Tandem T:slim remote bolus

I got an email this week that Tandem’s remote bolus functionality was approved in the US! The phone app update is available now, but the pump software update isn’t ready yet. That will be rolling out in the near future, they say. They suggest downloading the software update program for your PC or Mac so you’ll be ready to install when it does roll out. Keep an eye on your email and/or the Tandem website.

I’m excited for this. Being able to program a bolus from my phone instead of having to do it on the pump screen seems like a small thing, but I think it could simplify the process for something I have to do several times a day. Grabbing my phone off the table instead of unclipping and untangling my pump every time should be a little easier, and my phone’s touch screen is much easier to cope with than the pump’s smaller and more fickle screen. It’ll be a relief just to bypass the 1-2-3 unlock sequence.

What do you think?

4 Likes

I heard that too! It’s a nice feature to have, but I rather like not having to rely on remote - if I forgot my phone i would be up a creek. That said though, I read somewhere that pumps of the future would be moving to remote anyway so I just have to wrap my mind around the concept.

1 Like

I like having both options. As you say, I wouldn’t want to rely on remote. If you lose your phone or it drops the Bluetooth connection, you’d be up a creek. I do think it’ll be more convenient day-to-day to be able to do it remotely.

2 Likes

I would love to be able to remote bolus as well as dismiss alerts. I also worry about being opened up to being hacked . I wonder how this will work with airplane mode.

T:connect works over Bluetooth. That answers both your questions.

  1. It won’t work in airplane mode unless you turn Bluetooth back on. (Bluetooth is short range and low power, so you’re allowed to have it on. You can also just turn Bluetooth off for takeoff and landing if you want to play it extra safe.)

  2. Bluetooth is a direct pairing between two devices. The connection has to be approved on both devices and is not accessible on the broader internet. While it’s true that t:connect also backs up your data to the Tandem server, no one can send something to your phone that would get it to send a bolus command.

Dorie & Paul-Gabriel @wadawabbit @WearsHats, one of your hesitations for adopting the phone remote appears to me might be relieved. Based on my reading the data [I received the invitation to upgrade, and declined, just over a month ago] and read the following:

  • PRECAUTIONS: Always rely on your pump to make therapy decisions if using a smartphone that is incompatible, the smartphone is lost or damaged, or the smartphone loses Bluetooth® Connectivity with your pump. Important pump alerts and alarms are only received as app notifications when enabled and the app is either active or running in the background.

I think this is telling us that the t-Slim can continue to be used after the remote is activated.

2 Likes

I had no doubt that the existing t:slim X2 would continue to function independently. It would make no sense to disable the pump’s own touchscreen interface.

As I read it, Dorrie was talking about the possibility that future pumps might be designed without the screen, allowing the pump to be smaller, and relying solely on the remote bolus functionality. That would be a mistake, I think.

But it’s good to see Tandem explicitly acknowledging that it would be unsafe to do away with the pump’s built-in interface.

1 Like

Thank you @Dennis and @WearsHats.
Someone on the forum had referred to the Tandem Mobi (previously called Tandem Sport) and I googled it. In case anyone is interested, Healthline dot com had some helpful info and I was intrigued so I looked a little further and found a YouTube video where a reviewer was discussing future enhancements: and while the Mobi will initially have a bolus button he said that down the road future pumps would likely go fully remote - that pumps are moving in that direction.
Important note: that was not an official word from Tandem, but a statement from the reviewer. However, I could see things heading in that direction although I don’t knew just how far in the future. I had several Minimeds and some of them had a remote control you could use to bolus. That was a helpful gadget and in training we were told they were uniquely programmed so we needn’t worry about them opening our garage door much less working on someone else’s pump.
We shall see what the future holds. I like the assurance of having a backup plan in most areas of life so it will take some adjustment when this does come to pass.

Interesting. I suppose it’s possible. Time will tell. But these pumps are built safety first. They know our lives literally depend on the pump working properly (and they could be liable if things go wrong, or at least get really bad press). Fully remote means you’re depending on a third party device for essential functions. Doing that with the Dexcom is one thing, and the pump can work without it. But depending entirely on your phone for something as fundamental as programming a bolus… that would be a big step.

It assumes that every pump wearer has a smartphone. Many kids aren’t allowed to have phones. Many schools and camps don’t allow kids to use phones during classes and activities. Many older adults don’t use smartphones. Many others may not have phones for other reasons.

Phones get lost more easily than a pump that’s literally attached to your body. Phones break more easily, too. Not to mention the risk of someone taking your phone. For punishment, abuse, or just theft.

Having the option to do a remote bolus makes everyday life a little easier. It’s neat. But having that be the only way seems really risky.

I can understand what you’re describing with the Mobi. Get rid of the touchscreen. That’s expensive and half the pump’s size. You can have a cheaper, slimmer pump if you leave the CGM graph and all that to the phone. But you still have a bolus button and a few other controls on the pump itself.

Then again… there’s already the Omnipod, which is fully remote and has been for a while now. It works for some.

I just can’t see that being the only option.

4 Likes

Both have good information, and one of the few reasons that I would have the remote access [my t-Slim is always with me] is when/if I need outside assistance. I mentioned this a while back when asked by Tanden to provide ideas for the interface.

Also note that Tandem emphasizes that a phone is a “secondary” access device. As of now, I do not believe that any phone model has been qualified by the FDA as a medical device. Similarly, the OmniPod has its PDA as “primary”.

1 Like

My first thought when my mom got the email update was that wearing a dress/funky Halloween costume/ski pants/other bizarre clothing will be so much easier!!!

1 Like

We think like twins! Wholeheartedly agree😊. At least with Omnipod you have a PDA which could be a backup to managing by phone. I would just want some sort of backup instead of putting all my eggs in one basket.
We’ll see what comes down the road…

This kind of begs the question - I know I’ll get dinged by the moderators for venturing OT😊: if a true artificial pancreas became available - a closed loop but one that figures out carbs on its own without input did not require calculation and input (you know, functions like an otherwise healthy body) - would you trust it?

1 Like

Ah Dorie @wadawabbit, a little correction in your first paragraph; the Omnipod PDA is, and will continue, the primary controller and a phone when activated will be “secondary”. Probably will remain that way until some phone manufacturer applies for and receives designation as a certified [form 510(k)] medical device.

You won’t get called out on this Dorie because it appears to relate to the identified Topic, but I may hear something with the following because it does deviate. My name formerly appeared on the ADA Diabetes Forecast Magazine masthead until I began strongly objecting to articles with “Artificial Pancreas” as the title. My objection was that even the wonderful iAIDs system that you and I both enjoy, and then these were still a dream, are nothing more than what the name says - Automated Insulin Delivery; the Beta Bionics moves a step closer to an actual pancreas. Our wonderful CIQ does nothing about producing c-Peptide, alpha-cells, t-cells or any of the other functions of a pancreas.

I have been looking forward to being able to remotely bolus, and have received my “limited launch” invitation this afternoon. I am a little trepidatious about being in the early wave doing this though. Am looking forward to any early adopters providing feedback on how it goes! (The reason I have been so looking forward to this is because, as a slim female who often has to dress professionally in dresses, skirts, suits etc, which may or may not have adequate and accessible pockets, being able to easily bolus will be a game-changer. I don’t think there is as much an issue for men, who seem always to have adequate pants pockets built in to professional clothing especially.
)

Elizabeth @elizabethm, I can understand where you are coming from on both your Con and your Pro assessment. What may help you with your hesitation is that you would NOT be required to bolus from a remote [phone] device - although I can see it being a wonderful convenience during professional meetings where lunch is served. For me, the pump wasn’t a concern, and even prior to that I didn’t hesitate to pull out my insulin pen during a Board Meeting and jab myself in the belly, after doing a finger-stick.

As for the other, and I’ve been saying this to my wife before we married 56 years ago, “why don’t WOMEN design their slam their feet down and design, or have, cloths properly designed”; eliminate the need to carry a sach [i.e., purse] and free up hands and the need to find a safe place to stash their valuables.

I had issues with the term “artificial pancreas” - apparently some use that to refer to the loop system but it doesn’t sit quite right with me. Thank you too for your comment on the Omnipod PDA - I did not mean to suggest it was currently controlled by phone. Always appreciate clarification!

You should do a little more research on the security of a Bluetooth connection. BlueBorne is a Bluetooth malware that doesn’t even require your sevice to be discoverable to infect it. The bad guys have figured out how to hack just about anything that is connected via air waves. I am more concerned with the stop gaps Tandem put in place for over limit bolus info and other such items via the app.

Hi Everyone! I too got my early launch notice this past Tuesday. I completed the supplemental training, and I upgraded my pump on Saturday. My iPhone had already updated to the new T:Connect software, so after my pump rebooted, I the remote bolus function was automatically enabled. You can still bolus and control all pump functions from the pump. The T:Connect platform on the iPhone looks the same as before, except that the bolus icon between the dashboard and the notifications icons at the bottom of the screen.

Entering a remote bolus requires face recognition. I tried to remote bolus in the dark, and I was not able to do so. There was no option for me to enter my phone passcode as with other apps.

Next, the pump beeps that accompany boluses continue to sound. Mine were set low, and I increased the volume so that I have the positive affirmation that the pump got the remote directive, and that the pump bolus concluded.

Lastly, all alerts can only be acknowledged from the pump which means you still have to interact with the pump more than just changing cartridges.

As a former Medtronic user, the T:slim has revolutionized my diabetes management since I made the switch 7 months ago. Now to have the remote bolus function. Whew boy, I feel like Dozer (the Matrix)…“It’s a VERY exciting time!”

Cheers everyone. Have a good week.

5 Likes

Interesting. I’m on Android. My phone doesn’t have face unlock (for which I am grateful). I wonder how that’ll work. I guess we’ll see when my turn comes.

I think the security settings on my phone have something to do with the lack of entering a passcode.
That said, facial recognition eliminates the step of entering 1-2-3 or whatever your phone passcode is :wink: