts, calls, or whatever medium I might want to use. And when they issued two different voluntary recalls on cartridges - mine were affected - I was alerted by tweets, phone calls, emails, AND snail mail. 
  • Back to those t:clip cases - again, a small thing, but you can totally mix and match colors on these, because the clip is two parts. 
  • One last thing - I'm looking forward to hearing more about the partnership Tandem and Dexcom have forged in order to get an integrated system to market. 

I'd also be interested in hearing what other t:slim users do or don't like about pumping with this particular device, so feel free to comment all over this.

As I said, I'm only three weeks in. Time will tell if this pump is a good fit for me over the long haul, but so far? Thumbs most of the way up.

UPDATE SEPTEMBER 2016: To those wondering, two and a half years later, if I'm glad I picked the t:slim... I am. I'm not sure there existed a better option for me at the time I was able to get a new pump (January 2014). That said, I am on my third t:slim as I write this. My original pump, and its refurbished replacement, got to the point that they would not accept a new cartridge installation - which essentially means the pump was rendered useless. Because my pump was still within its four years of warranty, it was replaced at no cost to me. And with my third (current) version, they sent a pump that included updated software.

SO MUCH BETTER.

Here's hoping the updated software continues to solve the "no cartridge for you!" issue my previous t:slim pumps had. After two replacements, it has become more challenging to completely trust this tiny, life-bettering machine on my hip. 

UPDATE TO THE UPDATE, DECEMBER 2016: I'm on a pump break for the first time in 11 years. Details in this post.


90 comments:

  1. I'm glad you feel like the occlusion alarm is really sensitive. I've had the alarm go off multiple times and almost every time I've just unkinked my tubing and pressed resume and it's been fine. If it goes off twice in a row I'll change it out. Also, and probably not a problem for those not in a stand on your feet for >8 hours a day profession, but the occlusion alarm happens really frequently with tubing under compression hose, just a fun fact.

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  2. Hi Kim...I'm about 15 months in and generally agree with everything you've written! Love my t:slim - it's a worthy successor to the cozmo!! -ellen

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  3. Wow, thanks so much for this feedback! I just connected with a t:slim rep and have started the process of switching from Medtronic. Question on the manual bolus problem: So are you saying you can't just bolus for say, 2 units, just because you feel like it or know that you may have eaten extra at lunch, for example. You would have to enter a blood sugar or carb amount to bolus?

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    1. Technically, yes you can - you just have to use that workaround that I mentioned to get to the point where you can specify what you want your bolus to be, in units. But no, there is no way to "officially" do it, unless you're using the touch bolus button and don't need a super-specific amount of insulin (i.e. one button press, for me, is one whole unit). Does that make sense?

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    2. Ah, okay. So "touch bolus" could be an option around it. Great review, btw! Very helpful! Also, I adore the cookie monster.

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    3. I am a little confused by this. I can perform a quick bolus, two units at a time (which is programmable to other increments 0.5, 1.0, 2.0 or 5.0) by pressing the silver button on the top. Is the issue that you cannot input a more specific amount? Not sure what a touch bolus is.

      And spot on with the Cleo - yuck!

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    4. Amy - yes, that is exactly what I mean. :) If I wanted to just program, say, 2.55 units without associating it with a BG or carbs, I can't do that (save for using the aforementioned workaround). With the Ping, I could just input a specific amount like that.

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    5. Yes, you can manual bolus with no workaround! Just tap the units button on top of the screen (not the grams button).

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  4. My son's been using it for about 4 weeks and I've been trying to write our/his review. You pretty much write was I was thinking. We haven't had one occlusion alarm, so that's weird. He thinks the delivery noise is loud (he also switched from Animas) and he did get the carb/bg buttons mixed up (while groggy in the middle of the night) and gave insulin for 331 carbs rather than a bg of 331, which I luckily notice half an hour later. He hates the high profile clip but has to use it during PE. He won't even do cartridge changes because they're so ridiculous, I've been stuck with the task every time. Overall, we're both happy with it, no scrolling through numbers makes up for a lot.

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  5. Yep. You nailed it. The whole "you may go low" thing actually bothers me a bit. I know it's all "math-y" and stuff, but if I want to correct a high sugar, and it's night time when I'm far more insulin resistant, and I still technically have enough IOB, I hate having to do a workaround via quick bolus because my pump thinks it's smarter than I am. The priming process is ridiculously long. And the Cleo infusion sets are awful. AWFUL. I almost decided not to pump because they ripped off so much and hurt my skin and kinked a lot. My distributor (not my rep) says a lot of people don't like them.

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  6. Ive been on the TSlim for about 4 months.

    Drive me nuts category:
    1) Air Bubble Paranoia
    2) Incomplete Bolus Alert - When I put something into the calculator, its because I want to see if a correction is necessary. If its not, just let the bolus time out. All those loud beeps aren't necessary.

    Good things:
    1) Touch Screen
    2) No longer asked about why I have a beeper (Although someone did ask about my MP3 player the other day).

    Dexcom integration, please hurry!!!!

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  7. I used Cleos with my Cozmo, and I was never a fan, so I would also recommend the Insets! So far, the t:slim and I have been getting along well for the past 8 or 9 months. I don't seem to have issues with air bubbles like some people do, but on the other hand, if they are very tiny air bubbles, I am not so insulin-sensitive that these would normally cause me any issues. I feel like the primes are long, but I also think my Cozmo primes were somewhat long, because it doesn't always seem that bad to me. Of course, I am frequently multitasking, so while the t:slim is priming, I'm running around doing things. Also, having 10-digit numerical entry with a delete key AND a calculator is fantastic. I am not great at math, so when I know Food A has 12 grams of carbs and Food B has 26 grams of carbs (and there is a train going from Philadelphia to Boston or whatever), I can just enter 12 + 26 and it's there for me. I feel like no pump is perfect for me, and the t:slim has been a great option so far, and WAY better than my other option when I was choosing a new pump last year.

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    1. Yes! Thank you for mentioning that feature - I had forgotten to include it. I appreciate the ability to add when bolusing for multiple things, too!

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  8. For what it's worth, when I upload my Medtronic pump data to Carelink for my doctors to review, I also need to give them my username and password. But I agree, I feel a bit "violated" in doing so, even though I have nothing (in that data) to hide.

    That manual-bolus thing really sounds like a pain in the ass. Does that mean you can't give it a BG and then choose your own correction without adding carbs? Also, I'm curious to know what you think of the reverse-correction "bug", where it won't subtract from a carb bolus unless you're under 70. I know that bothers some people.

    Last question for you -- for those of us unfamiliar with the "Cleo" sets, what are they, and do they resemble a set that another manufacturer distributes? If it causes such problems, I'd be curious to hear what happens with the same set connected to different pump.

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    1. Hi Scott - to clarify, you can specify carbs and/or BG. You don't have to do both. :)

      The reverse correction issue doesn't bother me, but I know is important for some.

      I linked to the Cleo sets above, but here's another: http://www.smiths-medical.com/landing-pages/promotions/md/cleo-home.html They pretty much work with any pump that accepts a luer lock.

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  9. My 13 yo daughter has been on the t:slim for about nine months, came from a Cozmo (she was the last one at her clinic with a Cozmo). We both love it and generally agree with what everyone has said. One thing that does bother me, though this should rarely happen... if you allow the pump's battery to deplete, you have to change the cartridge once it's charging/charged. Waste of supplies, insulin and time. Also, the anchor for the door that covers the charging port comes detached much too easily. She does get fairly frequent occlusion alarms, but they are very easily rectified. Question... Is there a way to turn the pump off? RE Cleos, my daughter has used them for almost five years and we both LOVE them. Love the insertion device.

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    1. Hi Shannon! I remember asking about how to "shut down" the pump, since there's no battery to remove, during training - but I'm afraid I don't recall the answer. A call to tech support may answer this.

      I'm glad Cleos work so well for you both!

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    2. I don't believe there's a way to shut the pump off. I went camping for a few days last summer where I chose to use insulin pens instead of the pump and it was a painful alarming process until the pump died.

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    3. I've taken frustration vacations from the tslim a few times. The first time, I put it in "shelf mode" where you plug it in to the charger, then hold down the button on top until it screams some beeps and goes black. To turn it back on, plug it in and hold down the button until more screaming and the screen lights up. THIS IS NOT AN OFFICIALLY SANCTIONED TANDEM APPROACH. There have been some concerns over data corruption, so shelf mode at your own risk. My other tactic is to just create a new profile with a 24 hr basal rate of 0 and switch that one when I want to take a break. The fully charged battery lasted me well over two weeks last time, and as long as I didn't have the site change reminder set, it stayed blissfully quiet the whole time.

      I'm one of those people who isn't all sunshiney about my tslim. I'm not sure it's always giving me the insulin it says it is. I get cartridge occlusions a lot. But I like it better than any other pump I've used, so I keep going back. It's my insulin infusing version of a bad relationship.

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    4. Create a new profile. Set the basal rate to zero. When you want to stop delivery for an extended time, activate the new profile. I called mine shower. I hate those alarms. The screen puts a red indicator showing basal is not going, but will not alarm or loose your info. I'm Jogger. I don't have any pump yet just testing my options. My concern with Tslim is insulin delivery not being complete, but not alarming incomplete bolus. I often experienced what I would call partial blockages.

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    5. Plug it in to charge and hold down the quick bolus button. That will turn it off. Make sure you don't mind wasting whatever insulin is in the cartridge because turning it off will nullify your cartridge. All information remains (profiles, settings, numbers, etc), but it's basically resetting your pump.

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  10. Hey Kim. I've been using the tslim for 16 months about and I would definitely agree with almost everything you've said.

    To get around the painful priming process I have been reusing my tubing for the life of a insulin vial. It also helps to know I'm not throwing away 43" of insulin every 3 days too. (I'm not recommending this - just stating what I do. If it were to cause significant BG problems I wouldn't do it but I haven't noticed anything yet. Although this could change.)

    One thing that bothered me at first was there was no alarm clock. Silly but I used it to remind me to take other medications on my previous pump.

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    1. Melissa,

      I'm pretty sure you can use the reminders feature to program any alarms that you want. I haven't used it much but it is there. Jason

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  11. Hi Kim,

    Air bubble paranoia (well stated above) became my biggest concern with the pig tail design. I would also add that the extended bolus feature has some limits that are programed into the pump (can't deliver more that 7.5 units per 30 minutes). Has anyone had issues with this??

    Finally, Tandem got really weird when I asked to return the pump and ultimately wouldn't allow me to which was super frustrating. Just be aware that when you sign the assignment of benefits form that you are agreeing to the return policy (30 days from the ship date).

    You review seems spot on.

    Jason

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    1. Is this correct? The maximum extended bolus s 7.5 units over 30 minutes? I am currently using an Animus One Touch Ping. I assume the extended bolus is the same as what Animas calls a Combo Bolus. Generally whenever I use this feature is when I have eaten something not to good for me (especially pizza). I know I shouldn't eat it but can't resist it occasionally. When I need it, then I need more than 7.5 u aver 30 minutes. .

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  12. My daughter (16 y/o, 4.5 months post T1D onset), just started on her t:slim today. Since we have nothing else to compare it to, and are still very much "beginners," it's good to read that most reviewers have positive feelings overall. We'll see how it goes...

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  14. I had a terrible time with the Cleo sets when I tried them, too. I think my dermis/subcutaneous tissue ratio just isn't good for them. I can't use an insulin pen, either, because the needles are too short.

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  15. They were super awesome on the recall I was amazed I only had 2 cartridges affected but they sent me a whole box. It makes me wish my insurance covered them directly and I didn't have to go through a supplier that sucks.

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  16. thanks so much for all this detail. the warranty on our mm is up in a couple of months and after doing the tslim trial at ffl, that's the one L is leaning toward, so it's great to see this real world look at things. L's main concern was the comfort/ease of the infusion set. she's used to mios.

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  17. You can use any luer lock infusion set with the tslim. The non proprietary version of the mio is the Inset... most of medtronics infusion sets are made by unomedical and come in a version for everyone else's pump

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    1. Do you know for certain that the Medtronic non paradigm luer lock quick set will work with the t-slim?

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    2. Any Luer Lock set will work... believe it or not , there was once a push by Smith Medical to call Luer Lock insulin pumps the "Open System"

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  18. I'm so glad I read your post as I have been having a lot of air bubble issues. Oddly enough, I have had the t-slim since July and have not had a single alarm or occlusion. I say odd, since I have had alarm issues with every pump I have used including Medtronic, Deltec, and Omnipod. I have been using Cleos (mainly because I had a super supply leftover from pre Ominpod days and wanted to use them up). I had the exact same problem you did, the ginormous bubble that sits between the leur lock and the tubing. What I don't understand is if it can use any infusion set with a leur lock why the problem with Cleos? But perhaps I need to do a little experiment and try a different set up. Great blog. I really do love my t-slim and I don't want to give it up because I am not so enamored with anything else on the market. So I hope I can get to the bottom of the air bubble problem.

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  19. Here is another site which covers the air bubble problem:
    http://www.tudiabetes.org/group/tandem-t-slim/forum/topics/how-i-beat-the-bubbles

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  20. If you would like to bolus in units, you can tap on the amount of units displayed at the top of the screen after entering a carb amount or blood glucose and then enter the amount manually. Or if you would like to use units exclusively you can change that option you can do so by going to

    Options>My Pump>Personal Profiles>(Select the profile you'd like to change)> Edit> Bolus Settings> Then change the Carbohydrates to off.

    After doing so your bolus screen should display units instead.

    Hope this helps

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  21. I'm looking into getting one of these in the next few weeks. My biggest concern is not being able to replace the battery if it happens to die while I'm camping or something of the sort. So my question is, have you tested how long the battery life is without charging it at all? How long does it last on a single charge? I'm surprised no one has asked about this yet.

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    1. I've never let it run down to zero battery, but to give you an idea: after 48 hours of use since the last charge, I was down to 80% this morning.

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    2. Also, you can solar-charge your t:slim too, apparently, though I've not tried it: http://www.diabetesmine.com/2014/03/using-the-suns-power-to-juice-up-our-diabetes-devices.html

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    3. I've seen talk of this on Facebook, any there are suggestions to buy a portable rechargeable battery power pack. One I have looked at is the Anker® 2nd Gen Astro E4 13000mAh. The only thing about such a device, is that I would want to at least use it few times a month just to know it's still working, and maybe have a back up one that I would test and charge once a month.

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  22. How is the bolus delivery time compared to a Ping which has Normal & slow delivery rates? I was playing with a demo unit in the office earlier and programmed a 10 u bolus & it seemed to take forever compared to the Ping. Was this just the demo pump or is it slow? I have gotten into the habit of making sure the bolus is actually delivered. Please confirm, the cartridge is NOT refillable? Any Medicare insurance users out there? Do cartridges, infusion sets & supplies come from Tandem or will I have to go thru a 3rd party medicare approved supplier (Animas dropped all their Medicare patients 4.5 or so years ago just after I started using the Ping system) Final question: Will the pump survive being dropped onto a hard tile floor from waist height-- say 3 feet, if not is this covered by the warranty?

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    1. You are correct that the t:slim delivers boluses much more slowly than the Ping does. The cartridge is not refillable, no. As for the rest of your questions - those would be really great questions to ask of a Tandem rep.

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  23. One thing that it's explained very clearly about a t:slim, you can't use Apidra rapid acting insulin in it. It wasn't tested with it, so it's not FDA approved. But, like yourself trying every possible way to test and stretch the limits of the t:slim when I trialed it. Apidra would gum up the "pig tail" the luer lock connector from the cartrige to the tubing. Boy, I haven' has so many "HI" blood sugars in my insulin pump career. So just a head's up to the Apidra users. ( I use continue to use Apidra in my Minimed pump- works great)

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  24. I just got a Medtronic 530G. So I have less than 390 days to change my mind. I was choosing between t-slim and 530G. I chose 530 because of integrated CGM.
    My question for the group: The alarms on the 530G are very high pitched, and not very loud. There is no volume setting, quiet is all you get. You can chose vibrate WITH NO SOUND, but you cannot have both.

    What is the volume like on the T-slim. Is it adjustable? can you have different "ring tones" for alerts, alarms? Can you have vibrate with sound vibrate only, and sound only? Can you silence almost all alarms if desired?

    SO far this is the biggest concern I have had with the 530.

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    1. Hey there - okay first, do you have a Tandem rep in your area? They can meet with you and show you a t:slim in person so you can hear all of the alarms, etc., for yourself. But to answer your question, you have the options of Vibrate (no sound), Low, Medium, or High and can adjust those for each alarm. (So for example, if you wanted a "low" volume for quick boluses, but a "high" alarm for a low cartridge warning, you can specify that. It's not one-setting-to-rule-them-all, like with some other pumps.) Right now it's just beeps - no choice of "ring tones", no. You can't have *no* alarms, but the vibrate option would make it silent, relatively speaking, if that makes sense.

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    2. If it's not too late Kim, check out the Dexcom cgm which is much superior in accuracy.

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    3. I have been a 530 user for several years and my warrantee is about up. I WON'T be buying another one. I am on my 3rd medtronic pump as it a) doesn't like water, b) is pretty cheaply made if you are active, and c) I don't think minimed is particularly good at quality control. When something breaks or alarms and can't be recovered, the unit is DEAD. If you didn't back up your settings, too bad. As an engineer, this is unconscionable.
      I agree totally about the Dexcom CGM. I've used both the Dexcom and Medtronic CGM's; Medtronic's CGM-- even the brand new one-- are WAY behind where Dexcom was 3 years ago. It is sluggish and slow reacting, HOWEVER, I love having it integrated! Their new sensor is more accurate, but still has a very slow response to changes caused by exercise, taking the wrong sized bolus, etc. I only stopped using the Dexcom because I had an allergic reaction with the glue they used. I even dropped it in the yard once and found the dog chewing on it. Dexcom makes a tough unit and it kept running!
      I've had a lot of problems with Medtronic's quality, tubes popping off infusion sets, etc. They don't seem as proactive as Disetronic. I've ended up turning them into the FDA twice.
      Disetronic had the best quality of the two as they told me about any problems before I discovered them. Also, they gave you a spare "backup" toy pump. That is particularly handy if you do have a problem. I never did with the Disetronic, but it has saved me from going back to shots twice with the Medtronic. But the older Disetronics had one insulin delivery speed-- which was way too fast-- and no bolus calculator. I could never go back.
      Why doesn't someone make a single unit with the CGM and delivery system integrated that really works? PLEASE give me a tiny unit and let me control it via bluetooth from my phone where I can program, graph, etc. everything? Just give it a 3 button mini user interface in case my phone dies and i need to bolus.

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    4. Tslim is trying to get approval to connect with the dexcom. I spoke to a tslim sales rep who said after FDA approval you would need a new pump. Plus no upgrade options will be offered. No reason to switch pumps now or buy the Tslim unless like me. I am a long time type 1 considering a first pump.

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  25. Reading through the list of issues, I wonder why would I consider it over the Ping?
    With Ping priming process is easy, waterproof design is great, air bubbles are no much trouble either.
    Besides, rechargeable battery sounds more like a hassle, considering once a month replacement on Ping.
    Convince me!

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    1. Hi "Anonymous" - you may find this comparison helpful, to understand what differs between the Ping and the t:slim (and other pumps): http://integrateddiabetes.com/insulin-pump-comparisons/

      No convincing needed - choose what works best for you. It sounds like Ping is a good fit for you now.

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    2. Thanks for the link! Will stay with Animas for now ...

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    3. I have been on the Ping for about 5 years now and before that was on the Paradigm from Mini Med. I have really liked the Ping but my warranty is ending soon and so I am looking into the T:slim. The reason I switched from Mini Med to Animas was the meter remote option they have with the Ping. I love that you can check your BG, add up the carbs and deliver the insulin all on one device without ever having to take your pump out.

      I have heard that with the new pump that Animas is working on, the Vibe, there is no meter remote option. Does anyone else use the meter remote? Has anyone heard anything about the Vibe? Does the T:slim have any meter connected with it?

      Thank you,

      Hannah

      Delete
  26. A quick question, does the t-slim have a temporary basal setting like medtronic. I know a lot of people don't use this feature - but I do. Some days I spend running around all over the place and I just set my basal rate at 70% for the entire day. Makes my life a lot easier.

    ReplyDelete
    Replies
    1. Hi! Yes, it does. I use it frequently!

      Delete
    2. Just know, if the basal rate in your active profile changes during your temp basal rate # of hours, whatever is 70% of the current basal rate will change also.

      Delete
  27. Hi all, I'm researching the Tslim right now, my MM 723 warranty is up. Have some questions, Is the insulin on board automatically subtracted from bolus calculations? And do you find that you miss the reverse correction feature when you are below your target but not yet at 70? In a previous answer you mentioned that there is no shut off option, is there a suspend feature for showering and such?

    ReplyDelete
  28. Great info! How do you disconnect for a shower, etc?

    ReplyDelete
  29. My 12 year old son is looking for his first pump. He was diagnosed just 3 months ago but thinks he really wants to get this going. I have not read all of the posts but I just would like your short, honest review of the t-slim. Thank you for your time.

    ReplyDelete
  30. My 13 year old daughter is in the process of picking her first pump and is currently torn between the t:slim and the omni pod. Thanks for the review and all of the comments!

    ReplyDelete
  31. I started on the tslim this week. T-1 since 1982, pumping since 2000, former pumps- disetronic H tron, then all the versions Animas has offered. Really trusted my Animas Ping and was reluctant to switch. If you are reading this, you are probably like me, and a little obsessive about wanting to make the right choice. At this point (admittedly less than one week!), I love the tslim. All of the concerns I had seem very minor at this point. I used room temp insulin with the cartridge fill and cleared air bubbles from the syringe and did not have any issues. Load time is longer but really a non issue to me when you take into account all the other positives. I read complaints about numerous confirmation screens, but to me it all seems faster than with the ping, which required lots of scrolling and confirmations. The only thing I miss is a slim clip. I run and the case/clip the tslim comes with makes it sit too high up- it bounces around a lot. I just use a running belt instead. I would suggest meeting with your local tandem rep to get a look at it and then decide. But, don't over-think it. No pump is going to be perfect, but the tslim is a big step in the right direction in my opinion.

    ReplyDelete
    Replies
    1. I feel the same... have had two pings, a mini-med, and the t-slim is by far the best. BUT>>> the darn clip. I hate the clip. On my ping I could clip the pump to the middle of my bra when I wore a dress... granted the pump is thinner... which is nice... but with the clip it is much wider and bulkier. Tandem.... you need to fix this! Otherwise I love everything about it. I tried Omnipod, Medtronic, and Animas and frankly... this is the best of all of them. I've had my t-slim for 3 months now.

      Delete
  32. Are there going to be any upgrade options, if I were to purchase a Tslim pump now? I,
    I am deciding between Tslim and the 530 by Medtronic. If I thought I could upgrade when Tslim gets FDA approval, I would choose Tslim.

    ReplyDelete
  33. I'm looking at getting my son started on a pump. He was diagnosed at 13 months and is now 10. When he was diagnosed, doctors put him on humalog, NPH and lantus. The NPH has worked wonders for us over the years as he has avoided shots during the day and at school. With this and the combo of a lot of exercise he has stayed really healthy and we have not had to micro manage carbs and count carbs. The downfall is lows at night kill us as parents, and lack of freedom from us. He could give his own shots but he can't draw up the insulins, plus he's really tired of shots. He has been on the Dexcom CGM, which is amazing and so helpful. We looked at medtronics, animas and the omni pod..He likes the look of the tslim, of course. I was warned of the smaller reservoir size of the animas pumps, and I was drawn to the tslim because they are going to partner with Dexcom in the near future here. We may have a real-estate issue with having both the pump and CGM on. He's a tall, skinny kid and he pretty much wants to play hockey, lacrosse, bike, swim, etc... 24/7. Any feedback I can get, good or bad would be greatly appreciated!

    ReplyDelete
    Replies
    1. Hi Anonymous. Did you guys decide which pump to get yet for you son? I met with tslim rep today, pretty interesting pump. I have accu-chek combo, like it very well! Meter is paired Bluetooth with the pump. I can run everything by the meter. Time for me to get a new pump but not sure if I will leave my accu-chek with their technology. Thanks. I am trying to get feedback to see if I need to change pump companies.

      Delete
  34. Time for me to get a new pump. Anyone have any suggestions on the pumps they like or dislike? I have been with one company for 17 years and I might be ready for a change. Thanks!

    ReplyDelete
  35. Not sure if anyone has mentioned this yet, but the one thing I hate about this pump is that if you stop delivery for more than like 5 minutes, it freaks out on you and does this super annoyingly loud beep 3 times. You can't make it not beep, even if you change the settings to vibrate. It forces you to do a temp rate or new profile with an insulin level set at 0 if you want to get around it. Other than that, though, and the long tube filling process, it's a great pump and I would recommend it!

    ReplyDelete
    Replies
    1. I just got my new Tandem pump. Normally I just let my pump drip while I am unhooked, but that would just be for showering or something quick. The recent software update in April addressed the long priming issue. If you haven't gotten your one free update, that would help. I love it that the company listens to suggestions and complaints!

      Delete
  36. For anyone that has been on a Medtronic pump, what are the drawbacks of switching to a Tslim? As a lot of people here, I'm trying to pick the perfect new pump and am frustrated with my choices! I've been on a pump for 30 years (starting with a gigantic one, then disetronic and currently Medtronic). I'm concerned that you can't link a bgm or cgm to it. Another question is can you print out the reports of blood sugars you enter into the pump? Or doesn't it work like that? (I'm comparing to the care link software here). Thanks for all the info and I'd appreciate any more anyone can provide.

    ReplyDelete
    Replies
    1. Tslim is working with dexcom, should have full integration in late q3 or early q4!

      Delete
  37. i also have a medtronic pump and am thinking of switching to the t-slim... so all this info is really helpfull thanks !

    ReplyDelete
  38. i also have a medtronic pump and am thinking of switching to the t-slim... so all this info is really helpfull thanks !

    ReplyDelete
  39. Thanks for the update. I'm also considering an omnipod pump because its tubeless.

    ReplyDelete
  40. Please be advised the FDA has approved the t:slim/Dexcom integration; however, this upgrade is NOT available for current users, only new customers.

    ReplyDelete
  41. Hello! This was a good read but I have a question. My tslim does the change cartridge alarm very often. I only put 180u in it every time. It has happened so often and the beeps are SO loud. I have it on vibrate but as you know, after the vibrate it turns to sound thinking you are unaware or something. It has happened many times and I was wondering if anyone else had this issue? Thank you!

    ReplyDelete
  42. I'm an 17 year Medtronic pump user, leaving Medtronic because they have basically the same product as my first Medtronic (Minimed) 1998 pump,and quite frankly I'm tired and a little scared of Medtronic's frequent safety alerts and recalls, and basically just ready to have a pump that doesn't look like something from the Seinfeld era. I'm also a faithful DEXCOM user for five years, after wasting three years before that on the inferior inaccurate Medtronic CGMs.

    So I was very excited when the T-Slim with Dexcom G4 integration was just released.. HOWEVER I already have the new Dexcom G5 system, so the T-Slim pump with G4 integration IS ALREADY OBSOLETE unless I wanted to stay on the G4 system, which I definitely do not because the G5 with bluetooth display on my iphone is wonderful, (and since of course I will want to upgrade to the Dexcom G6, G7, etc. as they come out). According to my T-Slim rep, there will be no software update to make the new T-Slim G4 compatible with the G5, and no future upgrades available, so the brand new T-Slim/G4 is already unusable for me. I am still however considering just getting the basic T-Slim, because with my Dexcom G5 displaying on my iPhone I can really do without the display on my pump.

    so just be aware that if you get the new T-Slim/Dexcom G4 that you'll have to stay with the (now old) G4 system for as long as you have the pump. It just seems that not many Dexcom users would want this new pump now that the G5 system is out.

    ReplyDelete
    Replies
    1. Just my two bits for what it's worth.... I use an Animas Ping (love it) and used the Dexcom G4 for a couple years until the G5 came out. I upgraded and have learned the following.

      1. Bright screen, almost two bright. The thinner black lettering is almost overwhelmed by the brightness of the screen.

      2. The G5 transmitter lasted just over 4 months (the G4 lasted 6 months).

      3. When I exchanged the transmitter on the G5, I shut down the G5 CGM and re-started it, then an extremely loud alarm sounded on re-start to alert me that the G5 had failed its self-check routine. Of course, I called Tech Support at Dexcom and waited on the phone for an hour for my call to get to the front of the line. I finally left a message. No call back for several days. I also sent an email which asked me to call Tech Support. When I finally did talk with a Tech Support person I learned that Tech Support has been a bit overwhelmed with G5 user issues. Yep, I did receive a new G5, but after that experience and because I still had my G4 and a spare G4 transmitter, I went back to the G4.

      4. As I live in rural Minnesota, cell phones overall are much more difficult to use as there are many fewer towers so the ability to stream G5 data to a smart phone is less of a draw for me.

      Said all that to say this, the G4 is a solid, tough Dexcom. I even washed mine by accident and after letting it dry out thoroughly for two weeks, it actually worked again! Tough, tough, tough! The new G5 I received is in a drawer and will stay there.

      Thanks to all for the great Tandem feedback. I am due to upgrade my pump in December so truly appreciate the time and effort to get thoughts out to others.

      Delete
  43. I was recently informed by the t-slim rep that the basic t-slim (which has bluetooth) is currently working with the FDA to be compatible with future Dexcom devices (G5) via bluetooth. No release date yet but hopefully within the next year.

    ReplyDelete
  44. I bought the Tslim in January knowing that the integration of Dexcom was coming soon. All of my paperwork shows that was my main reason for purchasing this pump because Dexcom is more comfortable to wear than Minimed's CGMS. I was told that if I went ahead and got the pump, that it would most likely be a software update to add the Dexcom or that they would be issuing upgrades. Six months after I purchased, integration happened and then they said, No Upgrades unless you've had the pump less than 30 days or two weeks...something absurd. I was told I could upgrade when I was eligible for a new pump with my insurance...so in four years??? I'm furious! I have enjoyed this pump but feel like Tandem doesn't stand behind their products and would caution you to buying into them because of it.

    ReplyDelete
    Replies
    1. I think u are in the best situation with the tslim and not the tslim G4. The tslim G4 is not compatible with the dexcom G5. I was told that the tslim G4 connects via radio frequency whereas the dexcom G5 uses Bluetooth. The tslim has Bluetooth capability but it is disabled as no fda approval but after approval potentially could be turned on. If u don't have the G5 the next time u need transmitters order the G5 transmitter and you'll be up and running on your phone. I returned the tslim G4 for the basic model as I'd rather use my phone for display and hold out for Bluetooth being enabled in the tslim.

      Delete
  45. I want my old Animas pump back.

    When I first got the T-Slim in April 2015 it was cool. I loved the touch-screen feature. But after about the first two months on it, I have had nothing but trouble. The problem with pumping issues is that there are so many variables. How do you diagnose anything? My blood sugars are good the day I change a cartridge. After that my bg starts rising. Is it the Inset tubing/Humalog combination (which has NEVER given me trouble before), changing tubing without changing cartridges, fats interfering with insulin absorption, bad absorption at the site, a slow occlusion alarm sensor, or a faulty pump? After six months of this I HATE this pump and want to go back to what worked.

    Just FTR, I much prefer the old plastic plunger cartridge to the T-Slim cartridge. I could push all the insulin out of it or pull insulin back out of my tubing with it. This new method wastes a TON of insulin. At $200/bottle I can't afford to throw away half-filled cartridges or tubing with insulin still in them. The T-Slim price is what sold me, but the difference is quickly being made up in more frequent cartridge/infusion site changes. It stresses me out. If you're like me and you don't have insurance, think twice and consider EVERYTHING.

    On the positive side, the ketones are keeping my weight down. Always look for something good, right? :)

    ReplyDelete
    Replies
    1. On my last cartridge change the pump said I had 12 units left. I used the suringe to draw out the remaining insulin from the cartridge, which btw was exactly 12 units, and injected it back into my insulin bottle.

      Delete
    2. Hi Sally,

      Your feedback is very timely for me. While reading all the positives about the T:Slim the negatives kept popping up and were finally leaping off the page at me. I am a Ping user and have been happy with the Ping minus that the screen has lost some of its brightness over the 4 years that I have had it. That is the only picking point. Based on your feedback, I am moving to the Vibe. I, too, had to pay out of pocket for many years so sure do understand your comments about that. I wonder if someone may reach out to you to offer a used Animas rather than doing a trade in?

      Delete
  46. Thanks to all for the personal input, I am a 60yo who is looking at yet another advancement in my Type I management. I have to admit not injecting several times a day has a real lure for me. Not sure which unit is best for me, but this has been VERY helpful...thanks again to all!

    ReplyDelete
  47. I've had diabetes for 18 years now and have always been a little weary on using a pump. I have an appointment with my endo in February and I am trying to decide which pump would be best for me (a first time user). The first one I looked at was the OmniPod now I'm liking the t:slim also. Any advice?

    ReplyDelete
  48. Hi all, I did a google search insulin pumps 2016 and saw the tandem t:slim, which, as already mentioned by some, looks like a pump should do nowadays. I am quite disappointed by Minimed's lack of ideas and design and the new 640G looks like a joke.
    What is making me hesitant to Tandem is primarily the cartrige - they should be able to make one side transparent, with a scale on it, but also the old school Luger lock. I don't know how safe/unsafe that is, but it looks terrible and not like something people would like to use discretely. I have not used Luger since my Minimed 507, some 15 years ago and I have been very happy not having to deal with it..
    Also, I can agree with most of you complaining a missing belt clip.

    How about charging, doesn't it feel strange to have to connect the pump for charging twice per week? On my Minimed 554 Veo, I am distrubed for having to change the AAA battery once per month, I think that long priming + recharging of the battery would drive me mad.

    ReplyDelete
  49. I have had a medtronic pump for several years, my warranty is out so looking at the tslim. I already have the dexcom cgm. just wondering if anyone has come from medtronic to this pump and if so are you glad for the change or should i go back with medtronic?

    ReplyDelete
    Replies
    1. I've been pumping since 2012

      I switch from Medtronic to Tslim and my choice for the transition was for the integrated cgm.
      My minimed was older, heavier, but it still has more options than the current tslim.
      Tslim issues:
      1. Cartridge Refill, are not like the vial of a medtronic, as its a cartridge and you will have to do multiple work arounds of pushing and pulling of the syringe to try and get all the air out.
      2. You will lose about 20-30 units in the priming of the tubing to get the air out that you will see stuck in the luer lock.
      3. Alert Alarm for stopping insulin delivery for showers is insanely LOUD! Drives everyone in the house nuts. (yes there is a work around, but you start to notice that with a Tslim workarounds are what is becoming a norm compared to the ugly tank Medtronic pump, but that does not need any work arounds).

      The above are the known issues and I myself not a fan of the Tslim.
      Personally the Tslim basal rate is inconsistent compared to my minimed.
      With the use of the Dexcom CGM, I calculate that things should be steady 100-160 but for no reason the levels will rise over 180 to the 260 range and have to add a correction bolus.

      I suggest you get a loaner try before you buy as the return policy is 30 days from shipment not from use and like most I suspect those of us that wanted to return it kept it in the box waiting for pump training to arrive, which cut into the 30 day return policy making it null. I wish I had tried it first or read the multiple post about the pump first instead of being glossed over by the outer shell of its looks first. ;)


      Delete
  50. Do you wish that you would have stayed with the ping?

    ReplyDelete
  51. Any specialist professional of the team in your area will contact you immediately, arrive at your doorstep and get the setup and installation done with a perfect demo to leave you with your device in the best of running condition.


    For more information visit site :- Geek Squad appointment

    ReplyDelete

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