Showing posts with label pump review. Show all posts
Showing posts with label pump review. Show all posts

Wednesday, November 30, 2022

Review - The T:Slim X2 Insulin Pump

The T:Slim X2 insulin pump home screen

It's been a long time in the coming, just how long? You'll need to read through some of my blog posts from the summer of 2021 to get an idea. However, let's not dwell on time frames and fighting for funding. The title of the blog should indicate that I'm going to tell you all about the T:Slim X2 pump. I'll try! 

The above image was taken a few moments before I began writing - I'm almost at 48 hours on this pump, now and it was handed to me, fully charged. It was suggested that the battery would last between 5 and 7 days for normal pumping (not looping) and that seems correct, right now. I think most of us could cope with one "big charge" of the battery every week or so. Although, the suggestion of charging it for 10 - 15 mins each day seems like a good one. Perhaps it's worth popping on charge while you take a shower or a bath, with the pump unplugged from you at that stage. I'm happy with a rechargeable battery, rather than a disposable one, as it seems more planet friendly and a once per week charge or a few mins each day is not going to disrupt my life.

The pump feels very smooth, almost slippery, to hold. It's made from aluminium and it feels very strong and well manufactured. It's also a very small and light weight pump. If you've ever used a Combo, it's smaller than that. How about one of the Medtronic bricks? It's much lighter and thinner. I actually have some pocket space again! 

How about usage? The image above shows the home screen and the numbers 1, 2, 3. To unlock the pump you tap the numbers; 1, 2 and 3. That's not your PIN! If you want that second level of security then you can add a PIN in your pump settings. I like this form of unlocking, it prevents accidental unlocking and the tapping of functions. If you do leave it unlocked and randomly tap an area of the screen which is not a pump function then, after 3 taps, the pump will recognise that you're not purposefully trying to activate a function or setting and it will lock itself again. You can manually lock the screen by pressing the T button on the top of the pump - that's your on and off switch, in effect. Yes, the pump does still carry on pumping when you press the T button to turn the screen off.

The screen, just like any mobile smart phone - you tap to navigate around but there is no swiping or scrolling, just the tapping of arrow buttons to move up and down the pages or to go back and forth between options. And the display? It's bright and this is my first, albeit tiny, gripe; There is no obvious way to reduce or increase screen brightness. During the evening, I'd like the option to reduce that just a little so it's a bit kinder on the eyes. It is only a minor gripe and in comparison to my old Combo screen it is far superior and easier to look at.

Is it loud? Oh, yes! Fortunately, there ARE options for volume! From high, medium and low volumes on all the important pump functions - and if low is still too much then you can set it to vibrate instead.

There is wizardry in the form of a bolus wizard. I'm delighted to report that it's really very good. It'll take into account your insulin on board (IOB) and your target blood glucose along with your carb to insulin ratio before delivering a bolus. I've used it for every meal, every snack and every coffee for the last 2 days and my time in range has been 99% and 94% for those days.

Insulin to carb ratios and basal rates should be set up before you begin pumping. It's very easy to do those things, you'll probably learn how in your pump start up appointment and they can be adjusted by you at any time.

Temporary basal rates can be set, extended boluses are an option - standard stuff, these days, but they're very useful features and certainly ones that I use from time to time. How about stopping insulin delivery? Because, you know, you might have a hypo sometimes. Easy! it's just a couple of taps away. Insulin can be suspended for a minimum of 15 minutes or you can specify an amount of time in that menu.

Insulin? Ah, yes, that's pretty important. You'll need to draw up your Banting Juice in a syringe and inject it into the cartridge, doing all the air bubble avoidance and removal things. It's a little bit fiddly because the pump and carts are so small. If you have issues with your grip or a visual impairment then you might need to seek assistance at this stage. Also, it's a NovoRapid or equivalent insulin only pump. So... yeah, no Fiasp or Lyummy! *cough, cough*

How about the Infusion sets? AutoSoft 90 was provided and I think they'll be the best option for most people. Other sets are compatible and there is a steel option so, find the one which works best for you - YouTube is your friend, here.

What else? There is s belt clip and a cartridge removal "tool" although, you can remove those with a coin if you'll do what I'm very like to do and lose the tool. You might also get a lot of "suggestions" for places to shop for belts, pump stickers, etc. But! I don't mind a little spam if it comes with a free pen and a ketone check monitor.

So far, I'm very happy with this pump. It is a million miles better than the Combo and I really loved that pump, too. However, it's early days, problems might happen later on and I'll report back if they do.

Thank you so much for reading this blog. I do appreciate your visit and your support. As you might know, I LOVE COFFEE! So I've teamed up with a thing called Buy Me A Coffee. If you enjoy my content and appreciate the time it takes to create such things then you can buy me a coffee! If you leave your Twitter @ name when you buy me a coffee, I will personally thank you. If you'd rather be anonymous then that's totally cool. Thanks for the caffeine!


 

Sunday, November 21, 2021

90 Days on an Insulin Pump



The 90s were definitely "my era". At the beginning of that decade, I was a schoolboy. Ten years later, I was engaged to be married. Everything in between was magnificent; the friendships (some of which still exist today), the nights out, the loves, the football, the TV, the Internet became a big thing and the music... Wow! the music. Of course, many reminisce about their teens and early adulthood and remember things through rose-tinted spectacles. Why not? Holding on to good memories can't be a bad thing. So, the 90s were important to me but you didn't come here to read my autobiography. 

90 days on an insulin pump has become incredibly important to me, too. I'm not sure I would swap the entire 1990s for this experience but it's up there with life changing events. 90 days is often the window used to monitor T1D management. Your HbA1c, TIR, hypo events and all the usual MOT bits and pieces get the once over by your HCPs for that period. I have some data because of using a CGM, some of that looks like this:

- Time in range: 82%

- Estimated HbA1c: 6.8%

- Hypo events: 7

 How does that compare to Multiple Daily Injections? I have some data!

- Time in range: 63%

- Estimated HbA1c: 7.5%

- Hypo events: 9

I am delighted by the improvement in the numbers, of course but they are a second, a distant second, to something more important. Something which, once we've accepted that Type 1 Diabetes is here to stay, becomes something we might strive for; a good quality of life.

QoL will differ from person to person because we all lead different lives. For me, it means reasonable levels of sleep, to not feel overwhelmed at the prospect of another injection, to wake up without Dawn Phenomenon ruining my morning, to be able to bolus for meals in comfort in public, to have more confidence in so many ways... to feel, dare I say, a step closer to being a person who does not have Diabetes. A baby step, perhaps given that I look like Robocop. Your move, NICE.

Ah, yes, NICE. Guidelines, criteria, a tax funded system. I know, I get it. Tax payer funded healthcare must have a criteria for various things which could impact upon the purse. So, unless you meet the current insulin pump criteria, you're going to find NHS funding hard to come by. Your health and wellbeing is secondary to the bottom line, sorry. That's the harsh reality of where we are with insulin pump access in England. All the noise and enthusiasm about Looping trials is super but you can forget Looping unless you're on an insulin pump and for that you need to meet the NICE criteria. A1c under 8.5% and on MDI? suddenly all the exciting Looping headlines don't look so... exciting.

"Keep asking"

"Keep making noise"

Oh, I will. Earlier this month, I reached out to my practice nurse and GP in regards to my switch to pumping and the barriers I am facing in getting full NHS support for it's long term use. We did have a nice exchange and I feel very supported by primary care but, of course, there is little they can do to change the decision of secondary care. Secondary care are understanding to a degree but their hands are tied by NICE criteria and a limited budget. Frustrating, eh!? This isn't a Path To Pumping blog, it's a little overview of the last 90 days, so I'm going to stop this particular subject in this paragraph. Needless to say, we are not done.

A few things have cropped up in other discussions, lately. Some questions which I can actually answer!

How does long acting insulin work in the pump?

It doesn't. The pump continually "drips" fast acting insulin. That becomes your basal. You don't notice it happening as you might not if you've ever had a drip in hospital. Your pump is programmed to give you the insulin you need, hour by hour. For a bolus, you ask it for more!

How are you rotating sites with your pump and CGM?

Legs! Although I have plenty of abdomen to work with. The CGM is a "set and forget" thing for 2 weeks, the pump cannula can then be moved around that. The pump works perfectly well on a thigh, by the way.

Are you going to Loop?

Once I have obtained NHS pump funding and Looping is embraced across the board, maybe! I know some are Looping and have more lows than me but similar numbers in other ways. I will, undoubtedly, try it. It seems inevitable and I expect numbers to be the same or better but the more important QoL will be ramped up another notch.

One of my patients mentioned your switch to Fiasp and Pumping in their appointment!

Good! Apparently, I'm an "Influencer" but I don't try to be. 

It seems that my switch to pumping has gained a lot of interest from my peers and various HCPs. As always, what works for one does not necessarily work for all. However, if you think that pump therapy might work for you then please do start the discussion. Noise will change things for the better for us all. The squeakiest hinge gets the most oil.

Thank you so much for reading this blog. I do appreciate your visit and your support. As you might know, I LOVE COFFEE! So I've teamed up with a thing called Buy Me A Coffee. If you enjoy my content and appreciate the time it takes to create such things then you can buy me a coffee! If you leave your Twitter @ name when you buy me a coffee, I will personally thank you. If you'd rather be anonymous then that's totally cool. Thanks for the caffeine!