A Few Things

I don’t want to have a blog of complaining, as many would probably think I’m doing, but there are a few things that I both like and dislike about the t:slim throughout my time of using it. These things come out of both just daily use of the pump itself and out of comparing it against other pumps that are out on the market.

Things I like:

Built-in “safety” mechanism whereby you are not exposed to the entire cartridge of insulin, but rather just 0.3 units.

Touch-screen makes for easy input.

Personal “profiles” instead of separate categories for each thing such as basal rate, bolus calculator information, etc. It’s all in one place. Not millions of other places.

It’s tiny. Doesn’t take up a lot of room.

Upload doesn’t require anything special other than a standard micro-usb cord.

You don’t have to upload to see a data-snapshot of how your week or month is going as far as insulin delivery is concerned.

 

 

Things I don’t like and wish could be changed:

The cartridge system. I do not like the “bag” idea as it seems to create more problem than it’s worth. If there were a way to create a better container that would act similar to how an insulin pen cartridge works, that would be better. (Maybe if there were, instead of a bag, a vial with a stopper inside of the cartridge container that would adjust to the amount of insulin? I’m no scientist, but I do believe this system could be improved upon.) It could still be a syringe-type cartridge (similar to how the Omnipod system works, and would be filled the same way as well), but without a piston rod pushing the insulin. The mechanism pulling the insulin out of the top would be similar to how we insert a needle into a vial to remove insulin now, but it would just remove 0.3 units at the time. I think this would cut down on a lot of the problem with the pump not calculating the correct amount of insulin in the pump as well.

Speaking of how the pump determines the amount of insulin, I don’t like it. While I see the need for it to subtract out 20 units for a “cushion”, that’s half of a days worth of insulin for me. Why not, instead, let us fill it, type in how much we put in (say, 200), and let it subtract off 10 units (leaving 190), and then let it subtract out just what we prime, and not another 20 units (thus if I prime out only 15 units, the pump would then show a total of 175 usable insulin units, not 160).

The “pig tail” connector. This thing is cool yet irritating. Bubbles get caught in this thing frequently either due to air in the cartridge bag being periodically pumped out or the connectors not being tightened enough. Problem is, I check my connectors frequently and somehow, they become loose. If there were come way to create a connection directly to the pump cartridge similar to how the makers of the Snap insulin pump have done, that would eliminate not only the pigtail but also keep the original idea of eliminating the bump connection on other pumps such as the Medtronic and Animas brand pumps.

Some have complained about feeling as if the pump doesn’t have consistent basal delivery. While I haven’t experienced this myself, I feel that for those who have, it could be an issue with the way the cartridge and pigtail connector are made. And, if air gets into the pigtail connector, it can affect delivery. So, please, find a way to fix that!

Confirmation screens. OMG, the confirmation screens. I really don’t see where all of these are needed. What if, similar to how a Quick bolus is deivered, instead of having tons of confirmation screens (yeah, like the “Dude, you’re above your target BG!” one? Duh, I know this already), why not, after plugging everything in and receivign the suggested amount, we just press and hold the “T” button for one second and let that take the place of the dozen “Are you SURE you want to deliver this bolus??” screens that are supposedly safety measures because it’s a touch screen pump and the FDA doesn’t want us butt-dialing doses. Pressing the “T” button would be a definite “YES, deliver my bolus” confirmation over a tap on the screen.

 

Bottom line? I like the pump. It’s keeping me alive, and does it rather simply. I just wish there were things I could change about it.

(And, as an additional wish out there… I wish I could just plug my meter into my pump and download every reading into it, so that if I look into the history of the pump for the Summary, you would also have BG averages and maybe even graphs in there as well. Sort of like a portable t:connect.)

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Orientation

There are a number of things that I like/love about the t:slim. The orientation is not one of them. Just like most all pumps (except for the Omnipod PDM controller) are landscape oriented, meaning that it is longer than it is tall. While this is okay and probably will be super helpful once Dexcom integration is here, it just doesn’t help the pump sit comfortably in your hand for one-handed operation. Being a mom and everything else that I do, I usually have both hands busy with something, and if I can bolus single-handedly while being able to hold my crying kid, I consider that a huge win. I can usually bolus single-handed now, but I’m reading sideways. If the pump could be portrait oriented, it would be so much easier!! But, of course, this is just a wish. Doesn’t have to be a priority, but I would absolutely LOVE this!! (And once Dexcom is integrated, maybe let those screens be the only ones that are landscape?)

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Smurfing

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There’s a new Smurf… didn’t ya hear?

It’s Pumpa Smurf!

Nooo… not Papa Smurf….

PUMPa Smurf!

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Haha!

I love being able to mix and match the t:clip cases to fit whatever I want it to look like.

Where’s My Insulin?

This is probably going to be my number one complaint of the t:slim pump since my old number one complaint is being fixed soon. This is an issue that I doubt will ever change, though I wish it would.

Traditionally, when you fill an insulin pump reservoir, you fill it to about what you need, and the pump – when it loads the cartridge- will show relatively what you have placed into the pump. If you fill it to the 150u line, then typically, the pump will recognize about 160-140u in that cartridge (because they’re not exact and you are sort of eyeballing what you place into it). The t:slim is a bit different.

Upon loading the cartridge, the system removes any air that may be present in the cartrige. It then tells you to fill it. This is where it gets a bit wonky in the system. You yourself have, for instance, drawn up 200u of insulin for both priming (which it takes about 20u or more to do with the t:slim) and just use, but you also have to account for 20 to 30 units that becomes hidden in the pump. So. Let’s see. You’ve filled it with 200 usable units, but you’re only going to actually have access to about 150 of it after loading and priming.

This bothers the crap out of me. I already feel that it wastes a TON of insulin to prime, almost twice the amount, but to hide 20-30 units as well? I understand why they do it… as it was explained to me that since the system uses a bag, it’s similar to a ketchup bottle or a jelly packet… you can put 100% of whatever into it, but because of the nature of the container, you’ll never get 100% out. But we’re not talking about ketchup or jelly. We’re talking about expensive-as-heck insulin. We’re talking about enough insulin, that over the course of a month, is being thrown away, and enough to keep me a live for another 36 to 54 hours (day and a half to two days). For some, they have to pay out of pocket for this insulin, and to simply have to throw life sustaining liquid out into the trash is simply wrong (though some have found ways around this by reclaiming the old insulin and using it to pre-prime the tubing for the next site change).

I wish there were some way around this. Especially since the pump does not always only subtract out the given 20u, but sometimes more… I’ve had it make 50u disappear before. Honestly, I wish we could load the pump with the insulin and type in how much we filled it with. And, if we filled it with 200u, we could type that in, and the pump would subtract maybe only 10 + how much ever we primed (just say 20u) and then show a total in the cartridge as being 170u. I know this probably wouldn’t happen since it would introduce another layer of human error, but it would help us save a lot on this expensive life juice that we use every day. I mean, really…we’re so blessed to have it, and yet we’re having to throw so much away because of a safety measure…, when the amount being thrown away could save a life.IMG_5858