Moving On

This just a small update for you all. Over the past two weeks, since returning from FFL12, I have been slowly moving my blog and stuff to a new site/address. I am really excited about this, yet kinda annoyed. The web address I had wanted disappeared on me. I find that to be quite weird how I can verify its existence one day and the next day it just “happens” to be “taken”. I had my eye on that domain for over two months now.

That being said, I am still putting some of the finishing touches on my new home. I just figured you should all know, at some point next week I will be posting a “closed” sign on this blog. I am not closing it, but there will be no new updates. All of my previous posts will be on both this blog and the new one. However, all new posts will start only showing up at the new home. I just remind you if you have me bookmarked/linked to correct the address when it shows up next week. I will eventually turn auto-forwarding to the new domain on as well. However, if anyone had linked to one of my posts previously the auto-forward may not actually get one to that link on the new site.

Anyway, get excited for the new changes. I am! Yeah for my own domain. Who thought I would ever want to do that?

Love you all!

Oh and for a good time, go to any of Kerri’s or Sara’s You Tube video’s and click on the button for a chat transcript. The “errors” or mishearing of the software is priceless.

T:Slim an update

So last week I posted my review of the t:slim, yet when I was done with the review, I personally had some questions that were left unanswered. So I sent an e-mail off to one of the people I happened to have a chance to talk to about the pump, both during the demo period, but also when I was”gambling” away all of my “millions”, at the adult casino night. He was able to answer some of the questions/concerns that I had brought up, for which I am glad.

A few weeks ago, right after the ADA scientific sessions, word had leaked that there would be no 30 day return policy for the pump if one did not like it nor was there an availability for one to trial the pump before one invested in it. Mind you this is only one link of many complaints that had come out. Bernard Farrell over at Diabetes Daily had this one follow up to the controversy, that I had found later last week. If nothing else, this promise left me feeling happier. My contact over at Tandem had this follow up comment as well. It is a long quote, but ehh… Nothing like filling space right?

Regarding your question about the return policy.  Tandem stands behind its product and we want to make sure that it meets our customers’ needs.  In the event t:slim does not meet someone’s needs they should be aware of the therapy and insurance implications.   t:slim is a medical  device that requires a prescription and is usually paid for by an insurance company.  If the t:slim pump does not meet  one’s needs, they are welcome to return the pump within 30 days of purchase.  However they may have to revert to multiple daily injections if they do not have another pump since it may take some time for the insurance company to approve another pump, something that is completely out of Tandem’s control.
We wanted to bring that to people’s attention since as consumers were are used to running back to Costco or Best Buy and to getting our money back on the spot so we can go get something else off the shelf.
I believe that the confusion arose because most people have not had a chance to try t:slim.  Our goal is to make sure people have the chance to see and play with t:slim before making their purchase decision the way you were able to at CWD.”
So basically between what I have here and what Bernard had to say, it makes sense for the policy. I mean I was happy to hear this.
One of the random questions I had, was in looking over at Tandems page is that included in the package is a USB memory card. I was confused/intrigued about that since I had not seen any sort of slots on the pump to play with. So I asked. Here’s the answer…. 
Regarding the USB card, each t:slim Pump comes with a Reference Guide that highlights the key features of the pumps. You received a copy of that Reference Guide during the trial at CWD.  On the USB card we will include an electronic version of the User Guide which is a more lengthy document with more regulatory language and information about t:slim.
This is the same User Guide that is currently posted online.  This electronic version is searchable so it is more user friendly than a printed 150 page document.  We will also have some drivers of the USB card for t:slim to charge from a computer USB drive and in the future we will also have the t:connect uploader for our Therapy Management System once it is approved.”
I coulda summed that up into smaller phrases and words, yet today is my day off. The only day I have off all week, so I am a little bit country, a little bit rock and roll, and a lotta bit lazy. 
The last question, that I had raised was about the integration with Dexcom’s next generation sensor. The answer I got was pretty much what I was expecting to hear. They are working on the integration with their product, but at the same time taking what Dexcom has to offer and making it a friendly user experience across the board with their system, not just dumping the sensor software into the product and connecting the dots. (My words not theirs.) Anyway, I was glad to hear about this as well. Now, for me it comes down to making the decision about what to do since my pump is dying. the pro/con list is interesting for the 4 pumps I was considering. 
Disclosure: Once again, I state that the previous review and this update were provided by me. I was not asked to talk about the t:slim, nor was I asked to update the comments I had. I did this because I wanted to but I also felt it was important for those who read my first post to see the continuation of my inquiries here.  

Hand’s on w/ the t:slim

As I write this blog, there are a few things that I must state. The first and most obvious is my own disclosure on this review. I was given a 24 hour window by Tandem Diabetes to play with their t:slim. This testing was available to anyone who was at the Children with Diabetes, Friends for Life Conference. I am not being paid, reimbursed, asked, begged, or anything else to write about the pump. I am doing this of my own volition and willingness to talk about things I put my hands on (on reading this a second time that sounds dirty, whoops).

The t:slim pump by Tandem is a very interesting pump and I was so happy to have been able to “demo” the pump. The introduction to the pump which was about an hour addressed many different questions about the pump and also the training necessary to play with the pump. One thing I did forget to mention was that while the pump was filled with saline so we could sample bolus and use the pump as if it were filled with insulin, the pump was NOT attached to me in anyway shape or form.

The t:slim right out of the gate makes a nice impression. This is just based solely on the fact that the pump is the only touch screen, color, insulin pump on the market. This is obviously the first and most obvious difference between all of the pumps out there. The next thing that is kinda nice about the pump is the size/weight. I currently am using an Animas Ping pump and also did have the Medtronic Paradigm pump as well before switching pumps.

The size of the t:slim is smaller and most likely weighs about the same as the others. The one thing to note is that this pump uses a luer-lock connection to connect to the infusion set, however the luer-lock is not directly attached to the pump in the same way as it is to the Animas or how the Medtronic infusion set connects. The actual lock connection is roughly an inch higher up, so there is a little bit of tubing followed by the connection. The Tandem people said this option was for those people who wear the pump using a belt clip, the actual luer-lock piece is not poking into your side. (I liked that alot, can’t mention how many times I have poked myself uncomfortably with that item.)

The cartridge in and of itself is pretty sweet. It connects to the pump and is setup in such a way which adds to the slimmer profile of the pump. The cartridge actually has a small bag inside of it, which is used to store the insulin in it. The cartridge can hold up to 300 units of insulin. The Medtronic pump has an option for the 300 unit reservoir while the Animas Ping can only hold 200 units of insulin. Don’t get me wrong the 300 unit cartridge is nice and all, however I usually only go through about 175 or so units every 3 days.

The other thing that is nice about the t:slim is the actual technology that delivers the insulin from the pump to the infusion set. Feel free to look at the video from the Tandem site, that talks about the actual micro-delivery technology that is used. The one thing the Tandem people were talking about and it did catch my attention is the fact that the way the pump delivers insulin does make it harder to give yourself the whole cartridge of insulin. That is just safe, it wouldn’t sway my final decision, but I do like that option knowing how safe I could be.

The delivery for the pump is slower than what I have experienced with the Animas pump. Not that this is a bad thing. I will get into that in a second. In the scheme of insulin delivery apparently speed wise the Animas is the fastest while the Medtronic pump is slower. The t:slim is apparently middle ground in speed. The other thing that is nice, while I am only guessing the pump sounds for delivery are quieter than the Animas pump. I don’t remember the sounds from the Medtronic pump, but I do know it was quiet so this could be a middle ground noise as well.

While I would have like to sample the delivery through an infusion set, that option was not available, I can talk about the fact that if it delivers insulin slowly it will not be as painful. I remember when I first switched to my Animas pump the fact that the delivery was pretty painful until I found on the Bolus setup screen of the pump the option to slow the delivery down. This made a huge difference for me. A few months ago while myself and some of my friends were hanging out we were talking about the Animas pump. The conversation developed into a complaint by two of the people about the fact that the pump was causing some burning pain in the delivery of the insulin. That’s when I mentioned the slow feature of the pump. My friends both gave me a questionable look like I was crazy, and I said no, seriously you can slow the pump down. The happiness and tears of joy that one of my friends had made that conversation worth it. Apparently some people just don’t realize how much that the insulin can burn when it is shot into ones system.

The pump offers a few different features on the touch screen that are nice as well, the touch screen makes things easier to access the screens for delivery of insulin, seeing how much basal you have going on, the length of your temporary basal you have left. Insulin on board. Many other features. This is pretty much what all of the other pumps feature as well. However, the big thing is that the screens do make it easier to get from point a to point b without all of the scrolling up/down, back, home, etc. The touch screen makes a huge difference when it comes to plugging in boluses, carb ratios, combo boluses…. the list goes on and on. The touch screen basically makes things quite easy to use.

The one other thing to mention about setting up screens and profiles, once you have the initial program setup. Anytime you make a change to it or need a second profile, i.e. weekend, exercise, vacation, or whatever you want, it is pretty easy to make a new profile. Basically it will copy the old profile. You can name the new profile something different and start tweaking the basals and if needed I: ratio and stuff like that. Again, the idea is all about simplicity and ease of use. Which it definitely offered.

Other features to talk about is the fact that the t:slim runs on a rechargeable battery, no more batteries needed. This option did worry me just a tad bit. I mean while I would have problem charging the battery, I was worried about how long, how, etc. The pump takes 10 minutes to charge every 10% of battery life roughly. So basically you take a shower in the morning/evening it you can charge the pump in that time frame and have enough battery for the day. I mean, there can be issues with charging if you are overseas, out camping, and what if you are without power for an extended period of time. Tandem did try to take that into consideration, which is why they mentioned the fact that they will offer other charging options to people. Solar, external battery, auto charger, things of that nature. But at the end of the day charging shouldn’t be a big issue most days.

Obviously I have many favorable things to say about the pump so far. I may have forgotten other features the pump offers. I will focus on some of the negatives I have found or heard from other people as well.

One complaint I had myself was more user error than anything else. I decided to “set” a temp basal while I was demoing the pump while playing basketball. I did what needed to be done and changed the settings and moved forward from there. It seemed like an easy thing to do. However, because I just started playing and never turned the screen off/ relocked the screen apparently there was some bumpage on the pump and apparently I managed to stop all delivery of insulin. Truthfully, I blame being tired and user error on that one. Just as I needed to get used to the quirks of my various cell phones, so too would one need to get used to some of the quirks of moving to a new pump.

There were alot of confirmation screens about needing boluses, yes, no, etc… however, we were told many of those things were due to meddling by the FDA on safety and this is something that most likely will start cropping up on any of the newer pump models being released in the US. The quick bolus, audio bolus, the whatever bolus was a little awkward to use. Again, I am attributing that to more user error and just trying without looking at the screen first to see what I was doing first.

The one other “complaint” I heard from some of the other people who were demoing the pump at the same time as myself was the comment about the clock. Not that there was an issue with the clock, but just the size of the display for the clock. I guess some people use the pump as a watch and the bigger the display the better. Basically for me I just grab whatever I can get my hands on that has a clock attached to it, pump, Dexcom, or cell phone. So this was truly not a big end of the world sort of thing for me again.

Other things to note but I did not get to see, the t:connect software for the pump management was talked about but not demoed. This apparently according to their website is still awaiting the 510k clearance by the FDA. (Thanks again FDA.) So in this case, there is not much I can talk about this. I mean it is both PC/Mac compatible which will be nice. It will be able to download your data, which is nice. Otherwise, I got nothing else on this.

While the t:slim is not able to work with a CGM as of yet, there is the partnership between Tandem and Dexcom, what the means in the big picture is an integrated system, what it means now? Nothing. People have heard different stories about what will happen with the Dexcom integration, whether the t:slim can do it and just needs a software upgrade or if you need to upgrade to a new pump, who knows. I spoke with the sales rep. on the phone and she was not able to really give me much information about the plans in either direction. This was sad, but expected.

The pump will ship with a One Touch Verio meter, which is pretty cool. I have been playing with that meter for a few days now and like it so far.

I wish I had more information about this pump. The end result is that there is so much to like about this pump. I haven’t really had any major complaints when I played with it. At the end of the day it really does come down to our own desire/needs/wants. Stuff like that. I mean if I had to choose a pump today I would seriously have to draw up a list of pro’s and con’s about this pump and my Animas pump. The end results would be close, with one winning by a margin. Which one that would be, is well between me and me. That answer will come another day.

Disclaimer again: I went to the FFL conference on my own dime. I decided to demo the t:slim pump. I decided to write a review on it. This is all me aside from one or two questions asked of the Tandem people. They did not influence what I was going to say at all. Just me and my own two thoughts.