Wednesday, February 13, 2013

T-Slim Review

I’ve mentioned it a few times on this blog in the past, but in case you don’t know, back in October of last year I was diagnosed with type 1 diabetes.  Since then, I’ve gone through the gamut of emotions and all of it seemed very scary at first.  Luckily, with the help of my wife, family, and friends, I’ve come to accept my situation and learn to live with it the best way possible.

For the last few months, I’ve been treating my diabetes just like how each newly diagnosed person does, with multiple daily injections of insulin (sometimes 7 or more a day).  After a while this gets real old and becomes a chore and social stigma (or at least for me, it felt that way).  Fortunately for me, the last 20 years have seen great advances in diabetic medicine, and one such has been the creation of the insulin pump.  You can read more about the history of this invention here. 

I knew I wanted to go on an insulin pump since being diagnosed, but I didn’t know much about what was out there.  Like everything else I get involved in, I decided to do my research as to which one would be the “best” for my lifestyle.  Looking at all the options, I was slightly disappointed, as most of them looked like something invented in the 90’s.  And then I found Tandem and it’s Tslim….  Right off the bat, you will notice that this pump looks vastly different from its compatriots.  It’s sleek glass touchscreen and colorful digital display make the other pumps look like a Windows 95 version of insulin delivery devices.  Not wanting to buy something just for the look, I decided to do my own research.

I spoke with my medical group’s pharmacist, and she mentioned to me that I would be one of the first (I later found out I was the first) person in the area to purchase one of these pumps, so I was going into some new territory.  Reading some other reviews helped me calm my reservations, and I figured I would give the pump a shot since I had no prior experience with insulin pumps. 

A couple months went by, I received the pump in the mail (came in a nice shiny purple box), and was also trained by one of Tandem’s sales reps.  The rep flew out to my city and gave myself and the pharmacist a personal demonstration.  She also helped me learn how everything was supposed to work.  I had no problems and was immediately started on insulin.  I’ve been using the pump for over a month now, and here’s my review:

The touchscreen is the most obvious feature of this device, and I enjoy that it looks like a modern phone.  When I’m out in public and pull it out, it looks like I’m texting someone so It’s not as obvious as some other pumps.  I learned that when they originally designed the Tslim, they had swiping technology, but were threatened with a lawsuit by Apple and thus had to stick with a simple button touchscreen. 

Insulin is mainly calculated and delivered via a digital calculator that lets you input your current blood glucose level and also helps you had up the total amount of carbs you currently are consuming.  A calculation occurs which takes into consideration these two factors along with how much insulin you have onboard (insulin currently in your body).  It then suggests a dose and you can decide if you want that amount.  Delivery can then be instant of extended based on the time period you designate.  I find this feature helpful when eating high fatty foods. 

Another nice feature is the quick bolus button at the top of the insulin pump.  You can actually have the pump in your pocket, hold down the button, hear a beep letting you know you are accessing the quick bolus options, press the button again and again which increases the amount of grams of carbs you are consuming, and then hold down the button one more time to deliver.  It’s a nice feature, but I don’t really use it since I check my sugar levels before each meal. 

The pump is also nice due to its size.  It easily fits in your pocket and finds enough room with your phone or wallet.  The pump is also able to hold 300 units of insulin so you can definitely hold what you need.  The pump also has the ability to hold multiple profiles of insulin delivery and you can set many different basal rates, so the amount of customization is unlimited.  The only thing holding you back from treating your sugar levels is you.

Finally, Tandem is a nice company to deal with and they even sent me another case of insulin cartridges when it was hypothesized that the previous batch wasn’t working too well.  They are constantly updating their technology and have a bunch of exciting developments in the pipeline.

The first thing you’ll notice that’s a little annoying is the actual replacement of an insulin cartridge.  It’s a little different than other insulin pumps in which you have to replace the whole backing of the pump and inject insulin into the micro-delivery pouch.  If you don’t do this perfectly, you can mess things up and have to go through another cartridge.  I found that the first time I changed the cartridge, it was leaking out the injection site and I went through almost 300 units in a day. 

Secondly, the luer lock is outside of the pump and can be annoying for some.  The sales rep mentioned that the pump was designed this way to keep the size down, but it adds an additional 3 inches to your tubing length.  This could be annoying for some.

The touchscreen is only activated by you pushing a button sequence of 1, 2, 3, however the top “physical” button can be pushed in your pocket.  I found this happening to me frequently and it would start a quick bolus cycle.  I didn’t actually deliver insulin, but the pump would alarm and let me know that I did not finish my delivery and all insulin deliveries were stopped.  This became annoying, and I just turned off this feature.

Tandem recommends that you change the cartridge every 3 days, however someone like me who only uses 20-30 units of insulin per day total felt that this was a waste of insulin.  My alternatives would be to fill the cartridge partially or change my infusion set and not the cartridge.  I decided to go with the later option, and after day 4, the pump started giving me occlusion (or blockage) warnings, however some about 2 units of insulin were being delivered each time.  I know that the Tslim has some problems with Apidra insulin, but I was on Humalog, and didn’t think anything would cause occlusion warnings.  I actually did narrow it down to the pump itself by taking off the infusion set, and just letting the pump bolus.  It wouldn’t deliver more that 2-3 units.  Once I changed the cartridge, it wasn’t a problem anymore.  Even though I was using the pump outside the suggested tolerance levels, it was a little disappointing to know that this happened.

The biggest annoyance of all was the distributor Tandem uses to send me my supplies.  Better Living Now is the worst company I’ve ever dealt with and has caused me undue stress and anger.  It literally took my 1 month to receive my supplies, and they repeatedly get my information or order incorrect.  They have also lied to me multiple times on when a delivery was supposed to occur.  The only reason I am still with them is that they are dirt cheap.

Final Thoughts:
The Tslim is definitely a cool device that can even last for a while under water.   Tandem has software which should be approved by the FDA any day now called T-Connect, which allows you to download all the Tslim’s information to your computer.  You can even send this to your doctor or do whatever else you want with this data.  Some other pumps have the ability to wirelessly send delivery boluses through your blood glucose monitor, but the Tslim is not set up yet to do this.  The pump does have this ability when you use a Verio BGM, however the wireless feature is currently turned off on all pumps until they receive FDA approval for this too (I was told within the year). 

All told, Tandem is a newer company that has many things going for it.  That said, it is still working out the kinks, and things can still go wrong with your pump.  I would recommend this pump in a heartbeat, but you need to know what you are getting yourself into before you purchase one.  That said, I hope this humble review helped you out a little.  If you have further questions, please leave a comment.

Wonderful Moment of the Day: Grateful for medical technology that keeps me alive and healthy.  100 years ago, I would have died.

1 comment:

  1. Thank you for this honest review. Im about to go with the T Slim and truly appreciate a non gushing and straight-forward opinion. It truly is great that we are alive.