T Slim

[T1 mom]

Hi all. I haven't posted on here for a while. My 7 year old had his first diabetic seizure last week. Was awful to see that. It was due to a correction given to him in the night because he was so high, and so he came down lower than he should which caused his seizure. Yes, we slept through the alarms, was just so tired that night. We've been recommended the T slim with IQ technology which will work alongside his dexcom sensor. The great thing is that the T Slim will cut off insulin when it predicts a low, and will increase basal rates when it predicts a high 30 minutes in the future. We're hoping that this new pump will help us in the nights especially, as he seems to go high once we're all asleep, and has many hypos in the day due to being so active.

We're due to pick up the new pump in a few weeks, just wondered if anyone has any advise or specific questions that I should ask the nurse when we pick it up? Anyone had any issues with this pump also?

Many thanks in advance.

 

[Inka]

Sorry to hear about your son’s seizure @T1 mom They are absolutely horrible and it must have been extremely scary for you all. @everydayupsanddowns has the T Slim, I believe, along with Dexcom.

I think your son is already on a pump? When is he going high? Does he have a different correction factor for nighttime? I find that my correction factor is very different from late evening onwards. Usually 1 unit of insulin drops me 4mmol but at night 1 unit can drop me around 7mmol or even more. Once I’d confirmed that, it helped a lot. I hadn’t realised there could be a big change in sensitivity like that during the night. Perhaps you could try adjusting the correction factor as a stopgap measure while waiting for his new pump?

I hope your son is ok now and not too shaken.

 

[T1 mom]

Thank you. Yes, the hospital doctor has changed his insulin sensitivity for the nights. Currently he's on the Medtronic pump. I was told that I should have used his glycogen injection when it happened, but I just didn't know what to do. They have since shown me how to administer it. I just hope I'm never in that situation to need to use it.

 

[Thebearcametoo]

That sounds incredibly scary. My daughter uses a tslim and dexcom on basal IQ (we’re about to switch to control IQ which will also help with highs). The basal cut out helps a lot. It doesn’t cut out all hypos but catches a lot of them and helps to deal with the varying nature of kids and their activity levels. Any pump is only ever as good as the info you put in it so there will be a bit of fiddling setting it up and then some upkeep in managing it but it’s generally very good.

We use Sugarmate with the dexcom mainly for night times but it’s a useful back up in the day too. It will phone you if there’s a low (you set the parameters) which is much harder to sleep through than the alarms.

 

[everydayupsanddowns]

So sorry to hear about your frightening experience @T1 mom

Yes my family have always said that they would never know how to get through all the fiddly steps involved in administering glucagon under the stress of it being needed - they would just call for the paramedics!

There have been other possibilities tantalisingly close to being made available - such as a nasal powder which can simply be puffed up the nose (even if the PWD is unconscious).

Hope you get on well with the tSlim.

Your Medtronic (if a MM640G or later) would have offered a similar predictive low glucose suspend, but works with Medtronic’s own sensors, rather than Dexcom. Medtronic call their system Smartguard.

My experience with both Medtronic and Tandem is that their systems work amazingly well for me in reducing the amount of low level hypos I experience - but they can’t catch them all, particularly if BG is dropping rapidly, or if there is a lot of insulin on board.

It is also important with the tSlim to keep the basal profile, correction factors and meal ratios carefully adjusted.

One of the signs for me that my insulin needs have shifted has now become that Control IQ (or Smartguard) begins to struggle to work well.

Let us know how you get on 🙂

 

[T1 mom]

That sounds incredibly scary. My daughter uses a tslim and dexcom on basal IQ (we’re about to switch to control IQ which will also help with highs). The basal cut out helps a lot. It doesn’t cut out all hypos but catches a lot of them and helps to deal with the varying nature of kids and their activity levels. Any pump is only ever as good as the info you put in it so there will be a bit of fiddling setting it up and then some upkeep in managing it but it’s generally very good.

We use Sugarmate with the dexcom mainly for night times but it’s a useful back up in the day too. It will phone you if there’s a low (you set the parameters) which is much harder to sleep through than the alarms.

Thank you. Is sugar mate an app? I've tried searching for it on the Google play store.

 

[Thebearcametoo]

Ah maybe it’s just linked to Apple. https://sugarmate.io/ see if any of the options from the website work for you. On android phones dexcom should be able to bypass do not disturb but there’s no option for that on IOS so this is a workaround but we find it really useful as you can set texts or phone calls for different parameters.

FWIW we have been told to always call an ambulance if glucogen is needed even if we administer it. The call handler should be able to help talk you through it and the pack itself has clear instructions. We’ve never had to do it under stress conditions. Only used our out of date ine as a test run of drawing it up with out DSN talking us through it.