Видео

I’m getting a insulin pump because pills make me sick

Thank you for your explanation, Ariel, the takeaway is to treat with fewer quick acting carbs, got it. But would you also recommend dosing for the treatment carbs, too? I have a slight case of gastroparesis, so that 15g of quick-acting carbs takes 20-30 min to elevate my glucose. Was instructed by my Endo at one point in my T1D career (diagnosed at 10 mos, nearly 59 yrs ago) to treat 2x and dose for the second. With your explanation, I understand now that I shouldn't need to treat a 2nd time (that's when the caveperson brain strikes me), but should I still dose, accepting the bolus correction the pump recommends?

2 hours?? My wife’s takes 2 hours if it’s Christmas. Most of the time it between 4-8 hours. Sometimes 10 hours to update.

Amazing video! Recently, I've been dealing with a ton of bent cannulas, which I learned was due to loose skin from major weight loss. Thanks to your tips, I've learned several tricks to end this miserable saga of ruined insertion sets and constant phone calls for replacements. You're fantastic!

0:26 the title is failed sensors, yet this video though is simply how to add a new your sensor.

What do you think about the pump? Please do a comparison video!!

Since you are using the extended infusion set, then I will reference the quick set which has the exact same specs works for me and is working for the full 7 days without any problems. You can also reference the specs on the Medtronic website to verify that they are indeed identical which I have done. The problem is in step 6 for the insertion during the removal which I modified to 4-5 complete revolutions of the cap until it fully disconnects then releases and will just fall loose. The problem that I encountered was that any upward force applied on the blue cap resulted in lifting the platform upward on the needle. When inserted into the skin the plastic tubing would conform to the taper of the needle forming a donut shape which is seen after removal when viewed by a microscope. The tubing would compress the underlying tissue and would try to express the tubing upward causing premature release of the tape. You would see that the tubing was bent after removal being a sign of the problem. Using the modification in step 6, led to the tubing being straight after the removal confirming the correct installation of the quick set. I would say 99% of my problems disappeared after this revolution to me, but heavy sweating would still lead to early release of the tape. So, my trying to match up the week of sensor and life combined with the infusion set was no longer my priority, as they were still complicated with early failures of the G4 sensors.

One recommendation, when removing the base platform from the serter, I noticed that you were quickly lifting the serter. I will lift up slowly it to help ensure that the plastic tab covering the adhesive does not disconnect from the base. Then follow up by examining inside the serter to verify the plastic was removed as is the normal sequence of events. If it did not disconnect correctly, you can then use tweezers to reach into the opening and manually remove the plastic. I would also note when charging the G4 to watch the LED flashing as the repetition rate decreases as the AAA battery voltage drops which will increase your charging time for the device. As noted, if the G4 flashes after removal charger it will still have a full charge. I state this as we all want the device to charge as quickly as possible to return the pump to normal operation. One other thing to note, when you enter a manual BS reading to calibrate the sensor if the reading on the pump is off by say 15 then the calibration will be rejected by the pump for 15 minutes. You can override this lockout by quickly reentering the BS reading again to help prevent this problem. Yes, I have done this before as if you get a second lockout then pump will probably request a sensor replacement. Another thought, when applying the liquid adhesive is you have to be especially careful not to get it on the upper part of the exposed sensor. Since there are 7 individual sensor pads with 6 that are paired for replication and the most critical bottom most sensor at the end of the inserted tab. After examination, the early sensor failures have been linked to skin tissue covering the deepest sensor preventing the body fluids from reaching that area which is visible when examined under my microscope. Your body tries to encapsulate any foreign substance which is perfectly normal, so why will some fail early is the question that is not being answered.

Really informative video! Loved the analogy and makes sense

Well they suck it is what it is

There are 2 things I don’t like about tandem pumps # 1 battery using usb chord - medtronic is much better, convenient with AA battery #2 medtronic you fill insulin with syringe, tandem uses silly cartridge

My pump and cgm have been game changers but equal to those is these weekly wt loss injections - my A1c’s have dropped dramatially

This was great. I wasn’t told how Smart Guard worked when the sensor is changed and tonight is my first time changing the Guardian Four since I started. Thanks for the great explanation

One last point. The pump will only auto bolus to get you down 60% of the way to 110 accounting for IOB, but the BASAL increase, over a long enough period will put enough IOB to get you down ALL the way to 110, not just 60%. So if you are at 180, and running night shift, you may have 100% IOB from basal increases to get you to 110. Basal increases can only add 1x your hourly basal rate every 20 minutes, so they may take 2 hours to get a full correction on board but WILL eventually put enough on board to go 100% down to 110 except in activity mode.

Also, there is ZERO evidence that running a night time blood sugar in the 80s or 90s has any health or longevity benefits compared to 110-125. 110-125 would be bad for a non-T1D because it would indicate insulin resistance, but no studies have been able to demonstrate any benefit of running 90 versus 120 at night for T1D outcomes and no research has ever demonstrated benefits for T1Ds getting A1C under 6.5. Below 6.0 actually correlates to slightly worse outcomes. Except during pregnancy. You can push your night time blood sugar into the 80s by giving too much basal, and it will slide up and down between say 80-100 as it tries to counter-correct, but if your cgm goes down you can crash, and again ZERO cause and effect health differences running 110-120 versus any lower baseline, if not slightly better outcomes from 110-120.

A few points. 1) Harvard found that the best controlled T1Ds using a PUMP only had 30% of TDD in basal. People with higher % basal had high post meal spikes and tended to drift low several hours after eating. The range of good control was about 26%-33% basal. This is somewhat different from MDI where you have to have enough basal to get through the night, even if it's a little too high in the daytime. There may be exceptions. Very low carb dieters may have up to 70% basal, but with over 20% carbs it averages around 30%. 2) Control IQ in sleep mode wont do the 60% bolus, but it will raise basal by up to 300% and it will put enough on board at any one time to get you to 110. It also starts doing this when it thinks you will go over 120 and don't have enough IOB to cover it, while in standard mode, it won't start to do anything until you are going to hit 160, but will try to get your basal up enough to get you down to 110, and will give a 60% bolus if you are going to hit 180. 3) In activity mode, if raises basal only at most enough to target you to 140 (which may push you lower with activity). It only corrects to get you to a 60% correction with a bolus so it should never put enough on board to get you below 140 except that activity might raise sensitivity. In other words, if you ran activity mode but weren't exercising, and you were rising, it would raise basal only enough to cover to 140, and if it was going to get to 180 it would only bolus enough that when combined with the basal increase it would get you to 140, or 60% of the way down to 140 from wherever you are. Activity mode could be used at night if you tend to run low and want to play it safe since it will never target you below 140 (with a 60% bolus max to 110). 4) The pump assumes that the following amount of insulin comes off board each hour: 1) 25%; 2) 40%; 3) 25%) 4) 7%; 5) 3% 5) IF your correction factor is too low, you may get high enough automatic basal or bolus to make you low. For example. if your correction factor is set at 30 and it should be 45, and you drift up to 200 at night over a few hours, it will put enough basal on board to drop you 135 points, about 50% more than you really need, and enough to drop to 65. If you drift low at night after being somewhat high, your correction factor is probably too low. As a fairly good estimate, it has been found that good correction factors are around 30-35 divided by your hourly basal rate at that time. So if your basal is 1, typical correction factors are 30-35. If it is .5, you might be 60-70. People vary of course but that's based on how the liver works. 6) At any one time, you have about 2.2 hours of your basal rate in your system, so if your basal is 1, you have about 2.2 units in, and if it's .5 you have about 1.1 on board. If you trend low at night, it is usually your basal in the 2 hours before that point, and even more likely having your correction factor too low and getting an overcorrection after being somewhat higher for a while.

I tried it and so simple. No more knives cutting it apart 😂.

In my two attempts to extend a sensor, the removal, with a guitar pick, has been easy. However, the readings have been WAY off. Today, (Day 12, second day of restart), I got a LOW alert of 46, right after lunch. A finger stick showed me at 211. I had similar discrepancies on my first try with a restart.

Thank you. I learned something. Greetings from the Netherlands

Wonderful video. Thank you so much for the info. I have no idea what I am doing wrong. My Sensor expires, I turn my sensor off on my pump, charge the sensor until the doc stops blinking green, I take the sensor off and turn the sensor on on the pump at the same time, the green light blinks a bunch of times, I wait for it to stop and connect it, the light turns green again and the pump allows me to start new sensor, it warms up THEN 99.9% of the time it says sensor updating that ill take an hour or so then it says it again, then again and sometimes for the entire day or longer, then the sensor will fail >.< I am so frustrated. HELP please <3.

I’ve been using Medtronic for almost 4 years. I’m still using the pump, but switched to Dexcom 7 for my cgm. When I used the guardian 3 sensor and the 770g pump using smart guard, I didn’t have very good control. I was usually high. So I changed to manual mode. Do you feel like the 780g and guardian 4 smart guard is better now? I have to say I do like that the Dexcom 7 is so much easier to put in, and only 26 minutes warm up, and lasts 10 days with 12 hour grace period. I’m starting to shop around for other pump options now. Thank you for your insight on this, since you are now using Metronic’s.

LOVE MY TANDEM T-SLIM❤

i still waste so many of these they always come back out with the inserter. I've already wasted three.

Does Medtronic supply that overpatch as demonstrated? I recall when I used Medtronic the taping procedure was more complicated.

Thank you for this! Coming from using a Dexcom it was quite a learning curve switching to Medtronic.

I just discovered the Dexcom G6 will only be replaced 3 times within a year. I called to get 3 the other day and was told I'm not elligible for any replacement sensors. I was ordered by my doctor to remove them for an MRI and Dexcom just said that's not a bleeding or breakdown of the sensor. Obviously ever who made this decision doesn't have to deal with diabetic problems. There's something obviously they''re not willing to tell you. Odd.

Easily the best instruction video I have seen regarding the accusoft xc. I get a bent cannula one in four times and today had 3 in a row. I followed the suggestions, especially getting the v of fingers underneath. I think it worked.

I did this as shown. When I took the pen out of the plunger, it sprayed insulin everywhere and made a hissing sound. So, this technique didn't work for me.

Good advice. Even walking briskly, is extremely effective in lowering sugar levels. I had figured out that by walking around the block in my neighborhood briskly for seven minutes will every single time lower my numbers by 40.

Very good and very well explained. 😊

I've been using the Tandem T:slim for a year now and after watching this video I've learned more than what my trainer taught me which was pump therapy, but NOT how to insert the Auto 90. I had to watch you tube videos. This was better informative. thx Dr. Warren

Excellent tips. Thank you Ariel!

You will find that the four digit code has no purpose and you can use the same one for all sensors.😂😂😂😂

This actually does work. I have had high glucose levels and would just run down the street and back and just 10 min later my sugars would drop.

Instead of emailing the code to yourself, why not just take a pic or text to yourself? I send myself reminder texts all the time or just take a pic of something. Just an idea.

Very good, many thanks

Thank you for this. My mother will be getting a T:Slim X2 pump soon and I'm trying to select a good infusion set for her. Needs to be easy to use and comfortable. I wonder how difficult it would be for a caregiver to put on a patient (I have to put her dexcom sensors on for her because she doesn't have the hand/thumb strength to push the release button. I want something that doesn't have to be changed as often and that won't fall off. Hmm.. Ok, so when removing the applicator, you hold down the adhesive patch? Is there any reason why you didn't go with the Trusteel infusion set? Ketoacidosis is no joke. My mother had it back in November. Her finger stick meter wouldn't work (we since got a simpler one but now she has a CGM) and she mistook her high blood sugar for low blood sugar. It went up to 900 and she had to spend several days in ICU. Since then though she's had a few hypoglycemic events-- last one landed her in the hospital. She was unconscious but we got glucose tablets under her tongue. 3 of them got her blood sugar up to 47. Now she finally got the pump approved by insurance (which took months) and we're trying to figure out what to get.

I am Type 1 IDDM 40 years. I have a Tandem Pump with CGM. I have had Various Problems with infusion sets working on my body for the last year. I switch between Autosoft XC and Trusteel and Varisoft insusion sets throughout the year. I have spoken with Tandem about this issue multiple times over the phone. They have replaced boxes of infusion sets but I still have the issues. I am so happly when I can get one to work for 2 days. Going back to insulin injections is a last resort for me. Its been alot of work for me ontop of all of the Diabetic treatment issues for me. One day at a time.

Honestly, These sensors are only designed to be accurate for 10 days. If you think your saving money, Do yourself a favour, and check your readings against finger prick blood sugar meter readings. You will notice they are not as accurate after a re-boot. Kinda pointless if you are relying on a cgm , and it's not accurate. I've found readings to start to wonder after about 12 days. Just an FYI.

Ariel, having an MRI in a few days but I just put a new sensor in. Can I take transmitter out before and then put back in after?

I had a terrible time the first time I did control IQ it still kept taking me over 200 and the problem I'm having right now is that I have quick blood sugar changes depending on weather related issues and depending on stress related issues I've had it for 50 years and it's just so hypersensitive

Hi Ariel, that pump sounds amazing ! I have omnipod 5 but it does not have all the features to adjust the bolus according to protein and fat . Can you help me with this ?

I’m Dutch so I would like to verify if I understood your point. my bloodsugar is low and I’m going to eat and would need 6 doses of insuline for that amount of carbohydrates. With my Medtronic pump I would not give anything, eat and bolus somewhat less after the meal. Am I correct that i understand that you say that with my T-Slim with CIQ I give in the amount of carbs, he says: you need 6 doses, but I will deduct some because your bloodsugar is so low, that I should overrule him and not let him deduct ? Love your video’s and I have learned a lot as a T-slim user of two weeks already😁

Hi mam my morning blood sugar is how and feel week please advise

Adding my (hopeless) plea for universal connectors for these things. The Mio Advance applicator is SO much better than the old school pinch 'n' thwack inserter shown here, but the connector is not compatible with t-Slim, only Medtronic. Poop.

My teeny tip from my original trainer: spinning the canula cover tube keeps it from being sticky when you pull it off.

Thank you for this video, I wished that I saw this at the beginning of wearing TSlim. I wore a Medtronic starting in 1997. I decided to go off the pump while my kids were kids young because the rough housing dislodged a ton of infusion sites. I started again with the 670G and never had cannula problems. When I switched to Slim, I had too many bent cannulas to count that I've taken to not removing the previous cannula until I'm sure the new one is good.

🎉i have a libre2 sensor and im getting very itchy and jt hurts is there anything else i can be given as i dont want to go back to pricking? Please🎉

Just found your videos. Thank you so much for this one in particular. I've had diabetes since age 9. I am 54 now. Only been on a insulin pump for 14 years. Apparently, I've always thought it was me who was so upset, frustrated, and SO DONE ,with my diabetes. But I'm not! So thank you for making me feel I'm not alone!

Is there a way to reuse the transmitter? Been struggling dealing with United Hell-care.