Tandem t:slim X2 Insulin Pump - 2 months later

Type 1 & LADA
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So I’ve been on the Tandem for just shy of 2 months now. My sugars are definitely improved…got my first A1C under 8 in over a year (7.5%) and that’s with my continued disordered eating issues (I restrict/“binge” (I think) on and off and jump from diet to diet).

Sleeping is a lot better, not as many lows.

So a lot of checks in the pro column. For the con column, exercise has gone down the drain for me. I am an EXTREMLY active person, but find it exhausting to try to exercise with this pump. I have to wear a belt to keep it on, and despite trying many, I hate them all. I hate having to unplug for the shower or swimming, so my pool days have dwindled to nothing, and sometimes I don’t bother working out because of the shower annoyance. Psychologically, I hate the tubing. I drop the thing constantly and that sucks.

Another reason I got this pump was my Omnipod would only work consistently on my stomach, which I was way overusing. So far, I have been able to use my stomach and upper buttocks/lower back so that’s one more site. I used my mid buttocks and it didn’t feel great and the tubing constantly got pulled when I had to use the washroom. I currently have it on my leg, and it’s painful to sleep on that side and I’ve been running high the entire time, except for when I suddenly go low (if I try to exercise).

These downs might seem like I should just have an attitude adjustment, and trust me, I’ve tried. I will also continue to try. I’m also nursing a knee injury, but that still doesn’t stop me from biking, rock climbing, kayaking and going to the gym, so it’s more the pump than anything.

I want to be so happy about this pump, and I’m going to keep trying to get there, I mean I used all my savings to get it, even with my Uncle helping out, but yeah, the reality is none of these systems are perfect, none make me a non-diabetic, I’ll always be somewhat moody over T1D, but I’ll also always keep trying.

Just sharing my thoughts and feelings. I’ll see how I feel at the 6 month mark. Hopefully better.

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Maybe an upgrade/trade-in offer will be availabke for Mobi.

*(https://investor.tandemdiabetes.com/news-releases/news-release-details/tandem-diabetes-care-announces-fda-clearance-tslim-x2-insulin-0)

From article:
UPDATE: Tandem [announced]
on Feb. 16, 2022 that it had received FDA clearance for its mobile bolusing feature for both iOS and Android, and it’s expected to launch in summer 2022.]*

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I’ve been tempted by the idea of changing from the Omnipod for the same reason; I’m running out of places to put it. I’m back to stomach too. I don’t think I’d last through the tube thing, I’m not going to be happy wearing a belt.

It’s incredibly, annoyingly, frustrating. Some things get better, some times get worse. The more we try the more we fail. I remember all the years I didn’t give a damn and that was easier.

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Thanks for the update. On the exercise thing, have you thought about just leaving the pump at home when you go for an exercise? I know everyone is different, but for me it’s not a big deal to not have my pump with me when I’m working out.

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Looks like the pod. I wonder if it’s waterproof. I’ll take a read later today, thanks for sharing.

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I think that might be too long without it. I usually go to the gym for 1.5HRS and it’s about 10 mins drive either way, then shower too without pump. Might work, but I’d be pretty nervous.

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We should have a short acronym for the acknowledgment that every diabetic is different - maybe EDID?

Given EDID, I have gone for a day without my pump when I’m biking. My endo suggests I wear it all the time, so I’ve been trying to, but in terms of control it doesn’t make much of a difference (for me).

I guess you are willing to take some advice, given your response to @eric 's question. So my suggestion: try it and see what happens.

No doubt, the pump is a pain when exercising, and I get away without having it for long periods of time when I’m exercising.

Nervous is good - it means you will pay attention to the results. Maybe this will be helpful, maybe not. Are the risks of the experiment acceptable to you?

e

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I’ve mostly seen YDMV for “your diabetes may vary.”

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Oh yeah. I always carry pens in my bag anyway for back up, and I am very open to experimenting

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I’ve always wanted to scuba dive! Do you do it anymore?

Actually, for me, depending on what exercise I do, sometimes it can raise at the gym (very annoying). I wouldn’t feel comfortable going anywhere without both insulin and glucose. I’ve had a few scenarios happen that have ingrained this in my head: a couple lockdown situations where I work, where I’d have to hunker down for hours, got stuck in an elevator once for 2 hours, etc. Weird things like that where I thought to myself I will never not have my D supplies with me in case this happens again! I even take my purse with me going to take the garbage down in my building!! I just never know.

My Tandem at first gave me peace of mind at the gym because it accounts for highs and lows while I’m not paying attention, but I still went low at the gym even in exercise mode. I’m still figuring it all out and it’s frustrating and taking a huge mental toll on me for me for some reason. Still holding out hope that in the end it’ll all be worth it.

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The following is a long thread to read through but Daisy Mae, an avid swimmer, worked through a lot of pump issues.

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Some people arrange it to have 0 remaining IOB before exercise, and also suspend the pump to prevent insulin delivery. (Rather than starting with really high BG and lots of carbs in the belly.) But it depends on the intensity and duration of the exercise. At a moderate effort my BG slowly falls, but when working hard near my limit my BG rises from the stress. So we all have to run the experiments for ourselves to see how our own bodies handle our style of exercise. Folks here will offer suggestions, but if your CGM is working and you have insulin and glucose that you can get to if needed, there’s no danger to trying different things to see what works for you. You’ll get it figured out with practice. Kind of like learning to drive a car, it’s clumsy and stressful in the beginning, and pretty automatic after a while.

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I think my problem is I don’t have enough consistency to see any solid patterns yet. Sometimes I go high, sometimes low, exact same workout. Times vary, also what I’ve eaten, when. Last time I ran into an ex at the gym and I think the stress of that sent me skyrocketing lol, but a lot of factors. Hopefully I’ll figure it all out one day…

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I’ll have to look up those numbers because I’m Canadian, eh. Ketone strips…I have them, but have only used them in DKA.

Scuba :diving_mask: sounds amazing. I’ll definitely look into it.

Thanks!

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I’m surprised to hear that you consider below 120 mg/dL / 6.7 mmol to be too low. My endo best likes me to be in 80-120 mg/dL except for excursions.

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As @psfud123 observes. Do it now.

The DAN rules require a physician to sign off (not an NP, not a PA), they also require a BG before the dive of at least 150mg/dL (i.e. 8mmol/L, 8mM), and a max of 250 (14); I hate that part, but I follow the rules (I don’t think I would actually dive at 14 and I have aborted a couple of dives because I was too low).

With conventional pumps - they didn’t consider the Omnipod - they say to disconnect the pump before the dive, reconnect after. I wouldn’t do that either; when diving I swap to using a long-acting insulin because I’ve heard too many stories of non-Ds being accidentally left in the water for hours. I don’t have any endogenous insulin production so things start to go seriously wrong 2-3 hours after a pump failure. Long acting insulins avoid that problem and then it’s hypothermia that kills you if you get left behind.

FWIW if you do it the Omnipod is a blessing; during training, if it is done in a swimming pool, you can just wear it; pools don’t go beyond 25ft (8m) and then only if they have a dive (as in high-diving) pool. Repeated immersion at any depth will kill a 'pod; the pod is vented (you will learn the importance of that if you learn to scuba dive). Anyway, if you do it you will learn all of this (scuba is an OCD).

Watch out for places with real diving; I know that Dressel in Cozumel run their “open water” qualification dives at a location which approaches 60ft (20m) in depth. I’ve dived with a pod on (actually delivering basal until I learnt better) at that depth and the thing starts beeping after about 30 minutes. There are tricks to make a pod last longer at depth - it is vented, so it works at any depth - but they are just not worth it. This is why I swapped to Lantus on diving vacations.

Like @psfud I’m probably not diving anymore, but not because my buddy is inattentive; she is my wife (I wouldn’t dive with anyone else) and she is very attentive. Find a good buddy, marry them.

Yes, yes, yes. The first time I did any scuba I was recently diagnosed, a T1D of only a couple of years age, and my curious parents decided to go to Kenya. Now the diving was, well, for a 14 year old, weird, interesting and slightly scary, but the Kenyan national parks we were staying in (primarily the Tsavo) were utterly, unutterably, amazing. No longer. See it before it is gone, it will never come back.

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A lot of info! I’ll read this in more depth later, but firstly what do these stand for: DAN, OCD, NP and PA??

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DAN is:

The rules are actually part of a separate, world-wide, medical group which you can probably find from this page:

“OCD” means Obsessive Compulsive Disorder, which to my mind summarizes the attitude of most of the diving establishment. Divers aren’t, with some notable exceptions, suffering from an OCD.

NP: Nurse Practioner, PA: Physicians Assistant. US terms; neither are allowed to sign off on the RSTC:

form that you will get if in north america.

So my “PCP” (GP, family doctor, guy who I go to when purple and green spots break out all over my body) is an NP. My endo might be a PA; I’ve been unable to get an endo for, well, since last July when my previous endo left Dodge [Gunsmoke reference]. I now have an appointment in August, with a PA; no SCUBA [Self Contained Underwater Breathing Apparatus; blame Cousteau] there.

Have you tried paragliding? It’s amazing.

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Great little clip from Amazon. Very low profile and tight grip. Still slips off very occasionally.

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Lots of confusion about normal…here is the latest article I found quickly on WebMD, which is consistent with other studies I’ve read recently.

What Are Normal Blood Sugar Levels?

https://www.webmd.com/diabetes/how-sugar-affects-diabetes

They’re less than 100 mg/dL after not eating (fasting) for at least 8 hours. And they’re less than 140 mg/dL 2 hours after eating.

During the day, levels tend to be at their lowest just before meals. For most people without diabetes, blood sugar levels before meals hover around 70 to 80 mg/dL. For some people, 60 is normal; for others, 90.

What’s a low sugar level? It varies widely, too. Many people’s glucose won’t ever fall below 60, even with prolonged fasting. When you diet or fast, the liver keeps your levels normal by turning fat and muscle into sugar. A few people’s levels may fall somewhat lower.

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