Tandem pros and cons .

[Matchless]

Next month i will be offered tandem or medtronic pump i did have a omnipod for about 8 months that did not work out in the end then on my old animas but now on a loaned medtronic 640 that i have had before which is a good pump .i am interested in the tandem but i am looking for the pros and cons of people who are actually using the tandem pump with and without IQ as i am not over optimistic about getting dexcom reimbursed as my average control is not bad 6.5 and 6.8 when on the omnipod.i have looked on line but they ether love it or hate the tandem and donot generally donot give in depth reasons i only know everydayuppsanddowns has a tandem any personal reviews would be most welcome .

 

[SB2015]

Sorry I don’t have any info on T Slim, as I am using the Medtronic 780G with their sensors in a closed loop. A game changer for me, once I had got used to the switch from my old sturdy Combo. If that is an alternative offered to you, happy to fill in any details you might want.

As you say @everydayupsanddowns is our resident expert on Tslim with IQ.

I hope you find something that suits you.

 

[Lily123]

I can’t be of much help. I know @Sally71 daughter uses the T slim

 

[Sally71]

My daughter has the Tandem T Slim. It’s a good pump, we used it without sensors for about a month and it worked fine like that, nice colour screen, works pretty much the same as any other pump I think. Basal increments go to even smaller degrees than her old pump. Easy enough to use, you can download an emulator which turns your phone into a pretend pump so that you can practise with the exact software. We are now using it with Basal IQ which suspends basal when you drop too low, that’s a very useful feature, and are hopefully going to actually get our act together and upgrade it to Control IQ over the Easter holidays, which adjusts basal and gives correction boluses when high as well as dealing with lows. That will be interesting, we’ve been meaning to do it for months though and still haven’t got round to it!

Not many cons that I can think of, the refill procedure is a bit fiddly (although we’ve only got the Accu Chek Combo to compare it with) and it asks you sooooo many times whether you’re sure you want to do that it does get a bit tedious - yes I know that’s a safety feature, but annoying all the same, ours has now been named Marvin after the Paranoid Android in Hitchhiker’s Guide to the Galaxy (because the pump is a bit paranoid!)

The sales staff are always friendly when you reorder your consumables too, and they usually come within 3 days although they will tell you longer just in case. We had one delivery which came in less than 24 hours once, that’s not usual though!

 

[Matchless]

My daughter has the Tandem T Slim. It’s a good pump, we used it without sensors for about a month and it worked fine like that, nice colour screen, works pretty much the same as any other pump I think. Basal increments go to even smaller degrees than her old pump. Easy enough to use, you can download an emulator which turns your phone into a pretend pump so that you can practise with the exact software. We are now using it with Basal IQ which suspends basal when you drop too low, that’s a very useful feature, and are hopefully going to actually get our act together and upgrade it to Control IQ over the Easter holidays, which adjusts basal and gives correction boluses when high as well as dealing with lows. That will be interesting, we’ve been meaning to do it for months though and still haven’t got round to it!

Not many cons that I can think of, the refill procedure is a bit fiddly (although we’ve only got the Accu Chek Combo to compare it with) and it asks you sooooo many times whether you’re sure you want to do that it does get a bit tedious - yes I know that’s a safety feature, but annoying all the same, ours has now been named Marvin after the Paranoid Android in Hitchhiker’s Guide to the Galaxy (because the pump is a bit paranoid!)

The sales staff are always friendly when you reorder your consumables too, and they usually come within 3 days although they will tell you longer just in case. We had one delivery which came in less than 24 hours once, that’s not usual though!

Thanks for your reply i have watched videos on utube and downloaded the simulater but itt dos not quite have all the settings on the simulater but i do like having all the information such as IOB and battery and basal ect on the home screen but setting basal patterns look a bit heavy going they want to know the ins and out of a DA ha ha.yhanks again for your reply.

 

[everydayupsanddowns]

The tSlim and Dex combo are probably the best I have used personally - but of course that doesn’t mean that there aren’t niggles and frustrations, and strategies and approaches you have to learn and adopt in order to give the pump the information it needs to work for me.

Pros

• My time in range has never been better. In the last 30 days I have been more than 80% of time between 4 and 9 every single day. It’s not unusual for me to get a day or two a month of 100% 4-9 with the tSlim. 90 day average is 89% of time in range.
• Overnight the ‘sleep mode’ works brilliantly for me. It is very unusual for me not to wake happily pottering along in the low 6s, and I very rarely get CGM alarms at night.
• I don’t know what the effect has been on my A1c, because due to covid (and that pesky blood vial shortage a while back) I haven’t actually had an A1c since I started on the tSlim! Dex Clarity suggests it might be 6.2% (44mmol/mol).
• The pump is generally logically and well laid out and easy to use (both with sensors and without). All the things I want to access are easily available, and there are fewer confirmations to confirm the confirmation you have confirmed than the MM640G made me wade through.
• There’s a decent range of infusion sets (though slightly fewer options than I had with Medtronic). One tiny, but surprisingly noticeable improvement for me is that the cap I put on my infusion set for showering can go on either way up, whereas Medtronic would only fit one way. A tiny daily frustration when wearing a site around my back.
• The colour touch screen is responsive and fairly visible in most lights. The pump itself is small, sleek, and hangs horizontally on my belt.
• I was aware that the reservoir filling was supposed to be quite fiddly, but actually was nothing like as bad as the moans I had heard.
• Battery life is good, and recharging is unobtrusive in daily life. You can either opt for a short daily top-up of a few minutes (eg when showering), or do what I do and charge for a longer period about once a week.
• Dexcom is excellent. Tracks my BG very well and I am confident to bolus from the results. It is a bit laggy, and roughly 8-10 minutes behind when BGs are moving, but it performs well, is factory calibrated but can be calibrated when needed - so you get the option to pull an errant sensor into line, with none of the alarm nagging of routine required calibration.

Cons

• While my TIR is improved, the combination of Dex lag, plus the way Control IQ is configured (and can’t be adjusted) means that unfortunately I am less protected against hypos than I was on the MM640G. As a workaround I have a Dex low BG alert at 5.2 so that I can check and take a little glucose on board if I’m dropping (because when it sounds it means I was 5.2 10 minutes ago). This isn’t helped by my diabetes currently having a fairly ‘square wave’ approach to glucose variation - no change, no change, no change, no change, sudden rapid change… and repeat!
• Control IQ means you can’t set TBRs (which automatically cancel after a set time). So you have to remember to switch off ‘exercise mode’ or whatever after some time has passed. As a workaround I set a profile with the minimum basal delivery per hour so can effectively set a 0% tbr by swapping profiles (something I used for dog walks on my last pump). Several times i have frustratingly forgotten to switch back afterwards until I’ve had an alert for drifting upwards.
• Control IQ has a hopelessly optimistic impression of how quickly a slight basal increase or extra mini bolus will bring down above-range BGs. It alerts to say that levels are ‘still high’ long before I would expect anything to have happened.
• You can‘t really switch off and hand over the reins. Control IQ generally offers ‘too little too late’ for many BG rises and falls. It’s very good at gently steering the gentle drifts, but it’s not going to catch everything. You still need to be on your toes and taking preventative measures (eg prebolusing)

Hope some of these observations are useful

 

[Matchless]

The tSlim and Dex combo are probably the best I have used personally - but of course that doesn’t mean that there aren’t niggles and frustrations, and strategies and approaches you have to learn and adopt in order to give the pump the information it needs to work for me.

Pros

• My time in range has never been better. In the last 30 days I have been more than 80% of time between 4 and 9 every single day. It’s not unusual for me to get a day or two a month of 100% 4-9 with the tSlim. 90 day average is 89% of time in range.
• Overnight the ‘sleep mode’ works brilliantly for me. It is very unusual for me not to wake happily pottering along in the low 6s, and I very rarely get CGM alarms at night.
• I don’t know what the effect has been on my A1c, because due to covid (and that pesky blood vial shortage a while back) I haven’t actually had an A1c since I started on the tSlim! Dex Clarity suggests it might be 6.2% (44mmol/mol).
• The pump is generally logically and well laid out and easy to use (both with sensors and without). All the things I want to access are easily available, and there are fewer confirmations to confirm the confirmation you have confirmed than the MM640G made me wade through.
• There’s a decent range of infusion sets (though slightly fewer options than I had with Medtronic). One tiny, but surprisingly noticeable improvement for me is that the cap I put on my infusion set for showering can go on either way up, whereas Medtronic would only fit one way. A tiny daily frustration when wearing a site around my back.
• The colour touch screen is responsive and fairly visible in most lights. The pump itself is small, sleek, and hangs horizontally on my belt.
• I was aware that the reservoir filling was supposed to be quite fiddly, but actually was nothing like as bad as the moans I had heard.
• Battery life is good, and recharging is unobtrusive in daily life. You can either opt for a short daily top-up of a few minutes (eg when showering), or do what I do and charge for a longer period about once a week.
• Dexcom is excellent. Tracks my BG very well and I am confident to bolus from the results. It is a bit laggy, and roughly 8-10 minutes behind when BGs are moving, but it performs well, is factory calibrated but can be calibrated when needed - so you get the option to pull an errant sensor into line, with none of the alarm nagging of routine required calibration.

Cons

• While my TIR is improved, the combination of Dex lag, plus the way Control IQ is configured (and can’t be adjusted) means that unfortunately I am less protected against hypos than I was on the MM640G. As a workaround I have a Dex low BG alert at 5.2 so that I can check and take a little glucose on board if I’m dropping (because when it sounds it means I was 5.2 10 minutes ago). This isn’t helped by my diabetes currently having a fairly ‘square wave’ approach to glucose variation - no change, no change, no change, no change, sudden rapid change… and repeat!
• Control IQ means you can’t set TBRs (which automatically cancel after a set time). So you have to remember to switch off ‘exercise mode’ or whatever after some time has passed. As a workaround I set a profile with the minimum basal delivery per hour so can effectively set a 0% tbr by swapping profiles (something I used for dog walks on my last pump). Several times i have frustratingly forgotten to switch back afterwards until I’ve had an alert for drifting upwards.
• Control IQ has a hopelessly optimistic impression of how quickly a slight basal increase or extra mini bolus will bring down above-range BGs. It alerts to say that levels are ‘still high’ long before I would expect anything to have happened.
• You can‘t really switch off and hand over the reins. Control IQ generally offers ‘too little too late’ for many BG rises and falls. It’s very good at gently steering the gentle drifts, but it’s not going to catch everything. You still need to be on your toes and taking preventative measures (eg prebolusing)

Hope some of these observations are useful

thanks for your reply its not easy to find the true pros and cons in general most reviews praise the tandem or hate parts of it i do follow the tandem group on facebook and youtube i shall see what they offer me in may and thanks again.