dexcom with tslim hints

[HazelAnne]

Hi, saying hello and just joined for advice about above really. Had a pump for many years, a few niggles and teething problems. Similarly tried a decom once but thought libre quicker and easier but now want to try the loop thing. Thanks in advance for your views. Here's hoping we all get free dexcoms very soon!!

 

[Lily123]

Welcome to the forum

The Tslim is only compatible with the Dexcom G6.
Tagging a few people who use Tslim : @everydayupsanddowns @Sally71

 

[SB2015]

The sensors that link to pumps to enable looping are not readily available in the NHS : Guardian 6 for t-slim and Medtronic Guardian 4 for 780G. There is some funding available for these but hopefully this will grow. There is also talk of other pumps enabling looping soon.

A few years ago we never dreamt that Libre would be available in NHS, so who knows what will happen over the next few years. I am looping and self funding at present and would not want to go back from this now.

 

[Sally71]

My daughter only switched over to hybrid closed loop a couple of months ago but it’s been pretty good, way fewer Dexcom alarms now and she stays in range much more of the time. Next hba1c will be interesting! It’s not perfect of course, nothing is, but much better than anything we’ve done before. Haven’t really tested it with extremes such as illness yet, wouldn’t be surprised if it struggles a bit with that, but we’ll see. I’d certainly recommend it. We got lucky and are funded for the sensors as well as the pump at the moment, certainly just having a proper CGM with alarms was a complete game changer for my daughter and as a result she now spends almost no time in the medical room at school having hypos, whereas for a few years she spent far too much time in there. We used that as the reasoning to get the funding and it seems to have worked. So it’s worth asking about if you can present a good case, although not everyone gets lucky.

 

[martindt1606]

The integration between Dexcom 6 and TSlim is pretty good. Only have 2 issues:
1. Setting up the alerts and alarms in the dexcom app and on the pump - takes a little bit of time to get them synchronised 2. Whilst the Dexcom can communicate with the iphone in different rooms, the pump can lose contact if not on same side of body as the Dexcom. Again something you quickly get used to.
My latest Hba1c was a best ever 49 (i have a target of 58) and currently time in range is consistently over 85% so this closed loop thing isn't too bad.

 

[Thebearcametoo]

My kid also gets dexcom funded for looping now but I think it’s harder for adults to get the funding. We self funded for a couple of years before the recent swap to NHS and for us it was well worth it. We were on basal IQ until recently and now on control IQ which is definitely better but even on the basal one his HBA1C was low 40s.

 

[SB2015]

Next hba1c will be interesting! It’s not perfect of course, nothing is, but much better than anything we’ve done before

Just a thought for HbA1c after switching to looping. Mine went up into the low 50s from upper 40s but we concluded that this was because I was now rid of most hypos, which had been a daily occurrence before looping. With that the TIR was much improved (usually in 80/90s) which is a far more important to me as a measure of my management.

 

[everydayupsanddowns]

Welcome to the forum @HazelAnne

I’m another who finds the connection between pump and CGM to be a significant benefit.

On the rare occasions I have to ‘fly manual’ I immediately notice how used to the pump just quietly helping me out in the background I have become.

As others have said, each system will have its own foibles and peculiarities, and part of it for me has been a learning process of the ways I need to change my settings, behaviours and responses to what’s going on in order for the algorithm to have the best chance of success for my particular diabetes at this point in time. So it’s not a “set it and forget it” situation, but like others I’ve noticed a significant improvement in my time in range, which is better than its ever been with relatively low effort and brain space needed.

I posted this a few weeks back which gives an introduction to hybrid closed loops if you’d like a basic overview

Hybrid Closed Loop Insulin Pumps (Artificial Pancreas) - The Basics

What it's like to live with a Hybrid Closed Loop insulin pump (artificial pancreas). A brief introduction with video. NICE TA10845.

www.everydayupsanddowns.co.uk

 

[HazelAnne]

Many thanks, will read the other bit now. Did the trainer/Diabetic Nurse need to help much with on going input - thinking of basal rates I guess mostly at this stage?

 

[HazelAnne]

Thanks so much everyone. Really appreciate you replying quickly. I feel better prepared now and will know what to ask perhaps. I'm a bit worried about filling the cartridges as had trouble with first pump with air bubbles! Any further tips?!

 

[everydayupsanddowns]

Thanks so much everyone. Really appreciate you replying quickly. I feel better prepared now and will know what to ask perhaps. I'm a bit worried about filling the cartridges as had trouble with first pump with air bubbles! Any further tips?!

Filling the reservoirs on the tSlim is a bit of a knack to get used to!

In order to keep the reservoir small it’s a flexible bag inside the plastic outer. So you have to draw up insulin into a syringe, and then fill the reservoir from there. So there’s an opportunity for flicking and bubble busting at the midpoint.

You have to allow a little extra slack in your filling though. Perhaps an extra 20-30u or so.

 

[Thebearcametoo]

We were told to fill the syringe and expel bubbles then put the needle in the cartridge and pull back to get 3 bubbles or so and then expel those from the syringe. Then fill the cartridge. Then when filling the tubing keep the pump below the cannula to encourage any air bubbles to go first.