I have tandem T-slim and I absolutely love it, but I have been noticing that sometimes no matter how much insulin I give myself my numbers will remain high. Once I realize what’s going on many hours (or days) will have passed, usually changing my port/ insertion site helps. what would be even more helpful though is if there was something that told me if the site is leaking or not. I’ve been searching the web and haven’t found anything to help solve this issue. The closest thing I’ve found is moisture indicators for electronics. Has anyone else tried using those moisture indicators or know of a better way or product?
Hi @Katyarvt. I’m glad you’re enjoying your TSLIM - sort of. There are a few things that could be going on in having a little more info about you would be helpful but I’ll take a stab add best I can and ask some questions as well.
Is TSLIM your first pump, and how long have you been using it? If you’re new to pumping your endo will set you up with some initial settings - basal rate, can ratio, insulin duration… Chances are those will need to be tweaked as you learn how you’re body responds. And even if your settings work well to keep you in range (for the most part) now and then something needs to be modified.
You might start with a basal rate check to see if there are fluctuations in your numbers at various times of day while you’re fasting. There are instructions on doing the check online or your doctor can instruct you - they will include how many points difference may indicate need for a change. If you are new to diabetes and/or pumping you should work with your doctor to incorporate changes - in time you will be comfortable making them on your own. My experience (to learn from) when I was new to pumping I was having issues with high readings. I knew I could adjust my basal rates on my own and added a full unit to my rate! Thankfully my hypoglycemic awareness was intact (I didn’t have a CGM at the time) and a fingerstick confirmed the low, which was probably dropping fast. I banshee it and learned that small tweaks - even tenths of a unit - can make a surprising difference for me.
If you’re in a good range until you eat then you may need to change your carb ratio.
I am not a doctor - I’m one of the many many many people on the forum who live with diabetes and share our experiences. You will need to determine for yourself what works, and again please work with your doctor if this is new. Once you make a change give it a few days to settle in. I used to tweak something and if I didn’t see change a day later I did it again. Don’t rush the process unless the change results in a severe reaction of some sort.
Hi Katya @Katyarvt, I too like my t-slim x2 very much - I’ve been using mine for two years.
Concerning “your numbers” staying high, I like Dorie @wadawabbit, think that you should look at both your basal rate settings [for the entire day, not just at meal-times] and your Insulin-to-Carbohydrate ration. That is, unless you have actually seen insulin “leaking out” someplace; of all the infusion sets I’ve used over the years I haven’t had that experience. I have had a few infusion sets get cannula bent and block off effective insulin flow.
There are only two places where Tandem infusion sets could leak:
The connection between tubing and cartridge “tail”. If you see or feel moisture at this juncture, give the coupling another twist. The directions, say to twist-on, and then give another twist.
Where the set attaches to your body. Here too, if insulin is leaking, you should be able to feel moisture with you finger. The cause? your insertion technique, or if something like clothing catches and disrupts adhesion to your body, or the set is placed over a hard place like underlying bone. A little more information here, as to the infusion sets would help me offer tips.
hi @Katyarvt, you already got some good advice. I only want to add that I can tell if a site is messed up because I bolus and something unexpected happens, usually a random spike where there shouldn’t be one. that’s when I know it’s time to mchange sets. I have almost never noticed anything leaking (IE medicine not where it is supposed to be), but my sets are a little different than yours.
I like the thinking, but I doubt if a moisture detector of any kind would be helpful. Cheers and good luck!
An added thought (mine come in bits and pieces😊): it takes a while but over time but over time a person can develop scar tissue, which will interfere with absorption. Be sure to rotate your site and “zones” wIthin it. Abdomen is probably the most popular area but people use the butt, thigh and upper arm as well, making sure to note how well their body responds (insulin may work faster in thigh or upper arm due to exercise so be careful). As for zones, I’ve heard of people assigning a grid, maybe 3x3 or 4x4 if you picture a graph (imagined or on paper) and checking off when they use each one.
Just affirmation of your experience: my daughter felt moisture last night, and realized her Autosoft 30 hadn’t inserted properly.
I don’t know about a moisture sensor, but her CGM certainly showed that she wasn’t getting insulin. She changed the site out and problem solved. When in doubt, change it out.