Considering New Pump

I’m a LADA, and was on an Animas Ping for 13 of my 14 years since diagnosis. With Animas bowing out, I went with the Medtronic 670g. While on the Animas Ping, I just had the pump, and since my A1c has always been under 7, I didn’t see an overwhelming need for a CGM.

Fast forward. My A1c has gone sideways, I have multiple issues with the insets from Medtronic, the pump itself weighs a ton and is uncomfortable to wear. Since I accepted the buyout from Animas to Medtronic, I 've researched as best I can, but have found nothing that would prevent me from switching to Tandem. What the overall question is, is for opinions on the Tandem without a CGM. I have to believe I can bring my A1c and overall numbers back in line with a pump alone, and that just doesn’t seem to be possible with the 670g. I did a trial with a CGM back on the Animas, and really wasn’t comfortable with it, nor did it show any real ‘need’ for it, my endo and I have worked out most of the hinks in basal settings and C=I ratios long before.

Do you feel the Tandem TSlim is a good choice without the CGM?

hi @JanS, I don’t currently use a CGM either, but my a1c is and has been fine (~6.2%) I can’t help but wonder, what is really happening for you? the 670, without CGM is the same as my crappy old 730, without CGM is the same as a POD, without CGM. If you are having trouble with the infusion sets, and the T’slim infusion set is similar to the infusion set you currently use, then you will (very likely) have the same results as you are currently getting.

ugly and heavy pumps don’t have anything to do with control. so maybe we take that off the table for a moment. have you gotten better control with your 670 in manual? are you still trying to get automode to work? have you tried metal infusion sets?

all pumping makes more scar tissue. over time, it may be the case that all your regular infusion sites aren’t going to work for you. are you sure it’s not bad absorption at your regular sites due to scarring?

the 670g specs are as follows:
The pump dimensions in inches are approximately 2.1 width x 3.78 length x 0.96 depth. The weight of the pump is approximately 3 ounces .

the t’slim

  • Size: 2.0" x 3.13" x 0.6" (H x W x D)
  • Weight 3.95 ounces

so the t’;slim is heavier, and similar in size, but a smidge smaller, the most difference is in thickness because t’slim uses a innovative reservoir…

anyway Jan, I hope you first figure out what’s the cause of your control issues, and then pick the pump you like the best.

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Hi Jan @JanS, I can see, feel, your frustration. Just when one of us feels as if “I’ve got this diabetes thing mastered”, something will go wrong - Murphy’s Law. It probably doesn’t matter what hardware you will use, the major factor is what we have learned from experience and knowing hoq our body reacts - yes, we need to assume that our bodies change over time and what worked well 40 or 50 years ago may now apply now. The major difference between LADA and “Regular T1D” is that your learning began later in life. [Correct there is a new study that may contradict what I just said.]

When you say that your HbA1c “went sideways”, can we assume that it stayed just about level? During the last three or four decades, my A1c has remained between 5-7 and 6’4%, lab testing every three months. and during this period I’ve used many different pens - none the pre-filled type - , and three different pump models. My A1c may have been lowest before beginning a pump, after 47 years with injections, but I certainly enjoy the convenience of a pump and the 1,500 fewer needle pokes every year. I used MiniMed/Medtronic gear for 15 years and during that time I had a variety of infusion-set types; I suggest that you investigate the different types. Although my A1c might be slightly higher when using a pump, my glucose variability -the Standard Deviation - has been greatly lowered, which in my opinion is preferable. The Tandem infusion-sets, which I currently use, are very similar to the Medtronic sets in use and choice of style.

All that said, if you want to make a change in hardware, I strongly recommend the Tandem t-Slim x2; combine this with the DexCom G6 glucose sensor, and activate Control IQ, if a doctor will prescribe this for you, and enjoy almost hands-free diabetes management. Correct, you must first know your body, how it reacts to insulin and food, and enter into your pump correct basal rates for all periods of the day, carbohydrate:insulin ratios for all daily periods, and insulin sensitivity factors for various times of the day and night. Insulin duration is “locked” at five (5) hours, 24 hours every day.

I may be an exception, but Control IQ has certainly worked well for me. All I need to do, is have the correct Personal Profile selected for what I plan for the day, select [and remember to deselect] the “Exercise Activity” button when I’ll be exerting more than normal [this helps preventing “lows”], and count and enter carbohydrates whenever I eat. Really very simple and I often forget that I’m wearing a very small, easy to read, insulin pump. In the two and one-half months since I activated Control IQ, my TIR [Time-In-Range] has increased to well over 90% .

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Thanks for your response, Dennis. To clarify, when I said my A1c went ‘sideways’ that’s not a good thing. It means it went up, above where I want it, and where it had been for many years.

I’m looking for ‘just a pump’, not inclusive of a CGM. While that may come into play down the line at some point, I had (prior to) very good control without the CGM.

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Thanks for responding Joe. I’ve been the rounds on infusion sets, tried everything but a metal one which both my endo and Medtronic said not to because of how lean I am. I believe another poster here also mentioned having discomfort with the metal sets when laying down. Because of being lean, my choice of infusion sites is limited, and I have tried alternate sites (other than abdomen) usually followed by blood and really bad language, lol.

Thank you for the stats on the Tslim, I was led to believe that it was lighter and smaller than the 670. I’ll have to do some more research I guess. I am seriously considering the Inpen, and taking a hiatus from the pump. not that MDI is much fun at all, but at least I can use other sites for a quick injection.

Stay well!

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My first pumps were Minimeds - I had the 504, 506, 507c and 508 if memory serves (which is sometimes questionable😉). In theory pumps should be pretty much the same in terms of safety and accuracy, given the testing involved before they are out on the market due to the nature of what they do. So much of the decision is personal preference if you are looking at the basics.
I made the change to TSLIM because I really liked its slimmer, more modern profile. I saw a young lady wearing a Minimed when I was out shopping one day and exclaimed “Wear your pump girl!” She and her companion turned around and looked at mine as we spoke, and I was surprised how chunky and old fashioned her Minimed was in comparison with my TSLIM. I also prefer the layout of the buttons and screen, but those are just my preferences - Minimed is a good pump and lots of people are happy with it.
Another option, if you’re interested, is the Omnipod. No tubing to worry about if that’s a concern for you, and last I heard you could get a sample pod to try at home. It simply sticks on without inserting so you can get a feel for how it feels. Attached is a comparison from 2019 that may give you a little more detail and comparison about the ones out there. I know you asked specifically about the TSLIM but you might find it of interest.

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