A Review of Tandem's t:slim (Continued)
Part Three: Safety
- 10 seconds to cancel a bolus
- A plethora of confirmation screens, alerts, and warning messages
It's great to make a cool looking, sleekly designed insulin pump, but it's also a medical device infusing insulin. Consequently, I was glad to see a vast array of safety features built into the t:slim — confirmation screens galore, alerts when you have not completed an action for 90 seconds (e.g., you were in the middle of calculating a bolus and forgot to deliver it), red bold text to draw attention to important items, an automatic screen lock following a bolus or when the screen is tapped three times in quick succession (e.g., to prevent accidental touchscreen taps while in your pocket), and a user interface feature called "dynamic error handling" that prevents the user from selecting illogical items in real-time (e.g., you can enter 100 grams of carbs, but the pump prevents you from adding another zero for 1,000).
My favorite safety feature of the pump was the cancel/stop bolus button. After programming and confirming a bolus, the t:slim gives you approximately 10 seconds to cancel the bolus before it ever starts delivering it. On other pumps, programming and confirming a bolus initiates delivery immediately, so unless you have lightning fast fingers, cancelling the full amount of the bolus is very challenging. I found this feature of the t:slim valuable when I had second thoughts about the bolus I just gave. The cancel bolus button also appears right on the home screen as a red "X" during the 10-second grace period, so there is no need to dig into a menu and hunt around for this feature.
Part Four: The t:slim's Durability and Cost
As an outdoorsy and active person, I was initially concerned about the t:slim's durability. Tandem has told me that if a user accidentally cracks the screen, the pump will be replaced under warranty. While I can't say I did my own extensive crash tests, I know that many young attendees at the recent Children with Diabetes Friends for Life conference had "contests" to try and break the trial t:slim pumps, and it was pretty challenging for them to do so — I think in the end it took one t:slim pump thrown at another one to crack it (and it was still fully functional)! The starter kit comes with a hard plastic case that wraps around the pump for additional protection, and the t:slim touchscreen also has a pre-applied protective film. I have not worn the pump long enough to have too many accidental drops, but the durability will be on the top of my mind as I get more experience with the device.
Unlike the Animas pumps and Insulet's OmniPod, the t:slim is not completely waterproof. According to the company, the t:slim has been tested in three feet of water for 30 minutes (what's known as an IPX7 rating, similar to Medtronic pumps) — essentially, it's "water resistant." However, I must confess that I've broken multiple pumps due to water damage, so this is a concern for me. The pump worked fine after I submerged it in a cup of water for ten minutes, though I will need to wear it for a longer period to fully test its durability and water resilience.
Cost and Insurance
And of course, the very, very important question is cost. Insurance companies typically pay for a new insulin pump once every four years, though this can vary. Tandem has already signed contracts with some major insurers, and is currently working with customers on a case-by-case basis to obtain insurance coverage. We understand that the t:slim has a higher list price (about $6,995) than the Medtronic Paradigm Revel (about $6,500), Animas OneTouch Ping (about $6,300), and Insulet OmniPod (only around $600 for the starter kit, although "pods" are more expensive than sets on an ongoing basis), so that is an important consideration for those who must pay co-insurance. However, Tandem has a large staff dedicated to reimbursement, so if you are interested in getting the t:slim pump, the best way to figure out your situation is to contact Tandem directly.
I was impressed and plan to keep the t:slim assuming my insurance will help cover some of the cost (fingers crossed!), though the devil will be in the details since I changed to my current pump fairly recently. That said, I'm definitely still interested in trying the upcoming Animas Vibe (integrated with the Dexcom Gen 4 CGM), Insulet's smaller second-generation pod, and Medtronic's MiniMed 530G with low glucose suspend — as a reminder, all these devices are currently under FDA review or will be submitted to the FDA soon. Indeed, this is a great time for patients with so many innovations coming, and I had a great week trying out something so new. For more information on Tandem's t:slim, visit Tandem's website.
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NOTE: This information is not intended to be a replacement or substitute for consultation with a qualified medical professional or for professional advice related to diabetes or another medical condition. Please contact your physician or medical professional with any questions and concerns about your medical condition.
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An actual working pancreas would never pull this kinda crap! An actual working pancreas wouldn’t be like, “Hey, I’m just gonna take the afternoon off.” An actual working pancreas wouldn’t jump ship like a coward and march its squishy legs up to the nurse’s office and hide out there for two hours. It wouldn’t whine the whole time, complaining that A.) it’s disconnected and B.) it’s not charged. ...