Hi Daytona, I went ahead and checked out that pump you mentioned T:slim I wanted to ask you is yours the G4?
I have the
Tandem t:slim X2. I picked that because it is upgradeable. When it can talk with a Dexcom G5 CGM coming later this year, I can just update the software and have the new feature. The Tandem t:slim G4 is an older model that can only talk with a Dexcom G4. All the neat new features, like "hybrid closed loop" where the pump and CGM talk back and forth to manage your blood sugar, will be for the t:slim X2 only.
I am assuming you still have to give yourself the Long lasting basal insulin either with a pen or needle.
Nope! The way all the pumps work is that they give you a small amount of fast acting insulin (for example 0.05U) every 5 minutes instead of a long acting insulin. This is a big improvement over the long acting insulin because many of us need a different amount of insulin during the day/night, or when we exercise. So my pump gives me more insulin in the early morning before I wake up, and then I can tell it to not give me any when I'm exercising. Pretty nice to not have to take ANY shots!
What about finger pricks?
Since I have a Dexcom CGM (which I bought separately from the insulin pump), I only test my blood sugar with my meter twice a day, to calibrate the CGM. The next version of the Dexcom sensors will only need calibration once a day, and the new sensors will work with the existing G5 receiver.
the meter does not talk to the t- slim, yet I do like the freedom it seem to bring and it does the calculations for you. Let say, i feel my best at 116, and don't want to go below 90. Can I set it for that amount?
Yeah I'm looking forward to July when the t:slim X2 will be able to read my CGM, so I don't have to enter it in manually. Then in 2018, it should get a feature where it knows when my blood sugar is low, and suspends my insulin. That is something that the Medtronic 670G does already but Tandem is catching up quickly.
On my pump, I set a target blood sugar and it does all its calculations to keep me at that level.
Do you mind if I ask how long did it take for your insurance to approve the unit?
I paid for the insulin pump myself, and my insurance pays for the supplies (cartridge, syringes, infusion sets). I have United Health Care and they only cover Medtronic insulin pumps, which is why I paid for it myself.
Otherwise, how long it takes for approval really depends on how good your doctor is at writing the prescription. I recommend picking the pump you want, and having the pump manufacturer handle your insurance. They will figure everything out and just give you doctor the paperwork to sign, which speeds up the process.
I was told by my primary physician to first do a reading, then from there look at the sliding scale to calculate how much insulin to give yourself.
Sliding scale is not the recommended practice anymore and hasn't been for a long time because it's quite inaccurate. When you read any of those books, they will talk about a few terms instead that help you figure out how much insulin to take:
* insulin sensitivity or correction factor. This is how much insulin it takes to lower your blood sugar by a set amount. I have different settings for this depending on the time of day, because in the morning it need a lot more insulin to fix bad blood sugar
* insulin carb (i:c) ratio. This is how much insulin it takes to handle a set amount of carbs and again is different based on the time of day/meal.
My pump has those programmed into it and it uses those values to figure out how much insulin to give me.
For fast acting the physician told me that I have 15 minutes to eat a meal after injecting 4 time daily. If the pump is injecting insulin into your body or checking every 5 minutes, How do you know when are the best times to eat?
When the pump gives you insulin every 5 minutes, that's for your basal needs and doesn't affect the timing of your meals.
But how long to wait between bolusing and eating depends on a number of things and is very unique per person and per meal. Here are a couple examples from my own life to give you an idea, but the real answer is that if you have a CGM, you need to use it to watch for how quickly insulin starts working, and how long it lasts in various scenarios.
a) I am feeling shaky, my CGM says 80 with an angled down arrow and it's time for dinner. In this case, I eat first, making sure that it's pure carbs without fiber, fat or protein so that it starts working immediately. Then I wait until my blood sugar is over 100 and then I take my dose for the meal and eat the rest.
b) My blood sugar is 180 and the CGM has a straight arrow, meaning it's not changing. I take a combined correction and bolus to cover both the high blood sugar, and the meal. I then wait for my blood sugar to come down a bit, maybe to 120, then eat.
c) I'm going to eat pizza! :devil: I do a split dose of insulin, 1/2 when I start eating and 1/2 2 hours later to handle that pizza digests slowly for me.
I am not producing any insulin, in my pancreas. My physician told me that if i should run out, to go immediately to the hospital, and tell them it is a life or death situation. today I also had tingling in my hands when my reading are in the low sixties. I feel the best at 116. I also have blury vision when it is high. The shot does not hurt, but Lantus can burn when injecting at a higher dosage. My physician did mention I could lose 40 lbs with type 1. I am 5 feet 7 inches, and 125lbs. I can't afford to lose that much weight. I was wondering if the pump would prevent the weight loss?
If you ever run out of insulin (or are getting down to just a week or less), you can go to your pharmacy and they have emergency insulin that they can prescribe to you. Since I have a bad mail order pharmacy (due to insurance) my doctor writes my prescription for more than I need to give me a buffer so I never have to run low while waiting for them to fill it.
Yeah lantus does burn, I don't know of any tricks around that. Lantus isn't used in an insulin pump, so that's one more "plus" in it's favor.
As a type 1, often the weight loss comes from not getting enough insulin. As you get better and figuring out the right amount to take (both daily and for meals), you should regain lost weight and maintain it. So the pump isn't necessary, but if you like the pump, it will help you keep good control.
If you continue to struggle with unwanted weight loss, post back here and I can point you to some good books/chapters on how to gain weight safely.