In October of 2018, Tandem Diabetes Care, Inc received Health Canada approval to begin selling their t:slim X2 pump. Tandem is the latest pump company to hit the streets with a product in Canada. You can read more about the t:slim x2 pump and its features, here.
Now that there is coverage as part of some provincial pump programs, we’re starting to see t:slim x2s leave the shelves and head into the hands of community members. We decided to check in with two of them to find out what their experiences have been like. Thanks to Brad Lee and Michelle Lord for sharing their experiences with us.
Disclaimer: Please check out CIM’s Partners Page to learn more about the companies we work with. This post was not paid for and does not represent sponsored content, but it’s important to recognize that we may be biased based on the fact that some companies highlighted below support CIM in different ways. We still thought this info was important for you to know about.
T:slim x2 Primer
To learn more about the t:slim:X2 pump you can visit the Tandem Diabetes Care website, or check out our blog highlighting its features. Below are a few things we thought you might want to know:
- Cartridge Size: Can hold 300 units of Hovalog or Humalog U100 Rapid-Acting Insulin
- Site Specifics: Autosoft 90, Autosoft XC (formerly branded Inset), Autosoft 30, Varisoft (formerly branded Comfort), TruSteel (formerly branded Contact Detach). Read more.
- Watertight (IPX7): Tested at 3 feet for 30 minutes, so the pump is safe in the event of accidental dunks, sweat, rain, etc. However, they do not recommend users shower, bathe or swim with their Tandem pumps.
- Rechargeable Battery: The pump uses a micro-USB port to recharge. No battery changes or costs required. You can learn more about off-the-grid charging options here and the environmental benefits of using rechargeable battery, here.
- Large Colour Touchscreen: The touchscreen gives users a simple to use interface without the need for scrolling through menus. Last year, when CGM integration was approved for the t:slim X2, the touchscreen feature gave Tandem the power to move buttons around through a software update to make room for the interactive CGM screen. Tandem users in the US were able to do this update at home from their personal computers.
- Dexcom G5 Integration (Canada): The t:slim X2 pump comes with built in Dexcom G5 integration. You can see your CGM readings right on the screen of the pump! (Note that if you are reading this in the US, or t:slim X2 comes with G6 integration.)
- Remote Software Updates: When new features come out, you have the capability to download those updates to your current pump. No need to wait until the end of your warranty to upgrade.
Jen Hanson: Set the scene for us – Tell us a bit about your story! Who are you? When did diabetes come into your life? What have you used to manage your diabetes over the years?
Michelle Lord: I was diagnosed with type 1 diabetes when I was 12 years old. My first cousin had been living with Type 1 for a few years prior to my diagnosis, so our family knew what we were in for when I received my diagnosis. My blood sugar was only 10 mmol/L (180 mg/dL) when I was diagnosed, so I hardly required any insulin for the first year or so. I always did the JDRF walk to cure diabetes (even before I was diagnosed), but I was never really involved in the Type 1 community, until one day when I stumbled upon all these Type 1 Instagram accounts. I started connecting with Type 1s all over the world and finally got the courage to start the Type 1 diabetes YouTube channel that I had always wanted to create!
2017 CIM Adventure Team Member, Geneva, on a day-hike prepping for the North Coast Trail.
Brad Lee:I’ve had Type 1 diabetes since I was 34 years old, and started with multiple daily injections, followed by my first insulin pump, after I had an allergic reaction to synthetic insulin. The clinic recommended a three-day hospital desensitization protocol, which determined that my body could absorb smaller, continuous infusions of insulin without the adverse allergic effects of large bolus amounts. Eventually, I became less sensitive to insulin infusions, but I still carefully monitor and rotate sites.
Now, after nearly 19 years of living with T1D, I’m optimistic about my diabetes self-care with all the advancements in insulin delivery technology. I first heard about Tandem a couple summers ago, when I attended my first Slipstream camp with Connected In Motion (CIM). Hanging out in Algonquin Park with other adults living with T1D was a major eye-opener, and the experience motivated me to improve my T1D self-care and management.
CIM’s helpful reviewers of the T:Slim X2, Brad Lee (Left) and Michelle Lord (Right).
Mike Avery, heading out for a run during 2016 SoCal Slipstream on Catalina Island.
JH: What made you decide to go on the t:slim x2 Insulin Pump? What drew you to making the decision?
ML: The two biggest reasons for me choosing the t:slim were: 1) that it compatible with my Dexcom G5 CGM and I can get my blood sugars on my pump, and 2) the pump itself is very sleek and modern looking with the touch screen. Not to mention I had quite a few friends in the United States using the t:slim that had nothing but good things to say.
BL: I first saw a Tandem pump on the hip of one of my fellow Slipstreamers [that was you, Jen Hanson!] at the CIM camp two summers ago. It was the first time I’d ever experienced anything positive about having T1D. I’d only just been made aware of Continuous Glucose Monitoring (CGM) at another CIM event, but I was still poking my fingers five to six times a day, in what seemed like a losing battle to keep my blood sugars in range. My reference points for diabetes management at the time were limited to the twice yearly visits to my then endocrinologist, when I’d be told my HbA1c level, and what I should do to improve my numbers.
I’m pretty sure now that the pump I saw at camp was Tandem’s first t:slim series pump. At the time there was talk about easy software upgrades of the t:slim to integrate insulin delivery with CGM. That potentiality and the colour display screen, with easy-to-read information, that included an estimation of insulin on board (IOB), reservoir capacity, time/date and battery life, made the t:slim look sleek compared to my nearly 10-year-old Medtronic Paradigm 722 pump with it’s backlit alphanumeric display. To determine IOB on my old pump, I had to enter a hypothetical bolus wizard calculation to see what active insulin was estimated to remain. I’d also had a noticeable deterioration in my vision, that was not related to diabetes and has since been fixed, and it made bolusing and managing other pump functions difficult in low light.
Tandem was approved late last year by Health Canada, but it still took a few more months for it to be accepted for use under Ontario’s healthcare assistive devices program. During the approval process I learned as much as possible about the t:slim from friends in the United States who were already using it. I was also able to reach out to Tandem’s Canadian team, and I was very impressed by their professionalism and commitment to building a strong team for care of patients and product after sales.
JH: What was one thing that surprised you about the t:slim x2?
ML: Something that surprised me the most was how user friendly the pump is! I thought it would take me a really long time to get the hang of how it works and where to find all of the features in the pump, but everything was so straightforward and I felt comfortable with the pump after only 1 day!
BL: OMG! All those frickin’ alarms! With the t:slim X2, I had to get used to completing touchscreen button-pushing sequences in order to avoid so many bleeping alarms that “I-might-be-in-the-middle-of-a-bolus-operation-but-hadn’t-yet-completed-it”! It’s a simple tap on the Tandem “T” logo, at the right of the screen, but I was used to pushing buttons on the old Medtronic pump, and waiting for any incomplete operation to time out. And when the occlusion alerts began – the first in the middle of the night with three very loud beeps – I was driven to sleep-deprivation for a couple weeks before I discovered the biggest surprise about switching to the Tandem pump.
The biggest surprise is that I’m not going to be able to continue pumping ultra-fast Fiasp insulin in my new Tandem t:slim X2 pump. After several back-to-back occlusions, and having to try different infusion sets and cannula lengths to try to make pumping with Fiasp work, I’m going to have to switch to NovoRapid or go back to Humalog. The improvements in blood-sugar management I believe I was able to achieve over the last year and a half by switching to Fiasp, on both the old Medtronic Paradigm 722 and for a short time my t:slim X2, are probably still possible with improvements in the overall insulin delivery system offered by Tandem.
[Note: Fiasp is not approved to be used in any insulin pump. Although there have been small-scale studies looking at the possibility, no significant clinical trial has yet been completed to allow Tandem (or any other insulin pump company) to recommend the use of Fiasp in their pumps. It is important to note that Fiasp’s insulin action is different other rapid insulins that are used in insulin pumps which may impact user experience.]
JH: What was the biggest learning curve for you when you started with the pump?
ML: Definitely the changing the cartridge! This process is more complicated than my old pump because there are more steps involved. I had to watch the instructional video a few times before I could change the cartridge on my own.
BL: The biggest learning curve for me has been getting used to the amount of data that is readily available — and readable — on the t:slim X2. I love to see exactly what goes into a bolus calculation, and on the home screen I can see the all-important display for insulin on board (IOB) with remaining time, based on individualized insulin duration that can be programmed into each profile. The t:slim X2 can have up to six different profiles, each with up to 16 programmed variations in time to manage carb ratios, basal rates, insulin sensitivity and BG targets. It’s also super easy to duplicate existing profiles, in order to adjust them to various circumstances. This was possible on my old Medtronic Paradigm 722, but not anywhere near as easy to accomplish.
Testing out the waters at Two Harbors during SoCal Slipstream 2016. The t:slim X2 is waterproof to 3 meters for 30 minutes, so no need to disconnect for a quick kayak on the ocean.
As summer approaches, I’m going to be getting used to using multiple profiles for changes in level of activity. I have a standard profile for when I’m mostly sedentary, and sitting in a café or at home and getting work done. And I have another profile that I’ll switch to on days when I can fit in a little kayak paddling and fly fishing out on a lake; because of the constant motion of managing my kayak and casting flies to fish, I’ll set my basal rate at 40 per cent of the standard rate, and increase my carb ratio. I’m thinking I should probably create a third profile for summer days when I can get out for long walks around the city.
Improvements in insulin delivery technology, embodied within the Tandem t:slim X2, have made it necessary to update my knowledge of what it takes to live successfully with T1D. I’ve found that I’m moving more towards predicting the outcome of each bolus and basal dose, rather than hooking up to a pump and relying on numbers inputted by my endocrinologist or diabetes nurse. I actually feel that I am more in control of managing my own diabetes.
JH: Was there anything you were nervous about before starting on the t:slim x2 pump?
ML: I had been on Medtronic pumps for 11 years before switching to the t:slim, so the only thing I was nervous about was making the change to a completely different pump that I wasn’t used to.
BL: Looking at the field of what’s currently available in the field – and approved in Canada – for insulin delivery devices, I was mildly apprehensive about choosing Tandem’s first offering into the Canadian market. Its main competitor is Medtronic, which when I was trying to decide what pump to choose had rolled out its 630 model pump, and quickly replaced it with its current 670G model.
Updating the t:slim X2 insulin pump from a laptop. One of the flagship features of the X2 pump is future firmware upgrades.
The 670G represents a higher evolution of insulin pumps in general, with both a low-glucose cut-off function and some function to regulate basal insulin flow rates when blood sugars are above target ranges.
In Canada, Tandem’s t:slim X2 is not at the same level of evolved insulin delivery function – yet. But I do believe it is very close, and I understand that its Basal-IQ software upgrade for low-glucose cut-off function is now under review by Health Canada. And in the foreseeable future, its Control-IQ software, which combines insulin pump functions to manage both high and low glucose, will be available. For me, these technology rollouts are happening at a comfortable pace, and they’ll allow me to more fully learn how to improve my health outcomes with insulin pump therapy, while at the same time feeling more in control of the process.
The SoCal Slipstream 2017 group heading out for a hiking with their t:slims.
JH: What are you most looking forward to in 2019?
ML: I’m definitely looking forward to going on my honeymoon in Sicily in June!! The t:slim will be accompanying my husband and I on this trip 🙂
BL: TID took parts of my life away when I got it nearly 20 years ago. In retrospect, I was fortunate enough to start using an insulin pump very quickly after being diagnosed, and I was on multiple daily injections (MDI) for a relatively short time. I’ve experienced changes and an overall evolution in diabetes management in general, and I’ve been able to make conscious decisions to adapt to new standards in care.
Through recent experiences with Connected In Motion, and especially meeting many amazing people who live — and live well — with T1D, I’m really looking forward to reclaiming those parts of my pre-diabetic life that have been missing.
This summer and fall I’ll be doing more outings with friends I met at CIM’s Slipstreams. We’re doing a multi-day backcountry canoe trip, where we’ll chase brook trout in Algonquin Park, stare at the stars, and paddle more often with the current than against it.
Check out Michelle’s recent YouTube video about her experience so far with her t:slim X2!
