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Posts tagged ‘Tandem Diabetes Care’

The One About Animas.

[I have a disclosure about Tandem.  I had a previous disclosure about Animas.  Please read my disclosure page so you are aware of my bias.]

Yeah.  I know the news cycle is 15 seconds long now and many people have already moved past the fact that Animas is closing shop, but I heard about it while I was on vacation and haven’t had a chance to really process the news until recently.

Two years ago, there were six pumps to choose from:  Tandem, Animas, Medtronic, Insulet, Roche, and Asante.  Three of them are now gone.  (Also, rest in peace, Cozmo.)  With Animas exiting, Tandem, Insulet, and Medtronic are what remain in the US market.

This sucks for several reasons, but the main one for me is that diabetes is not a choice I made.  I am not a big fan of this disease, and taking insulin isn’t something I love doing.  However, I need insulin to survive, and pumping insulin results in better diabetes control for me.

When I was diagnosed, pumping wasn’t being pushed by my endo, as it was fairly new.  I went on my first insulin pump back in 2004 and it was a Medtronic 512 (smoke gray and reasonably badass for its time).  I used that for a few years, then switched to a silver Animas Ping and spent several years on their pump, then popped over to Tandem and have been t:slimming since.  All of these pumps made taking insulin easier, for me.  And each one of these pumps, I chose.

An insulin pump is an intimate device for people with diabetes.  It goes to school with them.  Goes to work.  Goes to bed.  This thing is literally by our side 24/7, so it needs to fit into our lives.  I remember choosing my first insulin pump and pouring through the brochures excitedly, as if I were picking out my first car.  Yay, the colors!  Yay, the tubing options!  Yay, the infusion sets!  Weird things to say Yay! about, but it was kind of nice to do some choosing when it came to diabetes.  Having a choice made me feel like I had a bit more control over this disease.  Can’t unchoose diabetes, but can choose the devices I use.  I appreciate that.

This whole Animas closing thing is rotten because people chose that pump.  That’s the pump they wanted to bring all over the place, the one they decided would fit into their life.  Having yet another choice removed/forced sucks, and I’m not sure what can be done to preserve the few choices we have left.

If you’re using Animas currently, you can switch to Medtronic but you shouldn’t feel forced into using Medtronic. Tandem and Insulet are options, even under UHC (although if you have UHC, it may require some paperwork/PITA hassle/moments when wine is necessary). Medtronic makes a product worth using, but it’s not the ONLY product worth using, and patient choice MATTERS.  Take some time to look at the remaining choices and make a decision that works well for you.

clicking the logo will take you to their Animas switch information

clicking the logo will take you to their Animas switch information

RIP, Animas.  Your pump saw me through my pregnancy with my daughter, and also through a handful of swim up bars – both scenarios are real life.  Thanks for making those life moments easier.

Tandem X2 with Dexcom G5 Update

[Please read my Tandem disclosure.  I was not asked to write this post.  But I need to disclose anyway, because it felt weird not to.]

Even though the update email came in a few days ago, I didn’t have a chance to update my Tandem X2 insulin pump until yesterday afternoon.  My original intentions were to sit down (preferably with a cup of tea and my reading glasses, so I could look the part of “focused” which would hopefully, in turn, become real focus) and update my pump in a relaxed environment, but that’s not a thing in my house anymore.  Every time I went to update the pump, the little Guy needed a snack or Birdzone wanted to play Spit (she kicks my butt regularly) or one of the neighborhood kids would roll through the house or the phone would ring or … the list of distractions remains long.

So I had to just sit down at the kitchen table and update the damn thing, house tornado be damned.

It was easy.  Thankfully, because I was only able to keep half an eyeball on the process as it unfolded.

The information I needed – my pump’s serial number and my “update ID number” – was in the email from Tandem Device Updater (if you’re looking for it in your inbox), so once I downloaded the device updater software to my computer, it took just a few minutes to update my pump.  I plugged my pump into the charger and then stuck the charger into the computer’s USB port, followed the prompts, and let my pump get pumpier.

The device updater

I knew the pump was ready to roll once this screen came up –
the update ID from the email went here.

Once the pump was plugged in, this screen popped up.

“Whoa, your pump updates like an iPhone?”  The 13 year old boy who lives down the street asked.

“It does,” I said, watching the blue progress line for the update move across my computer screen.

“That’s cool,” he said.

Truth.  My X2 now grabs Dexcom G5 results and shows them on the pump.  And I’m still learning the ropes with this new update.  In total, the update took about 15 minutes to work through.  I decided to wait until I was ready for a site change because in doing the update, I’d need to swap everything out anyway, and would also have my IOB set back to zero.

I have my iPhone running the G5 app in addition to the pump, and both appear to be working fine.  I was concerned about battery life after making the update, but since it’s been less than 24 hours since updating, I’ll have to come back to that at another time.


Updated!!

What was nice, though, is that my CGM was already up and running on my phone before I updated my pump, so when the update completed on my pump, the CGM results showed up immediately.  It didn’t seem like I had to independently calibrate my pump and my Dexcom phone app.  I’m rebooting my CGM sensor as I type this, so I’ll have a better sense of how this all works in a few hours.  In addition to CGM functionality and battery life, I’m really curious to see what the payment/update reimbursement structure will look like for future updates.  The G5 update was free.

The bottom line, for me, is that updates are available for my insulin pump that don’t require me to wait for a FedEx box to arrive before I can access them, and that’s damn convenient.  Having a pump that can be updated from my house while dinner is cooking (read: burning), kids are running amuck, and emails are dinging makes diabetes fit better into my life … in that I don’t have to organize my life around diabetes.

Blood Sugar Turbulence.

“The captain has the seatbelt sign on.  Please stay in your seats until the seatbelt sign is turned off.  This is for your safety.”

The flight attendants were also in their seats, having suspended drink service.

Turbulence sucks, but it passes quickly … usually.  Unfortunately, on this flight it seemed like it was going to be a 20 – 30 minute wigglefest for the plane.  And also unfortunately, we were at 38,000 feet and my blood sugars appeared to be making the same climb.

I’ve noticed, especially since my pregnancy last year, that I need to change my infusion set at the three day mark, or my absorption goes full crumb (climbing blood sugars, sticky highs).  I was traveling home from the TCOYD ONE conference in San Diego (awesome event –  more on that conference tomorrow) and my “it’s been three days – change your site!” alarm went off the day before.  I was on borrowed time, infusion-set wise.

I meant to change it at the airport but time was too tight.  And I had no intentions of changing it at my airplane seat, but my blood sugars were high, seemingly stuck there, and I needed to swap out that site ASAP.  Who know how long the air was going to be rough, and I could already see that my blood sugars were in garbage mode. So, tucked against the window and using my scarf as a barrier between me and my seatmates, I was able to quietly change out my site.

Covert site change on the plane. #insulincognito #latergram

A post shared by Kerri Sparling (@sixuntilme) on

And yes, the beeps are usually loud an intrusive but the speaker for the X2 is on the backside of the pump – that series of little holes – so keeping my hand firmly over that part made for a subtle set change.  Shrugged my shoulder out of my shirt and popped the infusion set on the back of my arm and I was good to go without even a side-eyed glance from my seat mates.

Stealth set changes at 38,000 feet without going into the nasty little airplane bathroom? And blood sugars that started coming down within 20 minutes of the set change? Check and check. See ya, blood sugar turbulence.

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.

Open the Door.

For several weeks, I was flipping open the charging port on my t:slim insulin pump and plugging it in while I was in the shower.  But then I noticed the charging port cover was looking a little worse for the wear, and I connected with a friend about best practices.  (“Best practices” standing in for “How the hell do you charge this thing without breaking the door off?”)

Turns out the door swivels.  And swiveling the door keeps it from ripping.

Swivel that door! #tslim

A photo posted by Kerri Sparling (@sixuntilme) on

Well I’ll be (… more careful, more aware, a swivel-er).

(Also, you tell me if “Open the door” as a post title immediately made you think “get on the floor … everybody walks the dinosaur.”

 

[Tandem disclosure]

 

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