t:slim with a Twist.
Several months ago, I switched insulin pumps. (Here is the post about the switch, and please read this post about the disclaimer that initiated the switch. My full disclosure page is here.) My first impressions of the t:slim pump were drummed up over a year ago, after trialing one for a few weeks, but my real t:slim immersion came once I switched in full.
Funny thing is the timing of that switch. When I packaged up my Animas pump in favor of a Tandem one, I had also just found out I was pregnant. Which means that I was adjusting to life as a pregnant PWD and also to a new insulin pump.
tl;dr – There’s stuff about the t:slim pump I wouldn’t have appreciated so soon were it not for the baby-en-route.
Because dude, if I had switched a year ago, I would have been all, “Oh, it looks so cool and the touchscreen is badass, and the fact that it’s flat all the way across the front makes it easier to tuck into my clothes,” making the wearability the most important part of my switch. Yeah, wearability matters, but not as much as ease of use and OUTCOMES does these days.
(None of the following is medical advice; remember, I’m not a doctor and currently can’t even see my feet in full these days.)
Entering a bolus is stupid-easy. And this matters, since every blood sugar counts double these days (for me and for my growing son). It takes me a few seconds to unlock the pump and bang out a bolus, and only a few extra seconds to add crucial information like my current blood glucose and the carbs I’m consuming. Part of my over-arching problem of diabetes management is keeping apathy from creeping in; the all day, every day tasks of type 1 diabetes wear on me in a way that prevents me from taking advantage of everything technology has to offer. Oh, so an insulin pump can calculate my insulin on board (IOB) and the dose I need to bring down a blood sugar back into range, or what’s needed to cover X amount of carbs? HANDY INFO! The only thing I have to do is enter that information and it spits out a result? ALSO HANDY. But having to scroll forever to enter information is enough to keep me from entering that information.
It’s pathetic, how often I was taking 2u of insulin because it seemed “close enough” to cover what I needed, instead of spending the time calculating the proper dose. Being able to input this necessary information in a matter of seconds makes me actually DO IT. My endo is very pleased with this uptick in my management, and my A1C 100% reflects these efforts.
Changing my basal rates is stupid-easy. Being pregnant means that my insulin needs are changing rapidly. First trimester brought about insanely sticky hypoglycemic events, which equaled out to dialing down my basal rates significantly and making frequent use of the temp basal option. (Again, it’s about the button pushing – it takes me seconds to set a temporary basal rate. Ease of freaking use FTW.) Second trimester showed a steady climb in my weight and insulin resistance, with a marked rise in my basal rates and my insulin:carb ratios. And now, at the beginning of the third trimester, shit is changing all over the place, with some basal rates going down a little bit and my insulin:carb ratio almost double what it was pre-pregnancy. There’s a lot of math going on in my baby-building body, and being able to change my rates after reviewing my data on Diasend and t:connect makes for easier management.
Holding more insulin is stupid-easy. The t:slim holds a ton of insulin (300u) and as my pregnancy progresses, I may need that cartridge to be filled in full, instead of the half-way filled I’ve been doing for the last six months.
Seeing my status is stupid-easy. One button push shows me how much insulin is on board, how long it will be active, shows how much insulin is left in the reservoir, the percentage of charge left in my battery, and the time. Oh, and what day it is. (This matters, as the day and time are bits of information that are being eaten regularly by intense pregnancy brain.)
Not everything is stupid-easy. This isn’t a list of perfect moments with my insulin pump. There are pros and cons, and the time it takes to change out the cartridge and infusion set is still cumbersome. I also am not a fan of the luer-lock tubing bulge, as it takes on a “third nipple” appearance more often than I’d prefer. And I’ve seen more occlusion alarms with the t:slim than I did in the past. But I’ll these cons over the pros, especially when I review my lab work from Joslin and see how strong my numbers are.
Being more on-target through my pregnancy is not stupid-easy. Let’s not make my successes as a pregnant PWD the product of an insulin pump, shall we? I am working my ass off to make sure my body and my baby are healthy, with just over 11 weeks left to go before we release this particular Kraken. But having a piece of technology that alleviates the bolus math angst, makes it impossible to forget whether or not I’ve taken my basal insulin, and being able to bang out a correction dose in a matter of moments helps take the pressure off, at least a little bit.
… even if the beeps and boops might startle my developing fetus. (If that study has any truth to it, my poor kids are screwed.)