My husband has had Type 1 for 40+ years and is thinking of going to full Medicare - right now is on my work insurance plan. He’s on a 670g Medtronic pump, and it’s made our lives more normal with the shut off if he goes low at night. Is there another pump option that has the shut off which is covered by Medicare? Or in your experience does Medicare cover sensors etc for Medtronic?
@Hope4b Hi Kathy, and Welcome to the JDRF TypeOneNation Forum! Here you will find many people like your husband who can offer suggestions to many aspects of life with diabetes. Most folks here, like me, offer “non-professional” thoughts based on personal experiences.
The Tandem t-Slim x2 infusion pump paired with Dexcon G6 sensor has automatic insulin suspend, as well as ability to increase basal insulin flow, and also will automatically deliver “correction Bolus” insulin. Currently, it has the most advanced FDA rating - iAIDs [integrated Automated Insulin Delivery system]. My pump supplies, and my sensor supplies are covered 100% by Medicare; I had a small DME co=pay when my pump was delivered.
Just last week, CMS [Medicare] published in The Federal Register its intent to fully cover all [? I think FDA approved] CGM sensors for Medicare Beneficiaries; this new regulation will probably become effective shortly after expiration of the comment period.
Dennis, thank you so much!
From Kathy Remmich
Annie, I am a little late in reading your message but am curious to know what you decided to do. I have been using Medtronic pumps since 2000 although I have been a diabetic for 53 years. Four years ago I was sold the Medtronic 670G pump and related cgm. The saleperson told me how much I was going to LOVE it. But, instead I HATED it and after three months stopped using the cgm. I continued to use the pump but find the functions laborious to work my way through. Seems like the functions are not organized in the most frequently used order. 18 months ago I started using the Freestyle Libre cgm which I really like - no calibrations. No obnoxious noises. But it does not speak to my pump. I really need a cgm that speaks to my pump and am not quite certain what to do. My Medtronic pump warranty has expired so I need to decide what I am going to do.
I took the plunge and switched to the tandem/dexcom and I feel like I have already added time to my life. The different is amazing. The dexcom is better in every single way than the medronic cgm, I don’t ever do finger sticks. And the pump feels so modern compared to medtronic. I was really town about waiting for thier next model, but I can’t imagine it could possibly compete with the touch screen, size and control IQ technology. I am very happy with the switch after almost a month.
This is a relief to read. My medical group is basically making this decision for me (I wanted the 770G upgrade but am not currently up for a battle after two failed appeals), and I’m nervous about the switch to Tandem/Dexcom. Any more insight you have about making the transition as seamless as possible would be so appreciated!
Hi @TD1Champion and welcome to the forum. Sorry to hear about your appeals - and the necessity for them in the first I made the switch from a Minimed (now Medtronic) 508(?) about 10 years ago and find that the benefits far outweigh the negatives I listed a few posts above
Check with Tandem but in various places in the forum I’ve read that you can give the TSLIM a trial run before making the commitment. There is also a Tandem simulator you can download to get a virtual feel for how to operate the pump.
I have been on tandem/dexcom for a few months now and it is absolutely amazing. My only regret is not switching sooner. It’s better in every way. The dexcom is amazing, it works all the time, as opposed to medtronic’s cgm. I go days without checking an actual blood sugar. I’m sure my a1c is going to be lower. I highly recommend.
Definitely go with the tandem/dexcom. It’s better in every way.
Hi again. Just wanted to let you know you can use Dexcom with a handheld receiver or your smart phone. Of course you won’t get the benefits of Basal or Control IQ, but if you’re wary you could still check out is accuracy in advance of starting on Tandem’s pump. I’m not sure if they let you try it before committing.
Thank you so much!
Natasha
Natasha I was a 12yr medtronic pump user. I switched to the tandem tslim x2 in November. The only major complaint I really have is if the tandem cartridge gets too low you can’t start a new site. I am a heave equipment mechanic and I have torn or melted tubing requiring a change out. If I had enough insu I in in cartridge to fill tubing with 670 I was good to go but Tandem will not start a new tubing fill with less than 80 units in cartridge. I personally preferred the AA battery for medtronic but have found that a USB power brick capable of quick charging is the answer for me. I stick the brick in my pocket with my pump while I do whatever I want to. The dexcom cgm is head and shoulders better than the medtronic one. My Dr recommended filling my cgm script prior to starting the program so I have a spare sensor for failure replacement when supplies are low before reorder time. Best wishes and if you have specific questions feel free to ask. Jason
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Hi all,
I am using a Medtronic 770G and thinking to switch to a T:slim. Reaons:
- I have the annoying alerts all the time
- The “learning” and AI side of things seems slow to react (days) when I make a change to my routine like having an intense weekend of exercise if I normally do not get to do that.
- I have needed to replace the pump a few times and this requires several weeks of running it without the automatic mode (closed loop) while it learns. Now I need to do again due to broken case
4.No Ability to give a bonus insulin in Auto mode when my BG is very high. I need to let the pump bring me down very slowly over 12 hours or so.
Questions:
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Does T:slim x2 have problems with infusion sets - I saw some Youtube reviews that indicated there were frequent blockages. I have never had that with Medtronic pumps during the last 10 years.
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How do you feel about T:slim X2 having the range up to 160 before corrections are given? This feels rather high to me and I strive for “normal” BG and being in range 90% of the time.
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How often does the battery need to be charged?
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Are you satisfied with the accuracy of the DexCom CGMS? Have you checked again blood in a tester?
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Besides the carteride filling, is there anything that you prefer in Medtronic 770g?
@xraptorx Hi Kris, and welcome to the JDRF TypeOneNation Forum! Note that this is an old topic, a little out-of-date information wise and you may not get many responses to your question. Comparing the Tandem t-Slim x2 with CIQ algorithm, “an iAIDs” with the MiniMed 770G, “an AID” is not comparing two similar devices - totally different in function. If you are seriously considering a pump change, it might do you well take a close at the MiniMed 780G, “an iAIDs” soon to be released. As a note, I use the Tandem system and really like everything about it - I previously had three successively improved MiniMed pumps. I’ll reply to your five specific questions:
- I’ve been using Tandem pump and infusion sets for more than 4 years and during that time I may have had one occluded infusion sets. Note that the Medtronic infusion sets and the Tandem infusion sets are all manufactured by the same company. I was with a Medtronic rep two weeks ago and she showed me a new style 7 day infusion set which she said works better than all previous sets.
- Don’t confuse basal corrections and bolus corrections. Basal corrections are made on my system, when in sleep mode, if BGL gets as high as 120 mg/dl; when in sleep mode, my range is 95 to 115 and my daily average according to the Reports for night-time [midnight to 6 AM = 110 mg/dl. The t-Slim has three different operation modes - each have differences in parameters.
- My battery level appears to decrease by about 15% over a 24 hour duration - so almost 7 days between charges; I charge more frequently - I have a charging cable connected to my computer for a reminder and convenience.
- The Dexcom G6 has the highest MARD rating of all continuous monitors - I’m highly satisfied. As a matter of record, The Dexcom G6 was the first device ever “FDA APPROVED” for bolus calculations.
- I don’t find much difference between filling a Tandem Cartridge and a Medtronic Reservoir. Some people have “hang-ups” just because it is different, a needle and syringe instead of a hybrid connection device.
I switched to tslim/dexcom after 25 years with Medtronic and, for me, it’s better in every way. I was concerned about the odd cartridge change system, but it’s not that bad. The dexcom sensor is accurate most of the time, enough so that I don’t even keep a glucometer with me for the first time in my life. If I’m not mistaken, I think it will start correcting at 130? I go for days without charging the battery sometimes. I try to charge it while I’m in the shower, but if I forget multiple times in a row, it comes with a really long cord that I can plug in while I’m sleeping. One thing I will say about Medtronic is that they could always get me a replacement pump the next day. I had to wait 3 days over a holiday to get a replacement tslim. During that time I had to use my old medtronic and it felt like an absolute dinosaur. I am only sad that I didn’t switch sooner. I have had a few issues with the dexcom not reading correctly when I had it in a spot where I was laying on it at night and a few “fluky” sensors, but overall it’s great.
Hi @xraptorx . I switched from a Minimed 508 to Tandem many years ago and have no regrets. I use the Autosoft 30 and Autosoft XC infusion sets, and save for occasional scar tissue have not have problems. Note, unless something has changed the Tandem and Minimed infusion sets are not interchangeable. They used to use the same ones but now the connectors are different.
I’m fanatical about keeping my devices charged so I often plug in while I’m watching TV, lying in bed, or even driving - charging blocks and my car charger work just fine; and on the rare occasion when I get down to 20% or less I can be fully or nearly fully charged in under an hour. I actually prefer charging my pump to using batteries. We have several charging blocks we keep ready to use, as well as the car, so there are options in the event of power failure. If you don’t have batteries and can’t get out, you’re stuck. People have their own preferences where that’s concerned.
As far as the starting number for corrections, I hadn’t given it much thought - it is what it is. Hopefully you can find tune your settings to keep you close to your goal that it won’t be a frequent issue for you.
I’m very happy with my Dexcom. I don’t do finger sticks often but when I do they’re within the range of variability (+/-15%) and the two have been dead on a few times although that’s rare. Dexcom can read low the first 24 hours or so. I’ve only experienced that recently since I’ve been on the G6 (a couple of years now).