One thing that all diabetics who use insulin pumps know is that Your Diabetes Technology may vary. And what works for you may or may not work for someone else. As is the case with the Tandem t:slim. It’s sleek, it’s cool, and it works… for most… as long as you’re not too attached (no pun intended) to a remote or to using Apidra insulin.

For me, it fits, but it’s not perfect. There have been aspects of it that I have been able to overlook because it’s benefits far outweighed the little things that bugged me. One of those things was how the bolus calculation works. As most of you know, I absolutely love and completely rely on my IOB tracker (insulin-on-board). The way they have theirs right there on the screen in simply genius if you ask me and really informative. What I don’t like, though, is how it calculates it in with a bolus:

tslim Reverse IOB

From Tandem’s t:slim user guide.

Basically, what I don’t like is where it only “reverse-corrects” your bolus if your blood sugar is below 70. And that value cannot be changed. While I thought it wasn’t that big of a deal, last week, it proved to actually be a big deal. I fought to stay above that 70 line a lot of the time, and for the most part, lingered in the 80’s when I would test for a meal. For some, that’s a great number. But for me, it’s too close to being an out-of-comfort range to NOT subtract out IOB, especially if you have 2.56u still working in your system. In my opinion, they need to just take out the middle option and let the calculation be based off of your Target BG… because, after all, that is your target, not 70mg/dl (that is, unless you do have a target of 70mg/dl.. and if you do… then you must be one wickedly in-tight-control diabetic). It’s just too risky not to. I’ve had to constantly do the math myself and subtract it out to avoid a drop later, which, with this “advanced” of an insulin pump, I shouldn’t have to.

SO, please, Tandem, make a change to how the IOB is calculated. You have a great pump, except for that little part that could be a major problem for us who rely on IOB calculations.



Filed under dblog, Diabetes

7 responses to “YD(T)MV

  1. bennetdunlap

    I hope you sent a copy to them.

  2. Yes, this! I brought this up in September when I first began on the pump. I asked my trainer about it and she said that Tandem’s view was that anything above 70 was ‘acceptable’. While that may be for some people, I, like you, feel it’s an uncomfortable area to be in for too long, especially with other IOB. Also, they are going to try to get this approved for children soon – I can’t image parents being excited about this. Many children have lows corrected below 80 and their night-time goal ranges are upwards of 120…..70 would be WAY too low for them. I love my t:slim but this is the one thing I hate – I wish it reverse-corrected like my Ping did!

  3. I agree that the 70 mg/dl should not be a fixed threshold, but I’m not a fan of using IOB to modify a food bolus. Maybe it’s just because I’m used to the Medtronic way of doing things, but I tend to bolus more than once for a meal quite often. Either if I eat more than expected, or if I’m at a restaurant and don’t want to give myself the full bolus until the meal is in front of me (but don’t want to eat before the insulin has been delivered either). If IOB were subtracted from the food, this wouldn’t work.

    I do, however, look at the IOB when I bolus, and manually adjust downward if I feel it’s necessary.

  4. Pingback: Clearing The Air | SarahKaye

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