I wish I could afford your services but I had to figure things out for myself after the system basically failed me in the beginning. It will be 25 years soon since I was diagnosed and I haven't spent a night in the hospital yet so I guess "I must be doing something right" as they say. I read your book along with many others from the library over the years. If I was in charge EVERY diabetic would immediately be enrolled in a comprehensive program of education and support.
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
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.
Hi Robert! So happy it was helpful for you. I had about 6 months of terrible sets when I first started with Tandem (since I have switched to Medtronic), so I knew I needed to help with a video. It's all about holding down the skin as you pull from the middle. I hope you are well with your diabetes care!
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 had a few bent cannulas the first month of using the Tslim. I switched to the stainless steel infusion set and it rarely is problematic. Thanks for sharing this info, there's always something to learn.
Thank you so much! I love Tandem especially for not needing to continually buy batteries. I also like how they send a replacement when called about a bent canula. A little prayer is usually said when changing my infusion set, now I can change it with more confidence. Thanks again.
Thank you, so much, for this video! I have had my pump for about a month and have had my blood sugars soar a few times. My specialist went over the process with me a couple times, but I was still having issues. Now I know it was the removal of the applicator. This has been extremely helpful. I really appreciate your help!
Great to see you back with another useful tip. Even though I’ve been pumping for 19 years it never occurred to me that I was lifting my skin during the process of removing the inserter. Makes perfect sense. Thank you.
I needed this! Had Medtronic forever and it came intuitively to hold down the insertion site before pulling the blue needle part out. The whole set change procedure was so easy. The sensor, not so much. An acquaintance (practicing PA) was diagnosed wit T1D as an adult and started on t:slim which got me seriously interested in looking at it as I already switched sensors to Dexcom. I made the change to Tandem. Love my new pump. It’s so light! The set change procedure initially was tedious and I flubbed a couple, one with the tubing as you described under the tape, one bent cannula. Now it’s routine. Thanks for sharing this.
Thank you so much for posting this video! I'm 6 days in with my first ever pump, and OMG, have had a hellish night with my first swap over by myself and have managed to have 2 bent cannulas, and I'm not sure what happened to the other 2 but they weren't working. This time I'm trying your V tip to keep my skin tight when I pull it off and hoping for the best. Not a great rate of success so far, but 100% when my educator was watching. Always the way. Have ordered the TruSteel for my next lot. 🙏🤞
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.
I'm so sorry for your negative experience. Even as an educator, diabetes 30 years (not quite 40 like yourself), I am still learning everyday from myself and my patients. Have you tried the trusteels? And different areas on the body?
So helpful! I started my t-slim x2 in late July of 2023 and have had 6 bent cannulas. I’ll see if the “V” method works or if I need to switch infusion types. Thank you so much! ❤️
Hello Ariel, Thank you for your video and the information shared. I will try your V "stretch the skin "approach for the next patch change, due to some recent bent cannulas. Regards Geoffrey It had to be better than
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.
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 had bent cannula but didn’t know right before bed one time. New w pump. Tandem. Next day kept going up up up. Called dr and tandem. No one told me to change set. Ended up in dka and er then icu with a 5000$ bill! I will not use a pump again. Too many unknowns. 😢.
I have no luck with the Autosoft 90's. Using Verisoft 30's and have bettr luck with them. And yes, infusion sets are the weakest link in the entire system .
I think possibility of using U-200 insulin would definitely help too, especially long term, regarding tissue scarring and stuff, for larger dose users. It's quite some volume pumped to a same spot with U-100. Maybe it could be also absorbed quicker. And maybe having specialized insulin versions for pumps. Maybe they could be improved to cause less inflammation, I don't know. It has to be a difference if you use one spot for several days instead of different spot for every injection.
I often have bad infusion sets with my medtronic 780. I've tried all kinds of cannula, swapped from plastic to metal, changed from abdomen to thighs or buttocks and still get days when the BG keeps going high. If I see it going higher than expected after a correction bolus I then change infusion set but often that doesn't work first time and end up changing sets 1 or 2 more times before I finally get one that works. 3 days later the whole nightmare begins again. The cannulas are not bent. Any ideas please?
How long do you wait for your blood sugar to go down before changing the cannula? Have you checked to see if you need a higher does of insulin? Do you check the tubing for kinks of tears? Are you double checking the cartridge and insulin? Just some thoughts.🙂 Also, have you accounted for stress regarding your blood sugars?
I've never understood the advantages of pumps. I know that sounds ignorant, but they've always seemed more limiting to me. A good CGM and MDI works great.
My hubby is type1. Also prefers mdi. Our kid wanted to do the pump journey. For her it's been great because I can fine tune multiple time slots for the day. So gym time, less basal. Night time, less basal. Breakfast, bigger correction+carb ratio etc. We tried all the tricks MDI with her and could not get her a1c below 8. First a1c after pump was 7.2!! We are still on the down trend on a1c and more time in range, not so many rollercoasters which we really struggled with her for her age and eating habits! Definitely a learning curve, but can be worth it if you really struggle mdi for a long time.
@@user-om1mi3fb9d That's completely understandable. I'm aging like a fine wine, but back in the 90s, I was either surfing or playing football every day, sometimes both. Having to be concerned about ripping out an infusion set wasn't worth it for me, nor was feeling like I couldn't do just as well as anyone else. So, the only option for me was to get right with MDI. I'm 40 years into having type 1 and my A1C is in the 5s. I'm in no way trying to knock what works for someone else. If a person can benefit from a pump, then they should no doubt use one. For me and my family, it meant higher costs with more limitations.
I'm glad MDI is working for you. But I am a pump user and will never go back to MDI. I say it gives me freedom in contrast to limiting as you stated: 1) Very quickly give myself a bolus for meals in less than 10 seconds. 2) Quickly make additional corrections, if needed during the day or night without even turning on a light (I also use a CGM). 3) Doesn't cause any anxiety among other people at restaurants, meetings, etc. with taking out syringes/insulin pens. 4) Because it is so fast and easy with a pump, one doesn't put off making a correction which results in better control. 5) Change reservoir/infusion set every 3-4 days and free from sticking oneself several times a day. 6) Much better a1C for me.
@@dwightl5863 I'm glad people have the option to use pumps and I'm aware that many find them beneficial in multiple ways. I've kept my A1C in the 5s for 3 years with time in target range over 90%. When I was younger, I was playing football and surfing, so the chance of losing infusion sets made the option of using a pump less appealing. At this point, I couldn't really hope to improve my numbers much by switching to a pump, so I don't see much of a reason for me personally. To each their own, though.
@dwightl5863 yes. I agree the pump gives so much more freedom! My kiddo loves we can just dose on the go. We do aim to prebolus which is so easy cause I just go, put it in and it's done.
Okay the order of assembly is problematic. Pulling the canula sleeve off before the paper removal and cocking the insertion seems so WRONG. Murphy says you WILL launch the set into your palm by doing it that way.😂😂😂 And as far as pulling the skeeve off... just spin it BEFORE pulling, this will make it easier. For me, I pull the paper off 1st, then cock the loader mechanism and LASTLY pull off the sleeve. How are you going to reset the site on its loading base with the needle exposed and paper removed?? That's a gotcha question.😂😂😂😂
Well it's about time you made a new video. I read your book, it was in my library. I've also read Mastering Diabetes by the 2 vegan activists and I've read Dr Bernstein's Diabetes Solution who lives on ANIMAL protein with veggies and doesn't eat grains or fruit. If you are very knowledgeable about the subject perhaps you might consider making a video that summarizes the for and against those completely opposite ways of eating.
You just taught me more than my pump trainer ever did. Thank you so much for these videos
I wish I could afford your services but I had to figure things out for myself after the system basically failed me in the beginning. It will be 25 years soon since I was diagnosed and I haven't spent a night in the hospital yet so I guess "I must be doing something right" as they say. I read your book along with many others from the library over the years. If I was in charge EVERY diabetic would immediately be enrolled in a comprehensive program of education and support.
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
Hi @brucebrotman , I'm so happy this video was helpful for you. I wish you the best with your diabetes care.
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.
Hi Robert! So happy it was helpful for you. I had about 6 months of terrible sets when I first started with Tandem (since I have switched to Medtronic), so I knew I needed to help with a video. It's all about holding down the skin as you pull from the middle. I hope you are well with your diabetes care!
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.
The part about doing the change before bed and actually before dinner is brilliant.
I had a few bent cannulas the first month of using the Tslim. I switched to the stainless steel infusion set and it rarely is problematic. Thanks for sharing this info, there's always something to learn.
Thank you so much! I love Tandem especially for not needing to continually buy batteries. I also like how they send a replacement when called about a bent canula. A little prayer is usually said when changing my infusion set, now I can change it with more confidence. Thanks again.
Excellent tips. Thank you Ariel!
Glad it was helpful!
Thank you, so much, for this video! I have had my pump for about a month and have had my blood sugars soar a few times. My specialist went over the process with me a couple times, but I was still having issues. Now I know it was the removal of the applicator. This has been extremely helpful. I really appreciate your help!
Great to see you back with another useful tip. Even though I’ve been pumping for 19 years it never occurred to me that I was lifting my skin during the process of removing the inserter. Makes perfect sense. Thank you.
I needed this!
Had Medtronic forever and it came intuitively to hold down the insertion site before pulling the blue needle part out. The whole set change procedure was so easy. The sensor, not so much.
An acquaintance (practicing PA) was diagnosed wit T1D as an adult and started on t:slim which got me seriously interested in looking at it as I already switched sensors to Dexcom.
I made the change to Tandem. Love my new pump. It’s so light! The set change procedure initially was tedious and I flubbed a couple, one with the tubing as you described under the tape, one bent cannula. Now it’s routine. Thanks for sharing this.
Thank you so much for doing this video. New to a pump. Type 1 for 20 years.
Thank you so much for posting this video! I'm 6 days in with my first ever pump, and OMG, have had a hellish night with my first swap over by myself and have managed to have 2 bent cannulas, and I'm not sure what happened to the other 2 but they weren't working. This time I'm trying your V tip to keep my skin tight when I pull it off and hoping for the best. Not a great rate of success so far, but 100% when my educator was watching. Always the way. Have ordered the TruSteel for my next lot. 🙏🤞
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.
I'm so sorry for your negative experience. Even as an educator, diabetes 30 years (not quite 40 like yourself), I am still learning everyday from myself and my patients. Have you tried the trusteels? And different areas on the body?
My teeny tip from my original trainer: spinning the canula cover tube keeps it from being sticky when you pull it off.
So helpful! I started my t-slim x2 in late July of 2023 and have had 6 bent cannulas. I’ll see if the “V” method works or if I need to switch infusion types. Thank you so much! ❤️
100 reactions, yes!!!! Thanks for the video info.
Thank you so much, Aerial, I will definitely try this method on my next site change with my T slim.😊
Hello Ariel,
Thank you for your video and the information shared.
I will try your V "stretch the skin "approach for the next patch change, due to some recent bent cannulas.
Regards
Geoffrey
It had to be better than
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.
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.
Thank you for sharing! We just changed to a airsoft 30. Seems to work for my son! 🎉
I dig your videos, thanks for doing this for us :)
i still waste so many of these they always come back out with the inserter. I've already wasted three.
I had bent cannula but didn’t know right before bed one time. New w pump. Tandem. Next day kept going up up up. Called dr and tandem. No one told me to change set. Ended up in dka and er then icu with a 5000$ bill! I will not use a pump again. Too many unknowns. 😢.
If you have an issue and then go on to bolus with a pen, how do you calibrate your pump in terms of Insulin On Board?
Thanks
I have no luck with the Autosoft 90's. Using Verisoft 30's and have bettr luck with them. And yes, infusion sets are the weakest link in the entire system .
I think possibility of using U-200 insulin would definitely help too, especially long term, regarding tissue scarring and stuff, for larger dose users. It's quite some volume pumped to a same spot with U-100. Maybe it could be also absorbed quicker. And maybe having specialized insulin versions for pumps. Maybe they could be improved to cause less inflammation, I don't know. It has to be a difference if you use one spot for several days instead of different spot for every injection.
I’ve dealt with this off & on for the past few months. But yesterday was the worst.
Will they your “V” method Monday. 👍
I often have bad infusion sets with my medtronic 780. I've tried all kinds of cannula, swapped from plastic to metal, changed from abdomen to thighs or buttocks and still get days when the BG keeps going high. If I see it going higher than expected after a correction bolus I then change infusion set but often that doesn't work first time and end up changing sets 1 or 2 more times before I finally get one that works. 3 days later the whole nightmare begins again. The cannulas are not bent. Any ideas please?
How long do you wait for your blood sugar to go down before changing the cannula?
Have you checked to see if you need a higher does of insulin? Do you check the tubing for kinks of tears? Are you double checking the cartridge and insulin?
Just some thoughts.🙂
Also, have you accounted for stress regarding your blood sugars?
I've never understood the advantages of pumps. I know that sounds ignorant, but they've always seemed more limiting to me. A good CGM and MDI works great.
My hubby is type1. Also prefers mdi. Our kid wanted to do the pump journey. For her it's been great because I can fine tune multiple time slots for the day. So gym time, less basal. Night time, less basal. Breakfast, bigger correction+carb ratio etc. We tried all the tricks MDI with her and could not get her a1c below 8. First a1c after pump was 7.2!! We are still on the down trend on a1c and more time in range, not so many rollercoasters which we really struggled with her for her age and eating habits! Definitely a learning curve, but can be worth it if you really struggle mdi for a long time.
@@user-om1mi3fb9d That's completely understandable. I'm aging like a fine wine, but back in the 90s, I was either surfing or playing football every day, sometimes both. Having to be concerned about ripping out an infusion set wasn't worth it for me, nor was feeling like I couldn't do just as well as anyone else. So, the only option for me was to get right with MDI. I'm 40 years into having type 1 and my A1C is in the 5s.
I'm in no way trying to knock what works for someone else. If a person can benefit from a pump, then they should no doubt use one. For me and my family, it meant higher costs with more limitations.
I'm glad MDI is working for you. But I am a pump user and will never go back to MDI. I say it gives me freedom in contrast to limiting as you stated: 1) Very quickly give myself a bolus for meals in less than 10 seconds. 2) Quickly make additional corrections, if needed during the day or night without even turning on a light (I also use a CGM). 3) Doesn't cause any anxiety among other people at restaurants, meetings, etc. with taking out syringes/insulin pens. 4) Because it is so fast and easy with a pump, one doesn't put off making a correction which results in better control. 5) Change reservoir/infusion set every 3-4 days and free from sticking oneself several times a day. 6) Much better a1C for me.
@@dwightl5863 I'm glad people have the option to use pumps and I'm aware that many find them beneficial in multiple ways. I've kept my A1C in the 5s for 3 years with time in target range over 90%. When I was younger, I was playing football and surfing, so the chance of losing infusion sets made the option of using a pump less appealing. At this point, I couldn't really hope to improve my numbers much by switching to a pump, so I don't see much of a reason for me personally. To each their own, though.
@dwightl5863 yes. I agree the pump gives so much more freedom! My kiddo loves we can just dose on the go. We do aim to prebolus which is so easy cause I just go, put it in and it's done.
Okay the order of assembly is problematic. Pulling the canula sleeve off before the paper removal and cocking the insertion seems so WRONG. Murphy says you WILL launch the set into your palm by doing it that way.😂😂😂 And as far as pulling the skeeve off... just spin it BEFORE pulling, this will make it easier. For me, I pull the paper off 1st, then cock the loader mechanism and LASTLY pull off the sleeve. How are you going to reset the site on its loading base with the needle exposed and paper removed?? That's a gotcha question.😂😂😂😂
Well it's about time you made a new video. I read your book, it was in my library. I've also read Mastering Diabetes by the 2 vegan activists and I've read Dr Bernstein's Diabetes Solution who lives on ANIMAL protein with veggies and doesn't eat grains or fruit. If you are very knowledgeable about the subject perhaps you might consider making a video that summarizes the for and against those completely opposite ways of eating.