Thoughts on the Tandem T:Slim pump, A follow up.

After a couple more weeks of using the T:Slim and some more research I wanted to do a follow up. I will say up front that I still regret my decision to give in to United Healthcare and switch from the OmniPod which was working for me so well but I wanted to pass along additional information on this new pump that I'm wearing.

Again none of what I'm writing here is supported by research and I don't have any real explanation for some of it. It is only one users experience with the pump.

Fist off I'd like to give what I understand is Tandem's explanation for the seemingly disappearing insulin. According to my research Tandem's explanation is that they are being truthful with their customer's while other pump manufacturers are hiding the fact that insulin disappears. They say that no pump can deliver all of the insulin that is loaded into it. Other manufacturers hide this by having the syringes used to draw up the insulin modified to match their pump. You don't notice the insulin that is missing as you draw it up because it appears you are drawing up 200 units of insulin when you may be drawing up 220. Tandem claims that the syringe they give for drawing up the insulin is marked correctly and in an emergency could be used to manually bolus. After loading the cartridge the pump lists the usable insulin and you notice the missing units. I'm trying to figure out a way to test this. I think I have a couple of Medtronic Syringes, when I end up with an empty insulin vial I may draw insulin into one syringe put it in the empty vial then draw it into the other to see if the units match.
I've also found that there is a metal tube at the bottom where the cartridge goes in that can get dirty and cause incorrect insulin level readings. One website I was reading said that Tandem recommended that they clean this metal piece with an alcohol swab at each cartridge change. I've started doing this and it seems to help some.

Another feature I've been reminded of with the T:Slim, that I forgot to mention in the first post was it's carb entering screen. It has a built in calculator. A nice feature if you're out to dinner and trying to count up your carbs. Instead of having to add the entre, potato, veggie, all in your head (yes we've all learned to do this over time) you can just put the carbs for you entre in on the screen hit the plus button then the carbs for your potato (or side) hit the plus button again and so on. The T:Slim adds up the carbs for you.  Not a huge deal but it does make things a little easier.

Those two things being said I'm still unimpressed by this new pump my doctors office seemed to like so much:

• Cartridge change and site change take a lot longer than any pump I've used in the past. This morning at least 15 minutes if not 20. This was from beginning to end. removing old infusion set, drawing up insulin, filling cartridge, filling tubing of new infusion set, inserting new infusion set, priming the cannula.
• No easy way to change Cartridge on the go. If I wanted to change the OmniPod at lunch at work rather than in the morning I took a vial of insulin and a new Pod with me. That's all I needed and the actual change took about 7 minutes. My Medtronic was even simpler. I took an infusion set and a pre-filled reservoir. In order to change the T:Slim you need: A cartridge, A syringe and needle, (these are not packaged together) an infusion set, a vial of insulin. You cannot pre-fill the syringe and you cannot pre-fill the cartridge. 
• I'm using more insulin and getting less result. Since I've begun using the T:Slim I have noticed higher spikes after eating and a much slower response in blood sugars coming back down. This was so drastic at dinner and in the evening that I changed the carb ratio at dinner to 1:5 from 1:6 and increased my overnight basil rates. Even with these changes I continue to see overnight rises in blood sugar that did not occur while using the OmniPod. I'm not sure if insulin delivery, site choice, infusion set could cause this but I definitely notice a difference.  
• After being spoiled by a tubeless pump I'm finding I really dislike fighting with tubing. So many things change with the tubing and a pump that's not water proof. I move a lot when I sleep. If I clip the pump to my shorts I end up rolling over it on my back and it wakes me up. If I let the pump lay beside me I end up tangled in tubing and waking up. I slept a lot better with the tubeless pump. Showers are a pain again. I hadn't thought about the way I used to do breakfast. I'd test my blood sugar and start a bolus. I usually wait till the bolus is delivered and give a couple of extra minutes before eating. I've found my BG spikes less this way. While the bolus was delivering I'd jump in the shower. I can't do this anymore because the T:Slim is not waterproof.

So Sorry to Tandem I know they worked hard on this pump and it does some cool stuff but after a month now of using it I wish I would have fought harder for my OmniPod.