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Posts from the ‘Robot Life’ Category

Some t:slim X2 Q&A.

[Disclosure:  I have a relationship with Tandem Diabetes Care that is outlined here.  Bias noted?  Good.  Read on, then.]

I am notorious for holding out on purchasing a new cell phone because I’m convinced that, the moment I hand over my money for Newest Phone it will immediately become obsolete at the announcement of NEWER PHONE.

Which is why I’m so excited about Tandem’s announcement regarding the t:slim X2 insulin pump because the pump software can be updated remotely.  Which means that when new software comes out, I can gain access to it from my house instead of having to wait and negotiate with my insurance company, etc. I wanted to share details on the t:slim X2 and create a sort of blog post clearing house for questions that I have (and that folks in the DOC have asked about), so with the help of the Tandem team and public-facing information (press releases, FAQs on their website, etc), I’ve cobbled together some Q&A hopefully A’s some of your Q’s.

Does the X2 currently work with the Dexcom G4 system?

The X2 currently has the same features as the current t:slim Pump, so it doesn’t work with the Dexcom G4 system. However, the demand will hopefully be high for the t:slim X2 insulin pump when Tandem rolls out the first major software update for G5 CGM integration, so they have an upgrade program in place for t:slim and t:slim G4 customers. (See more below for info on the upgrade program.)

When can users expect the X2 to sync up with the Dexcom G5 system?

The first feature rollout currently planned for the t:slim X2 Pump is expected to be integration with the Dexcom G5® Mobile CGM system, pending FDA approval. FDA submission for this feature is planned for late 2016, and Tandem anticipates availability in mid-2017.

Has the pump body changed at all with the X2?

For all practical purposes, no. The X2 is the same size and shape as the t:slim pump. It has a durable aluminum housing and will be compatible with all accessories designed for the t:slim Pump. (For those who have invested in ten thousand Myabetic cases for their t:slim, YAY!)

Is there a time frame in place for the PLGS ( predictive low glucose suspend) update?

As Tandem continues to build on the t:slim X2 platform after Dexcom G5 CGM integration is offered, the next feature they’re planning to launch on the X2 is a predictive low glucose suspend algorithm. This will be their first-generation artificial pancreas product. The IDE for a feasibility study has been approved by the FDA and the study is scheduled to be completed in August. Tandem expects to file another IDE for a pivotal study in early Q4 and, based on the typical review timing, anticipate that the study will take place in Q1 2017.

The goal to launch PLGS by the end of 2017 remains unchanged. Tandem anticipates a six-month review process for this first-generation pump algorithm because it will come on the heels of an FDA review of the t:slim X2 with G5 CGM integration. The only differing feature will be the algorithm. The X2 plus PLGS, with all the features and benefits of t:slim, will be competitive with other AP pump offerings as it predicts hypoglycemia, which poses the greatest risk for people with diabetes.

The second-generation AP pump algorithm will also be based on the t:slim X2 platform and will include the treat-to-target AP technology that Tandem recently licensed from TypeZero, as well as Dexcom CGM technology. To date, TypeZero’s technology has been used in more than 28 clinical studies with more than 475 people, with data referenced in a number of journal articles. They anticipate that this agreement will allow Tandem to remain on schedule for a pivotal trial in 2017, followed by commercial launch in 2018.

Users will be able to update their pump software remotely with the X2 – what does that process be like for PWD?

Here’s a little testimonial:

For pumpers already on the t:slim, what are their upgrade options? 

Online here: www.tandemdiabetes.com/upgrade

t:slim Pump customers who received their pump on or after July 1, 2016: Any customer who received a t:slim Pump on or after July 1, 2016 qualifies for a new t:slim X2 Pump at no cost. The no-cost upgrade is set to expire at the end of 2016. If folks choose to upgrade after December 31, 2016, they will still have the option for a fee of $399. Interested customers should visit www.tandemdiabetes.com/upgrade and complete the “Get Started” form or contact Tandem directly at (877) 801-6901.

t:slim Pump customers who received their pump before July 1, 2016: Any customer who received a t:slim Pump before July 1, 2016 qualifies for a new t:slim X2 Pump for either $399 or $799 depending on their date of purchase. Interested customers should visit www.tandemdiabetes.com/upgrade and complete the “Get Started” form or contact Tandem directly at (877) 801-6901.

t:slim G4 Pump customers: t:slim G4 Pump customers do not qualify for a free upgrade, but do have upgrade options available to them ranging between $399 and $799. Interested customers should visit www.tandemdiabetes.com/upgrade and complete the “Get Started” form or contact Tandem directly at (877) 801-6901.

t:flex Pump customers: t:flex Pump customers do not qualify for an upgrade to a t:slim X2 Pump, since it is prescribed specifically for its larger insulin capacity. Any change from a t:flex Pump to one with only a 300-unit insulin capacity will required a change in prescription and likely proof of medical necessity for their insurance company.

Note: These t:flex Pump customers could also opt for the 30-day return policy if they bought within the appropriate window and choose a pump with an upgrade path, if their healthcare provider feels this is a better long-term solution for them.

Once Tandem has the Dexcom integration and AP features, will it still allow you to use the Share/Follow apps on your phone?

From what I last heard, Tandem is working on a mobile app for use with all Bluetooth-enabled Tandem pumps, with the goal of providing their customers the option to see integrated pump and CGM information on their pump, their smartphone, or both. Rumor has it that Tandem is also in discussions with Dexcom to determine the best way to integrate pump information from the Tandem App with CGM information from their next-generation CGM display app.

Is there any information on the little asterisk and note in regards to the remote update of software for a fee? Will there be a fee involved to update?

Dexcom G5 CGM integration will be provided to all t:slim X2 Pump users at no charge. It seems that Tandem anticipates that some feature rollouts will be at no cost for in-warranty customers and that they might charge for others. The determination regarding cost will be made individually for each software update.

How can new pumpers/pumpers looking to switch get more information?

Here is the information page on the Tandem website.

New Pumpers, feel free to contact Tandem at (877) 801-6901, Monday-Friday 6am-5pm Pacific Time, or visit the Tandem website at:www.tandemdiabetes.com/getstarted

Pumpers looking to switch, feel free to contact Tandem at (877) 801-6901, Monday-Friday 6am-5pm Pacific Time, or visit their website and fill out the Get Started form.

That Clip, Though.

I’ve been using the t:slim pump for the better part of a year now, and over the last few months (here’s a handy disclosure that you should read for context on my relationship with Tandem), I’ve appreciated the new set of options that the t:slim has brought into my diabetes life.

… man, that sounds a little formal.  I’m too pregnant for formality at the moment.  (My feet have officially given up on being feet and refuse any covering other than socks or flip flops, and my son is moving visibly as I type, making sitting close to my desk a challenge. Eff formality.)  The reasons for the t:slim being a badass addition to my diabetes management RIGHT THIS SECOND are that I can take a bolus in a matter of seconds without scrolling through fifty different screens, I can edit my basal or insulin:carb needs with a few beeps, and the 300 unit reservoir is going to come in handy these last few weeks of pregnancy.

One challenge I’ve historically had with the t:slim pump, however, is the clip that is shipped out with it.  For me, the clip was a little bulkier than I preferred and also not as secure as I needed.  I wanted streamlined and secure, and as my pregnant body expands and clothing options like “pockets” and “waistbands” have been shoved into the distance.  I need my pump clip to be able to hang on by a thread.

This one works great, though:

I love this clip. #tslim #diabetes #insulinpump

A photo posted by Kerri Sparling (@sixuntilme) on

A friend suggested this clip to me and gave me one of theirs, but since trying it out, I’ve keep a spare or two on hand because it seriously solves all of my pump clip troubles.  The tape is very secure and I’ve had the same pump clip stay successfully stuck for the last six months.  I have no relationship with the company who makes the clip, and this is not an affiliate link or anything like that, but if you want to try out a pump clip for your t:slim (or any other pump) that is subtle, streamlined, and strong, this Nite Ize Hip Clip is worth a shot.

Hey! An informative post! Who saw that coming? Not me. Bring on the cat gifs.

cat filing his nails

“Do You Like It?”

“Excuse me … your, um, arm?  What’s that on your arm?”

Ninety-five percent of the time, I don’t care if people ask about my insulin pump or CGM.  More power to them for being bold enough to embrace the awkwardness and actually ask, instead of assuming.  (And even in the 5% moments of “argh – stop looking, don’t ask,” it usually ends up being a moment of discussion and disclosure I’m grateful for.  I should be more open to discussing diabetes in a public setting.  Hang on a second … let me start a blog real quick.)

“On my arm?  That’s my insulin pump.  I have diabetes.”

I was in line at Starbucks, grabbing an iced coffee (under the gestational lock and key of decaf for just a few more weeks), escaping the blazing summer temperatures for a few minutes before heading back to work.  I was wearing a skirt and a tank top, with my infusion set connected to the back of my right arm.  My body – thanks to third trimester expansion, has run out of subtle places to stash my insulin pump, so it was casually clipped to the strap of my tank top.

Kind of noticeable, but in a “who cares” sort of way.  It’s hot outside.  And I’m wicked pregnant.  And I have no waist anymore.  You can see my insulin pump?  Good for you.  You can probably see my belly button, too.

“No kidding.  Diabetes?  Is it because of the pregnancy?”

“No, I’ve had diabetes way longer than this pregnancy.  I was diagnosed when I was seven.”

The guy paused for a second, his eyes lingering on the infusion set on my arm.  “So you do that thing instead of shots?”

“Yep.”

“Do you like it?”

That question always throws me a little.  Do I like it?  The pump?  I do like the pump.  I like not taking injections.  I like not whipping out syringes at the dinner table and exposing my skin.  I like taking wee ickle bits of insulin to correct minor highs.  I like running temp basals to beat back hypos.  I like people wondering what it might be instead of assuming it’s a medical device.

“I do like it.  It works for me.”  I paused, already envious of the coffee in his hand.  “I like coffee more, though.”

He laughed and finished paying for his coffee.  “Can’t blame you for that.  Good luck with the baby, and try to stay cool in this weather,” he said.

I don’t like diabetes.  That’s for damn sure.  That shit is exhausting and I’m burnt out on the demands it places on my life.  But the pump?  Yes, I do like it.  It’s  a streamlined delivery mechanism for a hormone I wish my body would just cave and start making again.  It handles diabetes so I can go back to trying to put my socks on without tipping over.

Enjoy the Silence. Or Not So Much.

[Disclosure about my relationship with Dexcom]

During the first trimester of this pregnancy, lows were intense and weirdly symptomatic; a nice contrast from the hypoglycemia unawareness that’s crept in over the last five or six years.  (I ended up stashing a jar of jellybeans in the dining room hutch, only to have to move it into direct line of sight in the kitchen in efforts to keep up with the persistent low blood sugars of those first few weeks.)  As this pregnancy has moved forward, the lows have become slightly more predictable and the hypo-unawareness has returned, making the Dexcom BEEPS! and BLARGHS! more necessary.

Until that week when I noticed, “Hey, the alarms have been quieter.”  And then I realized, “Hey, the alarms aren’t working.”  Because overnight, my G4 receiver had been rendered mute.

When I received the Dexcom recall notice several months ago, it was very early February, and I was still using the G5 transmitter.  At the time, the only people who knew I was pregnant were my family and my medical team, but I knew, and I was stalking blood sugars with vigor (and a side of panic).  My endocrinologist, not a fan of the data output from the G5 application, asked if I would consider using the G4 for the remainder of my pregnancy.  Wanting her to check the “compliant” box on my chart (there’s a first time for everything), I switched back to the G4 the following week and have been on it since.

And for months, my G4 receiver was fine.  Alarmed all the damn time, vibrating and buzzing from my bedside table or my purse and alerting me to the changing needs of my baby-hosting body.  And then, all of a sudden, the speaker went full garbage, not working at all.  Only a vibration came from the receiver, making my phone* the best laid plan for alerting me audibly.

It wasn’t until I woke up one morning and saw the empty raisin box and the discarded juice box that I realized the night before wasn’t very comfortable.  And that I didn’t wake up because of alarms, but instead because of aggressive baby kicks.  I couldn’t ride out the rest of this pregnancy without replacing the receiver, because I was NOT waking up even with the phone alarms.  I needed high octane, receiver-in-a-glass-with-some-coins sort of jolting.  I needed to connect the alarms to Siah, encouraging her to walk across my face when I was low.  Or similar.

I needed the receiver to actually WORK PROPERLY.

So I went to the website – Dexcom has a special page set up for this particular issue.  There’s also a special hotline number to call: (844) 607-8398.  After a quick exchange with the woman on the phone, she asked me to confirm that my alarms weren’t working by doing the following:

  • press the center button on your receiver to access the Main Menu
  • scroll down to Profiles
  • select Profiles
  • scroll down to Try It
  • select Try It
  • scroll down to 55 Fixed Low
  • select 55 Fixed Low
  • verify that you receive vibrations first (vibratory portion of alarm), followed by beeps (audible portion of alarm).

And once we confirmed the alarm absence, a new receiver was scheduled to be shipped out.  Should be arriving in the next few days, in time for me to finish up this pregnancy as a G4 user (to make my doctor happy) and hopefully by staying in my threshold lines (to make my fetus happy).

If your G4 receiver suddenly craps out, sound-wise, call the hotline number and have a new one sent out.  Alarms that won’t alarm are alarming.

(* I follow myself on the Dexcom Follow app, along with one other person.  Yes, redundant.  In response to the dead receiver speaker, I changed the alarm settings on my phone so that I’d be alerted for highs and lows.  This worked, in theory, except when my phone was on silent or in the other room.)

Free Shower.

Internet LOLZ suggest I title this post “Free Shower Be Like …” but I refuse to do that.  My dad, and every English teacher I’ve ever had, would throw things at my head.

Instead, I’ll just assert that diabetes-device free showers are totally akin to this:

AKA the happy dance of airy weightlessness, scrubbing skin unadorned with medical devices.  It’s brief, but beautiful.

(unrelated but entirely related:  all of these gifs are terrific)

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