Are you still using the tslim x2? I've just been approved for a pump and was considering the tslim. (Omnipod isn't a viable option as I use too much insulin over 72hrs). How easy is it to retract the cannula on the infusion set? And how easy is it to fill the cartridge? Thanks.
My diabetic nurse is ordering my tslim soon. Going from pens for 9 years and this is making me real nervous, going from 2 insulins to just one. Not going too be using loop and will be dialing in. How have you started? Without cgm?. Or how would you find it without cgm?
welcome to the tubed pump world 😊 Long post, sorry, I hope it is not TOO long! I sleep with my pump next to me. I'm a side sleeper, and I coordinate the site of my Dexcom sensor (I use them on my upper arms) with the pump sites to make sure that both pump site and sensor site are on the side I *don't* sleep on. I don't move all that much during sleep, so this works fine for me. Sleeping on the sensor leads to these fake compression lows, and if the pump site is on the side I sleep in, there's a greater chance that the site will cause problems later on. As for site changes, I use the Combo, and I do change only the steel cannula itself every 2 days, not the entire thing. Tubing and reservoir I typically change every 5-7 days, when the insulin is used up. Neither the tubing nor the reservoir itself react with the insulin, so there's no problem. In the Tandem though the reservoir's material *does* react with the insulin, so you must change the reservoir (and presumably the tubing). Keep this in mind when people suggest that you only need to change the cannula. In your case I instead really would experiment with how much insulin you need in 48-72 hours and try to fill the reservoir only to that amount. Also, as said before, I use steel cannulas ("steelies"). Work super well. They don't kink, since, well, they are made of steel. They can hurt, but I maintain that in the positions where the steelies hurt, the plastic ones would probably eventually kink instead, which is worse IMO. (May not be true for angled plastic cannulas, I have no experience with these.) Steel cannulas are changed every 2 days, plastic (teflon) ones every 3 days around here. Don't set them on places that can deform a lot though, like the bottom bits of the belly (even in super lean olympic athletes these bits bend and deform a lot). I also strongly recommend getting a good pump clip, ideally one that you can rotate in 45 or 22.5 degree steps. I have one such clip for the Combo, and it is amazing how useful it is. The rotation allows me to adjust the pump as needed, for example having it point down if I am training legs and lying on my back etc. No idea what options there are for the t:slim though. If you find a good clip, get another one of the same type! If your clip breaks, you then immediatley have a spare, and it doesn't matter if the replacement clip takes a few days to arrive. Regarding basal, there's a german researcher called Michael Nauck who developed a circadian basal profile that works really well for me. It is based on the Renner rate that is popular in Germany. Talk to your endo about this. DOI link to his paper is: doi.org/10.1177/1932296819882752 also, be careful with insulin duration of action, which is more like 5 hours instead of 2-3 hours as commonly believed. Paper about this: dx.doi.org/10.1177%2F1932296813514319 Finally, regarding rotating sites, I use a diagram that is found in the app Diabetes:M, where you can record the site. It's really nice. It shows previously used sites as red dots. Older sites look more washed out, and eventually they are completely faded away. That way, you see what sites you used last, and how recently you used them. Greatly helps to rotate optimally.
Wow that's a lot of information - thanks! I'm slowly getting used to having it next to me in bed, jut very weird to start with. I'm working on finding the right amount of insulin for my 3 days with each reservoir so hopefully will have it sorted soon! On the current cannulas I'm using, the set up is attached to the tubing so you can't actually just change the cannula even if you wanted to. I think you can change the tubing without changing the reservoir though. For the 30 degree cannulas it's different, and I imagine it's also different for the steel ones. I'll try them all and see what works best for me! Thanks for the site rotation link too, it's looks really useful!!
I use a running belt to tuck pump for exercise and cami with a built-in bra for night time. I find I do not wake up to alarms unless it's at my chest. Good luck! You will find what works for you.
Glad to see you've made the leap Becky! I started on the same canulas as you have there but after reading up everyone recommended the steel ones and in my experience as well they're far superior. Also, it's prob too late now but if you have some left over insulin in the reservoir you can just pull it out w/ the syringe and put into the new one. 55 units is a lot to waste. As for sleeping i don't think there's a real good option. If you roll around a good bit it's just gonna be tough to not wind up on top of it- downside of a tubed system I guess.
I will definitely be looking in to all the cannula options. Thanks for the tip on getting the insulin out the reservoir, I’ll definitely be doing that next time!
Glad things are going better! She's Diabetic has a video on how she places her pump for exercise..might be helpful as I can imagine it is difficult. Even with omnipod I need to consider placement in relation to exercise:/ always lots to consider being Diabetic
Was it hard to switch pumps via NHS when funding was still going for your previous pump? I wonder if you could qualify for dexcom based on hypo unawareness and sports/exercise. Some athletes can qualify for it? It’s a lot easier to get for kids
I was only allowed to switch on the NHS because my hospital had so many complaints about the Solo they decided to discontinue it and swap everyone over. Otherwise I think it would have been really hard to switch. I’m generally really aware of hypos so wouldn’t qualify for Dexcom on that basis but will look into the sports angle! I’m not technically an athlete or anything but worth a try!
I sleep with my pump in a Spi Belt. There are times where I end up rolling onto it but it’s the best option I’ve had to prevent getting tangled or forgetting to pick it up. It’s also useful for the event that I am wearing an outfit without a convenient pocket. I also use biker shorts with pockets for under dresses and such. Also you can draw the insulin out of the cartridge so you don’t waste it, as long as it’s not near the 28 day mark of your vial. You’ll get the hang of it! Sometimes there are just sites that hurt more than others for whatever reason, but a lot of the time it will get less sensitive after you give yourself a few units. However there are those bad ones where it just hurts a lot and I always change it. Wishing you luck in this transition!
Thanks for the recommendation! I still haven’t got round to ordering myself a garter or anything so will look into that. I’m getting used to sleeping with it next to me for now which is good. Yeah I think dresses and loose summer clothes are going to be tricky but those are good suggestions thanks! Yes I did that today actually when I had a bad site - much better than wasting all the insulin. Thank you for the tips!
My pump just lies right next to me when sleep. I move around a bit when I sleep but I just let my pump just chill whenever it wants to go. You could try putting it in a sports bra, I do that sometimes. I used the soft cannulas for a long while but I find the steel ones to be far superior. I don’t have any occlusions, bent cannulas or leaky sites anymore which is great. It’s definitely annoying try to find places for the pump but after a while it gets easier. I don’t even think about it anymore. Question: Do you have Dexcom in the UK? Having Dexcom + T-Slim closed loop system is a great option
Yeah I’m slowly getting used to having it next to me in bed, I think I’m starting to subconsciously carry it around when I turn over which is helpful! 😅 I will definitely be trying out all the different cannulas, I’ve heard great things about the steel ones.
Oh sorry forgot to respond to the question! There is Dexcom in the UK but it’s rare to get it prescribed on the NHS and I can’t afford to pay for it right now. Hoping I qualify for it on prescription on day though!
You are not using the Basal IQ or Control IQ with the T:slim? Why not? The automatic basal adjustment ability of the T:slim or Medtronic pump is the only reason to get these pumps. The auto feature will help tremendously with your numerous daily hypoglycemic events. And hopefully prevent the rebound highs too. They are not perfect in auto mode. But much better than manually programmed basal pumps.
Getting mine in a couple weeks and I’m so excited!!
Ahh that’s so exciting for you! I hope you love it!
@@diabeticbeckyfitness4879 thanks so much!!
Great video thanks for sharing 👍
Thanks!
I love your charisma and energy so very much :) Absolutely spectacular ;)
Ah thank you! Really appreciate it!
Are you still using the tslim x2? I've just been approved for a pump and was considering the tslim. (Omnipod isn't a viable option as I use too much insulin over 72hrs).
How easy is it to retract the cannula on the infusion set? And how easy is it to fill the cartridge? Thanks.
I have the tslim and I love it
I’m really liking it so far!
My diabetic nurse is ordering my tslim soon. Going from pens for 9 years and this is making me real nervous, going from 2 insulins to just one. Not going too be using loop and will be dialing in. How have you started? Without cgm?. Or how would you find it without cgm?
welcome to the tubed pump world 😊 Long post, sorry, I hope it is not TOO long!
I sleep with my pump next to me. I'm a side sleeper, and I coordinate the site of my Dexcom sensor (I use them on my upper arms) with the pump sites to make sure that both pump site and sensor site are on the side I *don't* sleep on. I don't move all that much during sleep, so this works fine for me. Sleeping on the sensor leads to these fake compression lows, and if the pump site is on the side I sleep in, there's a greater chance that the site will cause problems later on.
As for site changes, I use the Combo, and I do change only the steel cannula itself every 2 days, not the entire thing. Tubing and reservoir I typically change every 5-7 days, when the insulin is used up. Neither the tubing nor the reservoir itself react with the insulin, so there's no problem. In the Tandem though the reservoir's material *does* react with the insulin, so you must change the reservoir (and presumably the tubing). Keep this in mind when people suggest that you only need to change the cannula. In your case I instead really would experiment with how much insulin you need in 48-72 hours and try to fill the reservoir only to that amount.
Also, as said before, I use steel cannulas ("steelies"). Work super well. They don't kink, since, well, they are made of steel. They can hurt, but I maintain that in the positions where the steelies hurt, the plastic ones would probably eventually kink instead, which is worse IMO. (May not be true for angled plastic cannulas, I have no experience with these.) Steel cannulas are changed every 2 days, plastic (teflon) ones every 3 days around here. Don't set them on places that can deform a lot though, like the bottom bits of the belly (even in super lean olympic athletes these bits bend and deform a lot).
I also strongly recommend getting a good pump clip, ideally one that you can rotate in 45 or 22.5 degree steps. I have one such clip for the Combo, and it is amazing how useful it is. The rotation allows me to adjust the pump as needed, for example having it point down if I am training legs and lying on my back etc. No idea what options there are for the t:slim though. If you find a good clip, get another one of the same type! If your clip breaks, you then immediatley have a spare, and it doesn't matter if the replacement clip takes a few days to arrive.
Regarding basal, there's a german researcher called Michael Nauck who developed a circadian basal profile that works really well for me. It is based on the Renner rate that is popular in Germany. Talk to your endo about this. DOI link to his paper is: doi.org/10.1177/1932296819882752 also, be careful with insulin duration of action, which is more like 5 hours instead of 2-3 hours as commonly believed. Paper about this: dx.doi.org/10.1177%2F1932296813514319
Finally, regarding rotating sites, I use a diagram that is found in the app Diabetes:M, where you can record the site. It's really nice. It shows previously used sites as red dots. Older sites look more washed out, and eventually they are completely faded away. That way, you see what sites you used last, and how recently you used them. Greatly helps to rotate optimally.
Wow that's a lot of information - thanks!
I'm slowly getting used to having it next to me in bed, jut very weird to start with.
I'm working on finding the right amount of insulin for my 3 days with each reservoir so hopefully will have it sorted soon! On the current cannulas I'm using, the set up is attached to the tubing so you can't actually just change the cannula even if you wanted to. I think you can change the tubing without changing the reservoir though. For the 30 degree cannulas it's different, and I imagine it's also different for the steel ones. I'll try them all and see what works best for me!
Thanks for the site rotation link too, it's looks really useful!!
I use a running belt to tuck pump for exercise and cami with a built-in bra for night time. I find I do not wake up to alarms unless it's at my chest. Good luck! You will find what works for you.
I might try the running belt for exercise, thanks for the suggestion!
Glad to see you've made the leap Becky! I started on the same canulas as you have there but after reading up everyone recommended the steel ones and in my experience as well they're far superior. Also, it's prob too late now but if you have some left over insulin in the reservoir you can just pull it out w/ the syringe and put into the new one. 55 units is a lot to waste. As for sleeping i don't think there's a real good option. If you roll around a good bit it's just gonna be tough to not wind up on top of it- downside of a tubed system I guess.
I will definitely be looking in to all the cannula options. Thanks for the tip on getting the insulin out the reservoir, I’ll definitely be doing that next time!
Glad things are going better! She's Diabetic has a video on how she places her pump for exercise..might be helpful as I can imagine it is difficult. Even with omnipod I need to consider placement in relation to exercise:/ always lots to consider being Diabetic
Thanks for the tip - I’ll have a look for that video on Andrea’s channel!
Was it hard to switch pumps via NHS when funding was still going for your previous pump?
I wonder if you could qualify for dexcom based on hypo unawareness and sports/exercise. Some athletes can qualify for it? It’s a lot easier to get for kids
I was only allowed to switch on the NHS because my hospital had so many complaints about the Solo they decided to discontinue it and swap everyone over. Otherwise I think it would have been really hard to switch. I’m generally really aware of hypos so wouldn’t qualify for Dexcom on that basis but will look into the sports angle! I’m not technically an athlete or anything but worth a try!
I sleep with my pump in a Spi Belt. There are times where I end up rolling onto it but it’s the best option I’ve had to prevent getting tangled or forgetting to pick it up. It’s also useful for the event that I am wearing an outfit without a convenient pocket. I also use biker shorts with pockets for under dresses and such.
Also you can draw the insulin out of the cartridge so you don’t waste it, as long as it’s not near the 28 day mark of your vial.
You’ll get the hang of it! Sometimes there are just sites that hurt more than others for whatever reason, but a lot of the time it will get less sensitive after you give yourself a few units. However there are those bad ones where it just hurts a lot and I always change it.
Wishing you luck in this transition!
Thanks for the recommendation! I still haven’t got round to ordering myself a garter or anything so will look into that. I’m getting used to sleeping with it next to me for now which is good. Yeah I think dresses and loose summer clothes are going to be tricky but those are good suggestions thanks!
Yes I did that today actually when I had a bad site - much better than wasting all the insulin.
Thank you for the tips!
How do you like your new pump
I really really like it! I'll be sharing a full review soon once I've got to grips with it completely but loving it so far :)
My pump just lies right next to me when sleep. I move around a bit when I sleep but I just let my pump just chill whenever it wants to go.
You could try putting it in a sports bra, I do that sometimes.
I used the soft cannulas for a long while but I find the steel ones to be far superior. I don’t have any occlusions, bent cannulas or leaky sites anymore which is great.
It’s definitely annoying try to find places for the pump but after a while it gets easier. I don’t even think about it anymore.
Question: Do you have Dexcom in the UK? Having Dexcom + T-Slim closed loop system is a great option
Yeah I’m slowly getting used to having it next to me in bed, I think I’m starting to subconsciously carry it around when I turn over which is helpful! 😅
I will definitely be trying out all the different cannulas, I’ve heard great things about the steel ones.
Oh sorry forgot to respond to the question! There is Dexcom in the UK but it’s rare to get it prescribed on the NHS and I can’t afford to pay for it right now. Hoping I qualify for it on prescription on day though!
You are not using the Basal IQ or Control IQ with the T:slim? Why not? The automatic basal adjustment ability of the T:slim or Medtronic pump is the only reason to get these pumps. The auto feature will help tremendously with your numerous daily hypoglycemic events. And hopefully prevent the rebound highs too. They are not perfect in auto mode. But much better than manually programmed basal pumps.
I can't afford a Dexcom so it's not an option for me unfortunately. There are still numerous reasons why the pump is beneficial without it though