Tandem® t:slim X2™ is approved for use in Canada and we’re stoked

t:slimX2 approved for canadaTandem® t:slim X2™ insulin pump has been approved for sale in Canada and I am excited.  I know that this pump is not for everyone but for us…well, we have been waiting since it was first brought to the US market.

We were Cozmo users.  Actually Cozmo lovers.  Any pump after our beloved Cozmo was just not the same.  So many features were missing. It felt like we were going back in time.

When the Tandem® t:slim™ insulin pump came out in the US, I was jealous.  Many of our fellow Cozmo pumpers made the switch and were in love.  It wasn’t perfect. Some people have issues with certain features but overall most of them felt that one or two annoyances (some of which the company is working to change) were more than worth it.

Let’s face it, this pump looks cool. It has an iPhone phone look.  It also has some features that we have been missing and others that we are excited to see.

Here are a few of the features that the Tandem® t:slim X2™ have to offer Canadian insulin pumpers.

t:slim X2™ Features:

  • the smallest insulin pump currently available
  • has a 300 unit reservoir
  • does not use batteries but rather is recharged when you plug a USB cable into a regular AC current. You can go approximately 7 days between charges.
  • has a shatterproof, touchscreen
  • Dexcom integrated
  • Bolus by gram of carbs or units of insulin
  • Quick bolus option
  • Integrated calculator with numeric keypad
  •  6 personalized delivery profiles
  • 16 timed insulin delivery settings
  • Site change reminders
  • High and low blood glucose alerts
  • Missed meal bolus alerts
  • Remotely update software (no need to buy an entirely new pump!)
  • Waterproof for up to 3m for 30 minutes

For us, these are features that are worth getting excited about!  You can read the full Tandem announcement here. You can also sign up to learn when the new Tandem® t:slim X2™ will be available in your province here.

Now that we have shown you why we love this new pump, I am curious, what features are most important for you when choosing an insulin pump?

Learn more about insulin pumps available in North America on our insulin pump page. 

How to manage airport security with an insulin pump and CGM

traveling with your insulin pump and CGMIn May of 2012, after reading about a friend having problems getting their insulin pump through security at a US airport, I did some research on the subject.  Should you put your pump through the x-ray machine? Can you wear your CGM through a full-body scanner? There were a lot of questions in 2012 and there still are in 2018 so I reached out to a few friends in the industry to see if things have changed at all.  Here is what you need to know when you are traveling with an insulin pump or CGM.

If you wear a Dexcom®

The Dexcom® G5 is cleared to take through metal detectors, be hand-wanded and be worn during flights. There are a few situations to be concerned about, however.

NEVER put your receiver or extra sensors through an x-ray machine.  Ask the security personnel to do a hand-check of the items to avoid permanent damage of these devices.

According to Dexcom®, the effects of full body scanners on CGM components have not been studied. It is therefore recommended that you do not take your Dexcom® through one.

Once you are through security and on your plane waiting for takeoff, make sure to set your app to airplane mode, keeping the bluetooth on and leave your receiver turned on.

If you use FreeStyle Libre

The Dream Big Travel Far blog contacted the people at FreeStyle and asked what the guidelines were for air travel with the Libre.  This is what they reported.

“We recommend the user notify security personnel when going through airport security screening. the user can go through X-ray machines while wearing a sensor. We recommend the reader be powered off during a flight and not used for scanning a sensor. However, the strip port on the reader can be used to take blood glucose or ketone readings during flight. Turning on the reader with the Home Button will activate the radio. The user must turn on the reader by inserting a test strip so as to not activate the radio.”

If you wear an Omnipod

Good news for Omnipod users! You can wear the pod through the metal detector, x-ray machines and full body scanners with no worry.  The PDM can also go through the X-ray. Insulet does recommend that if you are selected for a “pat down” you disclose that you are wearing the pod.

If you wear a Medtronic® insulin pump

Medtronic® insulin pumps can be worn through metal detectors and be wanded.  They should NOT be sent through x-ray machines however.

Medtronic® also notes that your sensor and transmitter must be removed if you are going through a full-body scanner. If you do not want to remove your sensor, you can ask to be pat down instead.

If you wear a Tandem® t:slim X2™ insulin pump

Tandem® t:slim X2™ can be worn through metal detectors and can be wanded.  They should not be sent through x-ray machines.

Changes in air pressure cause bubbles to form in insulin, and the related expansion can cause unintentional insulin delivery.  This is NOT a problem in the Tandem pump.

The pumping mechanism used in Tandem pumps isolates the insulin reservoir (bag) from the user line, so if bubbles are formed in the cartridge due to pressure changes, the internal bag will expand, but no insulin will be delivered to the user from the reservoir.  The only volume in line with the user at any given time is the insulin in their infusion set and cartridge tubing, and the contents of the 0.3 unit Micro-Delivery chamber.

There is no need to turn off your t:slim X2™ during takeoff or landing.  This system runs on Bluetooth which can operate during flights. If you are also using a Dexcom CGM that you are viewing with your smartphone, turn the phone on airplane mode and then turn on Bluetooth.

If you wear an Animas® insulin pump

A detailed list of where you can and cannot wear your Animas® pump can be found in my May 2012 post.

Animas® insulin pumps can be worn through metal detectors and can be wanded.  They should NOT be sent through x-ray machines.

Animas® pumps should not be worn through full-body scanners.

Click here for more tips on traveling with diabetes!

Fiasp Insulin. The New Kid on the Block

Fiasp Insulin the new kid on the blockIt has been a long  time since the diabetes world has seen a new rapid acting insulin brought to market.  The last one that I can remember was  Apidra released back in 2004.  It is  not surprising  then that the release of Fiasp by NovoNordisk is creating a lot of buzz.  Not to be let out, my son recently began using this insulin. Since Fiasp insulin is the new kid on the block, I thought I would give everyone a brief rundown on the highs and lows associated with it.

What is it?

Fiasp insulin was released by NovoNordisk onto the Canadian market in March of 2017.  Many of us scrambled to get a prescription because it promised better blood glucose levels without pre-bolusing for meals! According to the press release, you can dose up to two minutes before a meal and up to 20 minutes after starting a meal without compromising overall glycemic control or safety!*

How is it different?

A Medscape article states that  Fiasp is  absorbed twice as fast as its counterparts.

It does this with the help of  two excipients–Vitamin B3 is responsible for the increase in the speed of absorption and Amino Acid (L-Arginine)  has been added for extra stability.**

What do users think?

All of this science is great but most people are wondering how well it works in real life settings.  From what I have seen, the bulk of users really like it.  I could only find one person out of about a dozen users who had returned to their old insulin aspart.

When I asked my son for his review I was told “I still have highs. I still have lows BUT if I have a heavy carb  loaded meal, Fiasp kicks butt and I don’t have the same crazy swings that I always did before.” For a 19 year old who can definitely binge on carbs, this is huge.

Other users seem to have  had similar results.

Some people with diabetes found that the insulin peaks were no longer as pronounced.  They had some difficulty battling highs with Fiasp however while others found it perfect for corrections. In fact some people are purchasing Fiasp just for corrections.

Other users explained that the faster insulin action allowed them to more quickly respond to rising blood glucose levels.  This in turn meant resulted in much  tighter control.  The quick action has  also left one user to caution about the timing of any  prebolus.

Most seemed to agree that Fiasp insulin resulted in fewer food spikes and more stable blood glucose levels but as I said not everyone loves it.  For some users, their traditional rapid acting insulin seemed to work better.

Final thoughts…

All in all, most people with diabetes who are  trying the new kid on the block seem to be happy with it.  It offers another insulin choice  for those who struggled with post-meal spikes or don’t pre-bolus meals.

It must also be noted however that while Fiasp is not currently approved for use in insulin pumps in Canada, both those on insulin pumps and MDI are using this insulin aspart.

Finally, I was also happy to see that the price of Fiasp insulin was par with NovoRapid.  This meant that there was no need to worry about an increased cost for out of pocket insulin expenses.  My understanding is that Fiasp insulin is not yet on many (or any) provincial formularies.  This most likely will mean that if you decide to use the insulin and are currently using a publicly funded program, you may have to either pay for this insulin out of pocket or speak to your doctor about having special authorization added to your benefits to ensure full coverage.

Please remember to check with your diabetes team before starting any new insulin regimen. 

*http://www.novonordisk.ca/content/dam/Canada/AFFILIATE/www-novonordisk-ca/News/Fiasp_Launch_PR_English.pdf

**http://www.medscape.com/viewarticle/877892

 

Changing of the Pump

We finally did it…and it hurt. After 10 years of using a Cozmo insulin pump, and almost a year of no warranty, my son got a new insulin pump.

I was warned years ago that when we changed from Cozmo, we were best to simply forget that we ever owned a Cozmo. I was told to go forward as if this new pump was the very first one you had ever used. That was the only way to avoid the grief and pain that came with change. Boy were they right!

The change itself was beyond painless. I knew the pump that my son was okay with (if he had to retire his Cozmo).  The only issue was the color.  I contacted my Animas rep and in literally a matter of days, she had the pump ordered and was in our kitchen to do all of the training. Karyn is beyond amazing!

As we went through the features of his Ping versus the features we had on our Cozmo, Karyn was just as sad as we were to be switching pumps. She told us that she wanted some of those features on her pump! Kindly, another Animas employee asked that I send her a list of some of the features we were missing in hopes of one day being able to secure them for use in an Animas pump.  Did I mention that this company really has great people working for them?

The Ping doesn’t automatically switch basals from weekday to weekend. It doesn’t remind my son when to change his sites. It also doesn’t allow you to preset personalized temporary basal rates or do all of your pump changes on your computer and beam it back to your pump. It does have a remote that speaks to the pump.  Granted we had a Cozmonitor that did that too but we haven’t used it in years and it was attached to the back of the pump.  The Ping remote is a handheld devise that allows me to test my son at night, and do a correction without searching under the covers for his pump.

The Ping also allows him to upload his pump to a website and then Mom can “see” all of his bg tests as well as pump issues and basal rates.  This was a great comfort for reasons I will discuss in another post.

We are now about three weeks into pumping with the Ping.  There have been real glitches. We have both accidentally stopped boluses.  He has somehow suspended a basal rate.  He has failed to put a cartridge in properly and had issues but we will get there. This is still a good pump. It has a warranty if we have problems. We have great support and did I mention that its now under warranty?ping