32 Responses

  1. Bennet
    Bennet February 7, 2013 at 5:48 am | | Reply

    Thanks Will.

    Delightful read as usual.

    I the buzz I hear is Tandem may not have sent the desktop software to the FDA in a timely manner and if that is true then maybe FDA shouldn’t get the ding. Either way is the freaking software gonna work on Mac as well as PC and what flavor of OS? XP and 10.6? How about off the desktop and into the mobile?

    I think your last point about usability is really sound. Maybe that is an area where some patient input is needed in the FDA thinking process. Also I wonder how we do that.

    … I just want my damn insulin…

    1. Melissa
      Melissa February 7, 2013 at 7:09 am | | Reply

      Tandem’s software is web based, not desktop software.

      From their website:
      “t:connect* is our web-based Mac and PC compatible therapy management software that works with most internet browsers.”

      1. Bennet
        Bennet February 7, 2013 at 11:56 am | | Reply


  2. Andrea
    Andrea February 7, 2013 at 6:22 am | | Reply

    I’m on the other side of the atlantic and am very much looking forward to the t:slim finally getting CE certification for europe. In the meantime, I thank you (and other t:slim users) for your reviews. That last comment really hit home though. I’m still holding on to my Cozmo, partly because when I looked at the Animas Vibe, there seemed to be SO MUCH more button pressing just to get a bolus (or change any parameters). It looks like all pumps are going the way of extra button pressing for safety but seriously, four “are-you-sure” screens? That could lead to missed boluses for forgetting the final “Yes I’m freaking sure!”

    1. Skye
      Skye February 7, 2013 at 1:25 pm | | Reply

      They thought of that all ready, don’t worry, the t-slim comes with a “hey! you forgot to finish this bolus!” alert too, so if you zone out before getting through all the “yes, I’m sure screens”, it notices and calls you on your laziness.

      1. Skye
        Skye February 7, 2013 at 1:29 pm | | Reply

        The highlight of the “hey you didn’t finish your bolus” alert though, is that when you acknowledge the alarm, it takes you back to the screen you left off on, so you don’t have to input everything again, which is a nice touch.

  3. David
    David February 7, 2013 at 8:54 am | | Reply

    Tx for the review. Frustrating to realize the extraneous steps to bolus were required by the FDA. Another fail by the FDA to grok life with T1. Of course, insulin can be dangerous but we use it daily the way other people get in their cars and drive. Should drivers be required to press several buttons to deactivate a warning message, “Are you *sure* you want to drive?” every time they get in the car?

  4. Scott E
    Scott E February 7, 2013 at 9:38 am | | Reply

    Are you sure you would give up the t:slim because of this, Wil? Are you really, REALLY sure? :)

    1. Bennet
      Bennet February 7, 2013 at 11:57 am | | Reply

      You have to think about the Will cranky factor… LOL

    2. Wil
      Wil February 8, 2013 at 9:12 am | | Reply

      Scott–No, I’m not really, REALLY sure. Not yet. But here’s the issue: As far as I’m concerned there are two reasons to wear a pump. The first is a theoretical improved accuracy. I say “theoretical,” because while pumps are heaps more accurate than shots, I suspect that in general they far exceed the accuracy of diabetes, the human body, and the human operator. At least for me, anyway, I’m not sure I need THAT much accuracy. The second reason to wear a pump is it used to be move convenient than shots, and that’s the biggie for me. Right now it’s a toss up. The screens are sufficiently annoying that I’m trying to decide if it’s just not more convenient to whip out a pen. And if this is the way all pumps will be in the future, it’s not just a t:slim issue, it’s a pump issue. For impatient, or “cranky” patients like me, pens may be the way of the future (will someone please design me a skinny pen with IOB tracking????). The other side of the coin, that has me on the fence, is that I do very much like to make use of Temp Rates. That’s one place the worst of pumps trumps a Lantus shot. You can’t take away a basal insulin shot.

  5. Bill Woods
    Bill Woods February 7, 2013 at 9:55 am | | Reply

    Will great article. Being a t:slim user myself I agree with everything said.

    The part about the several Clicks (touches) to deliver a bolus is annoying. But like you, I heard this was part of the new FDA requirement.

    Who knows, maybe all new insulin pumps will have this “safety” feature included too.

    Nice piece as usual.

    1. stacey nagel
      stacey nagel February 14, 2013 at 8:31 pm | | Reply

      if bolusing takes too long for you, then just use the ‘touch bolus button”… eating 25 grams of carbs… click it 5 times….
      50 grams…- click it 10x.
      my son’s fav feature – just like the Cozmo….

      1. Bernard Farrell
        Bernard Farrell March 26, 2013 at 3:57 am | | Reply

        FYI I turned off the touch bolus on my previous pump and also on the t:slim. I found myself stacking boluses far too often. This was because I didn’t look beforehand to see if there was IOB. I decided the touch bolus was a luxury I couldn’t afford.

  6. Judi
    Judi February 7, 2013 at 10:07 am | | Reply

    Wil, just wondered if there is some sort of problem and you need to change the insulin bag before it’s empty, can you get the insulin left in it out, like you can in a normal cartridge?

    1. Skye
      Skye February 7, 2013 at 2:09 pm | | Reply

      Yep, unofficially of course, you just stick the giant syringe back in and suck it back out. Easy peasy.

  7. Colleen
    Colleen February 7, 2013 at 10:30 am | | Reply

    Great review! I’m a t:slim pumper as well. So far, I’ve really enjoyed it. It’s less of a burden than my old MM 722. The touch screen might not sound like a big deal to most people, but it really doesn’t make my everyday life a little bit easier. And really what more can I ask for?

    The personal profiles have truly been a life saver for me over the last few days as well. I was put on prednisone for 9 days (I’m 3 days in right now), and I was able to duplicate my “Normal” profile and tweak all of my settings without worrying about messing up my regular program. Love it! I think this has truly been the best feature I’ve used so far.

  8. Doug
    Doug February 7, 2013 at 12:15 pm | | Reply

    Great article – saying that seems redundant.
    even more reason to try to keep my cozmo alive longer….
    cant wait to see what / when /if the smiths patents are used for

  9. Melissa
    Melissa February 7, 2013 at 12:52 pm | | Reply

    Don’t quote me on this, but I *think* the number of “are you sure” screens is based on the amount of insulin delivered. I just bolused for 10 grams, just under 1.5 units, and I only had to click “Yes” to confirm request, then “deliver” to deliver the insulin. So two “are you sure” screens. I do know there’s the smaller “are you sure” screen that is like in the middle? I see it occasionally but never really paid attention it them. I am now in the “just press the buttons until it says delivering” mode. As much as it might be an annoyance, I think the couple times I might second guess my decision or want to stop the delivery for whatever reason, I’ll be thankful for it.

  10. Skye
    Skye February 7, 2013 at 1:55 pm | | Reply

    I was told yesterday by “my” t-slim rep that the software will be out by the end of the month at the latest, so that should soon be a non-issue.
    For what its worth, I was also told that the not-yet-in-existence T-slim integrated with a CGM (Dexcom) should be available by the end of next year. I’m already excited about that because trading my MM Paradigm all -in-one pump & CGM system for TWO thingies to carry around and give input to is kind of driving me nuts. I’ll get used to it, but its not something I’m adapting to very easily.

    No other pumps come with so many “are you sure” screens, so did the FDA just decide this was a required safety feature and all new pumps have to come with them, or is this just the excuse t-slim is handing out so we don’t blame them?

    1. Bernard Farrell
      Bernard Farrell February 7, 2013 at 3:31 pm | | Reply

      The smaller screen in the middle only appears for correction boluses. I was bothered by it until I spoked with a Tandem person. They clearly made a mistake with this screen because all other screens with a Yes/Cancel button combination appear with the buttons on the bottom of the screen. So when i first saw this screen it looked like stuff was missing.

      With meal boluses there are more confirmation screens. If you choose an extended bolus on the last confirmation screen then they throw in a few more for good measure. I suspect that some of these were an FDA requirement but that some were added by Tendem to ensure FDa gave a green light, I mean who needs a confirmation screen after loading the pump? Who would load it and then NOT resume the insulin delivery. That certainly seems extraneous.

  11. Mary Dexter
    Mary Dexter February 7, 2013 at 2:40 pm | | Reply

    As of Dec.26, I’m back on pens. My pump would say it was giving me insulin, but too often it wasn’t. With the pens, when I take my insulin, I know I got my insulin. Still carrying the pump around for the Bolus Wizard calculator and CGM, but no reservoir. So far, it hasn’t noticed that it still isn’t giving me insulin.

  12. Bernard Farrell
    Bernard Farrell February 7, 2013 at 3:37 pm | | Reply

    Wil, excellent review as always. I’m really interested to see what Tandem does with thos Cozma patents. I find it funny that Cozmo is now held up as a paragon because I know people used to complain about the number of buttons presses needed on the Cozmo to deliver a bolus. Something ironic about this. ;-)

    You mentioned the ease of numeric input. But one very important difference with the Tandem is the accuracy. You can set a basal rate or 1.37 units per hour, or bolus 2.58 units. I think this is going to take some getting used to.

    I was in hospital recently on huge doses of steroids. Before with my Cozmo and Dexcom 7+ I never managed to really control the blood sugars. With the t:slim and Dexcom G4 combination I was able to keep my blood sugars close to 140 despite taking almost three times as much insulin. I know that part of that success was the ability to move basal rates up or down by 0.01 unit increments. I think parents are going to LOVE this level of accurate delivery.

  13. Lisa
    Lisa February 7, 2013 at 4:55 pm | | Reply

    My 13 year old son wore the Cozmo since he was 5 and could not wait for the T-Slim to be available. This review is incredibly accurate. Overall we love the T- slim and highly recommend this pump. Completely agree about all the advantages and about the LONG time it takes to do a site change as the main disadvantage.

    As for the “are you sure” screens, we were told that all new pumps moving forward will have this precaution mandated by the FDA. So this would not be a disadvantage of the T- slim as compared to other pumps.

    The T- Slim is a great pump!

  14. David Aissen
    David Aissen February 9, 2013 at 8:42 am | | Reply

    I’ve been using the t:slim since September ’12. Previously I used the Medtronic/ Minimed since 1986. The touch screen is great to use and have no problems with the confirmations.

    One issue is the size of the display. Being a little vision impaired I have to use a magnifying glass when reloading the pump, especially when I’m tired.

    I had a problem with a cartridge. When changed it would throe an stop alarm. T:Slim immediately replaced my supply of cartridges based on the Lot Numbers. Great support and service.

    Finally, I wish I had the software. Great pump!

  15. David Parker
    David Parker February 15, 2013 at 5:23 pm | | Reply


    Your comparison of pumps versus injections missed what I consider to be the two most significant advantages of pumping. First advantage: variable basal rates to cover such things as the dawn phenomenon, Second advantage: no fighting with the variability of long acting insulin to achieve correct basal rates. As you point out dosage accuracy is a nice effect, too.

    1. Wil
      Wil March 25, 2013 at 2:36 pm | | Reply

      Good points both, as is the importance of temp rates when begining to run low!

  16. Joe
    Joe April 10, 2013 at 1:38 pm | | Reply

    I’m a MM Paradigm user and am considering switching to the t-slim. After reading several online reviews, one thing is not clear to me. I know the t-slim has a manual calculator built into it’s input screens and that it displays IOB, but does it have a bolus wizard that automatically subtracts iob from a correction (or carb) bolus?

  17. Nell
    Nell July 31, 2013 at 2:39 pm | | Reply

    Thanks for all this user info. I’m going to order my t:slim tomorrow.

  18. Ellen
    Ellen September 12, 2013 at 8:16 am | | Reply

    Thanks for the info about the button pushing. I have an animas ping and it also has that “feature”. I’m thinking about going back to Minimed because its interface was more streamlined and for the user -vs a cya for the manufacturer. I will definitely not get this. I like the recharge feature – except in a hurricane. The ping loses the IOB when you change the battery, but I didn’t have that problem with minimed. So, I’m going to do some pump comparisons but Minimed will probably win

  19. Jenn
    Jenn October 5, 2013 at 11:41 pm | | Reply

    I love my t:slim! The colors are the main reason I chose it. I have retinopathy and macular degeneration in my eyes and the color really makes it easy for me. I was on a paradigm many many years ago, but only during my pregnancy, but looking at the different pumps in my Dr. Office, this one was the easiest for me to read. I had no problems with having to get extra cords for the car and at home because it uses the standard 3.0 USB that most smart phones use so I just hook mine to my phone charger if I decide to (was really helpful during my long car ride over labor day weekend) I love the T:Connect program on the Tandem website. It’s straight forward and very easy to read and understandable and you can easily see patterns with the graphs. And since it is HIPPA approved all I have to do is give my dr the email and password and she can look at it while on the phone with me if I have concerns or issues. I don’t have pockets in my work uniform so with the smaller clip I got from the Tandem Rep I can clip it on and most people think it’s just a pager or small PDA, unless they really notice the tubing. I actually like that it asks if you want to correct a high BG because there are days I won’t be able to eat for some time and what if for some reason the correction works too well? Then I have to treat the low! So what I do is not correct but increase my basal temporarily by 20% which will bring it down a bit more slowly. Yes it does take a bit longer to change the cartridge and fill the tubing, but I look at it this way, I would rather take the 10-15 minutes it takes to change the cartridge than take 27 seperate injections every 3 days. Since I would have to correct before I ate, and did a meal bolus an hour after I finished eating due to my gastroperisis. Plus being 30 makes the technology a little easier for me to adjust to than say an older diabetic. Mainly if you are starting to have vision issues due to retinopathy or macular degeneration of any kind I highly suggest this pump bc of the color features and the way they use them. Anything in blue affects correction and or carbs eaten. Orange is for system tools like history, alarms, log and so forth.

  20. Matt M.
    Matt M. November 30, 2014 at 9:35 pm | | Reply

    It’s now close to the end of 2014, and I have used the t-slim for about 5 weeks, and I too am not crazy about the reservoir and tube change, and the additional confirmation screens. In fact, in the first three weeks of use, my neck kept hurting more and more as time went by, and I didn’t make a connection until about three weeks later. It was all the extra neck bending I was going, and the additional time fooling which the reservoir and site change. From start to finish, it takes me about one half hour to change the reservoir, fill the Inset tubing, and then insert the cannula as to which I also have more trouble with the Insets than I have had with the Medtronic quick-set.

    Now, it has been about one and a half weeks that I have been bringing the pump up to head level to do all the push buttons, and my neck does feel better to a degree, but not enough for me not to suggest Tandem get a remote control that can be worn at the waist, and brought up to head level to make all the pump decisions I need to do, and this way I don’t have to pull out tubing when I want to do a bolus or something.

    The reason I say much of this is that I have a bad neck, and for future t-slim customers that may also have a bad neck, a remote would be quite handy, and I would also suggest that Tandem give potential customers a chance to try an Inset vs Quick-set infusion set, and see which is preferred. I called Unomedical over in Denmark who makes the Medtronic luer lock Quick set, and the man I spoke with said the Medtronic luer lock quick-set is universal, and would work with any pump that requires a standard luer lock like the t-slim.

    I too am thinking of going back to a Medtronic pump even tough I am not thrilled the accuracy of their CGM at this point being the end of 2014.

  21. Tom
    Tom December 16, 2014 at 6:01 pm | | Reply

    Do you ever have problems with bubbles in the t:slim tubing?

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