Insulin Pump Review | Diabetic Doctor Reviews Tandem t:slim X2

In this video, I review and give my impressions of the Tandem t:slim X2 insulin pump.
Be sure to subscribe! kzbin.info?s...
Over the past 5 months, I've used this pump exclusively and have become quite accustomed to it. This video contains my honest thoughts!
Time stamps below:
0:00 Intro
2:10 What I Love
2:12 Fewer Hypoglycemic Events
2:39 No Shots
2:57 Easy Site Change & Easy to Use
3:15 Battery Life
3:36 What I Don’t Love
3:39 Corrections
4:15 Touchscreen Issues
4:34 Stops Working?
5:10 Final Thoughts
Follow me on my socials!
Instagram: dr.mike_md
TikTok: tiktok.com/dr.mike_md
Twitter: drmikeherring
Don't forget to like/comment/subscribe for more content!
As always, thanks for watching!

[@heathersharp9570]

I've been Type 1 for 62 years, and just got a T-Slim x2 about four months ago. I use about 17 units of NOVOLOG/day; there have been no problems with insulin delivery as the cartridge empties- thank goodness! I have a significant problem with "dawn phenomenon" that starts at 5:30am, and have changed my basal to combat this irritation successfully 👍 Good luck with the daily battle because it's worth paying attention. Thanks for your observations.

[@deewinston5651]

I’ve had the Tslim and Dexcom for a year now. I had the Medtronic minimed for about ten years. Before that I just did insulin injections. I’m 71 and have been a diabetic for 34 years. I really like the Tslim and Dexcom combination. My A1c is 6.5, which is good for me. I have always been pretty brittle, either really high or really low. A rollercoaster ride. Now that I have the Tslim, I have experienced fewer lows for sure. I have started prebolusing about 15 minutes before meals. I think it has helped not to have such a large spike after I eat. It’s not perfect and obviously not as good as a healthy pancreas, but I have been very happy with it so far. I think when I wait longer to change my site because I don’t want to waste the insulin, I’ve noticed higher blood sugars. I think the site might not be as sensitive to the insulin after three days, so I’m tryin not to put as much insulin in my cartridge when changing. Thank you for your video. It’s good to hear about others experiences.

[@renumanishgurbani7527]

Nice to see you again Angel...well done

[@marcchase4042]

Hey Dr Herring- I currently take 4shots daily (Novalog and Tresiba) and I am about to receive my Tandem x2 after years of pressure from my Diabetes Dr at the Joslin Diabetes Center in Boston (patient there since day 1 and I go 4 times yearly )- I am 72 years old and this August (2nd) will mark 60 years as a type 1 Diabetic- I am worried about the “old dog-new trick” thing- Diabetes has taken it’s toll along the way, and low blood sugars is ( and has been ) an issue - I appreciate your time making a video like this to help folks like me- With respect and gratitude Marc

[@DrMikeHerring]

I was treated at Joslin for 15 years! All the best

[@pranavkakkar7637]

Great review!!! My grandfather uses this, he used to use theMedtronic 670G but he says this is more accurate and the insulin pump itself is way less intrusive and easy to use.

[@DrMikeHerring]

Awesome! Glad I have some context versus the Medtronic!

[@kristinipp2995]

We absolutely love this pump system so so much!!!

[@DrMikeHerring]

I’ve been enjoying it so far!

[@michaelbusch3809]

I have been type 1 for 53 years. I am in the process of switching to Tandem/Dexcom from Medtronic 670G. I have used Dexcom in the past and loved it. Thanks for this video. It is good information for this new user.

[@michaelbusch3809]

I use Humalog U-100. My insulin usage varies greatly depending on the amount of exercise I am getting.

[@DrMikeHerring]

53 years! Dang! Glad you found the video helpful!

[@emergensiexit]

fuck Medtronic. horrible products and more horrible customer service

[@ntinaxatzi1056]

​@@DrMikeHerring ❤

[@TheHanStudios]

I've been on the T Slim X2 since Aug 2018 and G6 since July 2018 when it came out. I've had very few issues with the pump and love it. I'm currently on the beta Mobile Bolus update for the pump, one of the lucky few able to test it. Mobile bolusing is great and works exactly as you would expect, it just forces me to interact with the pump at least once a day due to the 24-hour auto-off, which is fine. Mobile bolusing is great and works just how you would expect, and it really makes me feel like we're entering the next phase of Diabetes management. I agree with you on the correction issue. I've gotten used to doing my own corrections pretty often if there is a slightly extended period of time where I can't monitor the BG to make sure it actually does go down. But, once it does go down, the pump does a good job. So, you're right in that you can't really trust the correction factor and there is a limit to how much you can set a base correction up to, and T Slim unfortunately is only able to make like 1 correction bolus per hour. The main thing is your formulas in the pump - correction factor, insulin sensitivity ratio, etc. It took me a while alongside my Diabetes Specialist to find formulas that worked really well for me. If I go to sleep around the 110 range, it stays pretty much flat as long as I didn't have a food that would affect me later into the night like a high protein meal, which is happening right now haha. When it comes to the CGM, for anyone having issue getting the full 10-day wear out of the sensor, I recommend wearing on the arm as I used to have tons of issues with sensor failing by day 6 or 7 and lost signal and other issues. Once I switched to wearing on the arm, I always get the full 10-day wear and never get noticeable signal errors either. Since everything I wear works so well together, I rarely have significant issues, but there are some from time to time, especially now since I've been going back into the office at work full time. The main one is an occlusion alert - something I can never predict will happen and something I definitely hope doesn't happen. Because of this, I carry some backup sites with me at the very least and often a pre-filled cartridge to go alongside it if I may hit the 50-unit or lower limit around the same time. It is unfortunate that you can't re-use a cartridge if it goes below 50 units and you need to change a site. I haven't tried yet but I may end up just trying to pull the insulin out of the old cartridge just to make sure insulin doesn't get wasted, but I haven't had to do that yet. Also, I've only accidentally pulled out my infusion site once for my pump, so I've been pretty careful and/or lucky. I use the pump with the case/clip and just have it clipped on my pants, but it definitely can get annoying, not so much with the tubing part but the pump/case itself. I occasionally get it caught on a chair arm or a tight doorway, so I just have to keep my surroundings in check at all times. The pump comes with its own built in screen protector and I'm glad it does because from all the bumping around I've done over the years, there's a small scratch on the device. However, there isn't much we can do about that since we can't perfectly protect the device at all times. For anyone on the fence, I suggest reaching out to a local rep, giving Tandem a call to inquire more about it and also asking other people like myself who have used it for a number of years how our experience has been and any questions you may have about actual wear and use. For me, I've only seen the pump get better and better with each update. Once I was able to fine tune my ratios with the help of my Diabetes Specialist/team, it was so much easier than MDIs and way more effective at control. I also have noticed far fewer lows, but I still get the occasional lows like 5-9% of the time, and I attribute most of that to just my aggressive correcting of highs which is something I'm always working on. Even then, it's nice to have that kind of fine control, and I usually am right in my corrections. Lastly, I wanted to point out how you said you use 50 units of insulin per day and consider that a lot, haha. I use around 100 per day - a cartridge lasts me about 3 days on average. I would assume the more insulin one needs, so in my case, around 100 units per day, the more likely you are to have the roller coaster/swings in your blood sugar since it makes it harder to fully control what comes from the insulin usage. But, it isn't something I or someone else can easily change because that's just our sensitivity factor. From the start of my diagnosis, I always had a relatively high sensitivity factor, aside for the honeymoon period. I've gotten used to tailoring my ratios to fit my needs and with great results. My A1C is 5.6% and has been in the 5.8% for many years, close to 5.8% for just about every A1C test since diagnosis nearly 8 yrs ago. Good luck to anyone thinking about a Tandem pump. Definitely ask questions and chat with other people that use the devices! You may find the answers you're looking for!

[@pattilieb3469]

Like your honesty. I’m following your site. Type 2 user. Thx.

[@iroshiadikari3989]

My dear Doctor friend, today I started follow your first step of your instructions. I ate vegetables. Thanks a lot. I will expect your instructions as usual for control my level of sugar.

[@DrMikeHerring]

Keep it up

[@callmescout5831]

Ever thought of trying DIY looping with Eros Omnipod? My target is 83 and it’s only possible with this system! My last a1c was 5.0 and with barely a low ever. I’m also very low carb Dr. Bernstein follower. My standard deviation is 27 for the past 90 days. This has literally been life saving and changing for me! I can exercise, like 10k steps sprints and walking/jogging in the 80’s for bg and maybe once in a weeks time need one glucose tab in the middle and keep on going.

[@kirkp]

Hey are you still on this system and low carb? How's your bg after a year?

[@callmescout5831]

@@kirkp yes I’m still on this DIY looping system! Wouldn’t trade it for the world! I’m using Dash pods now though since they cracked the code to use the Bluetooth! A1c from 5.0 to 5.5 for over four years now!!!

[@DarkWolfWRX]

I was just informed about this pump today. I have been sticking with my Medtronics since I had thought they were the only closed loop system. But seeing this makes me want to change. From what I can see this one is more convenient and potentially much cheaper.

[@DaBuick]

Medtronic closed loop was a nightmare for me. The sensor demanded calcs constantly so I didn't sleep while using it. The dexcom/tslim has been a significant improvement in quality of life and my A1C is lower than when I used medtronic.

[@user-nr5he3ic9o]

If you have time you should do a update and tell everyone what the tslim is like after a year. It would be interesting!

[@knightzero2489]

I know this is a year old but it was the first video when I was looking for reviews on this pump. My doctor is wanting me to get it if my insurance will cover it. I've been type one now for 32 years and I was 1 when I first got it. Information was very helpful thank you! ~Christopher~

[@sibogomez5796]

Thanks alot for good information Dr. Mike ❤🤩🤗👌

[@DrMikeHerring]

Happy to put it out there!

[@sibogomez5796]

@@DrMikeHerring 😊🥰thanks U

[@asm_canucks]

Hi! I'm 34YO and type one for about 22 years. I'm actually still on pens. Can't still see myself wearing this kind of device 24 hours a day. It was actually hard enough to accept to go with my librelink sensors, even if they're pretty tiny. But looking at the kind of results you're getting with your pump, maybe some day i'll have to think this through...

[@drewzerbruizer]

I experience that same thing with the cartridge being low, and it not being effective. In my experience it's the age or the damage of the infusion set that causes that. If I am certain the infusion set is delivering properly, my 670g will go down to below 10U and be effective. If I bolus and sugar goes up...something is wrong with the infusion set and time to change it. That's the rule I adopted. I am about to switch over to the Tandem. Super stoked.

[@timjones4905]

I use a tslim too. And it keeps my sugars far more stable than anything else ever has. I’m 34 years in. My last a1c was 5.5% and very few lows. You can get lower night time control by lowering your sensitivity setting so it will give you more for the reading you get. Normally at night I am around 105-110. The new smaller version out soon will eliminate the touch screen issues.

[@shauntayecooper9489]

Good to know

[@kidsrocket2932]

Thank you for good information 👍

[@DrMikeHerring]

Thanks for watching!

[@lumix14]

I also have the T:Slim X2 and I agree that it can not be as responsive to correcting a high. What my doctor has told me is it gives you about 60% of a full correction to bring you down some, but not make you go low. But you can always manually do a full correction.

[@DrMikeHerring]

That’s what I do when I’m awake, but my biggest issue is when I’m asleep

[@victorrodriguez1234]

That interesting doc, take care so much 👍

[@DrMikeHerring]

Cheers

[@victorrodriguez1234]

@@DrMikeHerring cheers

[@lakegirl239]

I have used Medtronic forever and can upgrade to the 670 system. Their sensor reviews and my own experience with the sensors is a stopper. I’m using Dexcom but there’s no interoperability with Minimed. I’m exploring changing to t-slim, but not being able to set my own target and loading the insulin cartridge-those are two issues Medtronic has the advantage. Anyway, without a clip on the pump, where do you keep it? I lost the Dexcom receiver once and was lucky enough to get it back so I stuck a phone ring on it and a tether! No more losses. Ideally I’d like a Medtronic pump with a Dexcom but that combo is n/a. What do I do? Still doing my due diligence.

[@kristinipp2995]

The 50 unit thing could maybe be that the insulin gets warm and doesn’t work as well. Just my personal thought there, no idea if that’s true. For my son I’ve noticed the 3rd or 4th day he requires a bit more insulin to get him down as a pose to the first 2 days when it’s crazy amazing.

[@jane-i5u]

Just got the tandem. Second day. BS was fine when I woke up but then started going up. Dawn phenomenon? Was disappointed that night mode didn’t anticipate this. Had to give myself two correction boluses. Good thing is on MDI would have been much more aggressive on correction and probably have gone low. Trying to be calm and let pump do its thing. Hard for this OCD person with last A1c of 5.3.

[@eastonguy62]

Hi there. Nice review. I’m also an internist with type 1 using the T-slim x2. I started with basal iq but have not yet updated to control iq. Like you, I’m not crazy about the preselected unchangeable glucose range. It makes sense to me that we should strive to keep our glucoses as normal as possible so I try to stay under 100. Not easy and I’m often on the roller coaster. Im using Lyumjev. I like it. Haven’t had problems like I’ve heard others have had with it including pain and burning. It does seem to not work as well by the third day though. Not sure why. Which infusion set are you using?

[@hezvandermeij]

Hi question! I'm from the Netherlands and use mmol/L not mg/dL so forgive me if the converter gets some numbers wrong 😂😅 Over here it's common to say that "normal sugars" are anything between 4 and 8 (so that would be 72 and 144), with 6,4 (115) being the perfect spot if you wanna aim for one rate. Is that so different over where you are that the preselected is off for you? Because for me it's near perfect settings Just curious, I love learning these differences !! ❤

[@hezvandermeij]

I fully get that you want it a bit more aggressive with corrections at night, for me the less aggressive is perfect. Somewhy at night my insulin resistance dissapears or something, if nothing happens I'm stable but if I take a correction now (still on the dreadful😅 670g, waiting to be allowed to change over), I'll crash and land typically in 2,2 mmol/L (39,6 mg/dL). Seeing as I have hypo-unawareness and my alarm often cannot wake me, this could end badly so I'm happy with hearing it's not super aggressive on it😅😊

[@zihonguyen2088]

I have type 2 diabetes. Thank you for sharing.😘

[@DrMikeHerring]

Thanks for watching!

[@Ry_Rides]

4 days battery doesn’t seem like a lot. I haven’t counted but my minimed lasts a hell of a lot longer. Also with the correction bolus, is that not customisable as sensitivity is different from person to person?

[@anupsatheesababu9205]

Thoughts on the omnipod? Would love to see a review on the omnipod system in the future!

[@DrMikeHerring]

It doesn’t talk to my Dexcom so I didn’t go for it!

[@Mayegelt]

Will you review the omnipod soon when the Dexcom and Libre support is added? (quoted as Summer-Autumn 2022 on various sites)

[@karlwarner7438]

My guess on the end of the vial/vessel is the insulin is starting to degrade. I have similar issues w/my 670g.

[@athenapop2878]

Hello Doctor Mike,tenho diabetes do tipo 2 qual é o melhor medicamento? Thanks

[@ChilangoDios333]

I use the tandem X2 with the dexcom G6 with U500 insulin from humalog I get about a week and a half of use and then I replaced the site and tubing sometimes I can get it to last as long as 10 days

[@laurinarem2454]

Hi Mike: I agree with your challenges. The pump does not seem to allow the bolus to work quickly enough. The pump will not allow my bolus to work right away. It strings it out and so consequently I always go up to 200 or more post meal....no matter what I do. It is frustrating at best and occurs whether I give the insulin 15 minutes before a meal or not. I keep working on it....but I guess I need this pump to deliver right away what I tell it to since I know my body. Ugh. Otherwise I love the sleep mode. It works well for me.

[@dwightl5863]

So you are saying that a bolus that takes 30 seconds to administer is not quick enough?

[@jane-i5u]

Personally I have used Omnipod and Medtronic pumps only. Medtronic was my first pump 18 or so years ago. Never liked it because it was so boxy and not very intelligent. Went to omnipod but had to change when I went on Medicare as copay was very expensive. So went back to Medtronic. Recently changed to MDI. Pump fatigue. Doing well. Just ordered Medtronic’s I port. Have to change device every three days but all injections go through port. Looking forward to trying.

[@tiptiktok320]

Very good

[@andybortel8549]

Could be a site issue at end. Try the trusteel infusion sets.

[@lethibachtuyet5855]

Do you think she will recover soon i think this sickness so serious and hard to be recovery yes

[@pallavimishra1843]

Very useful vid

[@DrMikeHerring]

Glad you liked it

[@NeckbonesNRice606]

Not sure if the grey area is the training. How do you work your way around not getting the basal and the cq control and Hearn you bolus

[@jefferylee3121]

i have caught my pump on door knobs so many times i am also looking forward to the new tandem t slim x3 control iq pump that is coming out soon about the end of this year too the next year

[@DrMikeHerring]

I’m excited to be able to control it from my phone 😂

[@jefferylee3121]

@@DrMikeHerring I am too it

[@ashapaikara5428]

Hello,I am T1D from India West Bengal. Price of this pump???

[@jimhesseling]

Medtronic 770 for 4 plus years, Diabetic for 20 plus years. considering switching to T-Slim mostly because of the Dexcom

[@JamesLyons]

You said it stops working at 50u? Thats really strange. But you also said something early in the video implying you change cartridge/reservoir and site at the same time. That could imply you are letting the site sit in you too long and its just failing due to time. My sites usually last 3 days but sometimes they go haywire and just swapping in a new cannula and i'll be good to go again. Made me wonder if "50u remaining" was a proxy for "my site has been in too long". site performance is pretty individual, depends on the type you use, and your own body -- so the frequency you need to cycle them is a pretty personal choice -- but the "my bs is not responding" is most likely a site failure, not a pump failure. And also -- I can easily change sites without changing cartridge -- so I don't link the two processes.

[@user-tk1gp6ww5t]

Are you still experiencing high blood sugars overnight. Just wondering if the pump has adapted to you. I use 770g. Considering either Tslim or 780g

[@DrMikeHerring]

I've adjusted my lifestyle slightly and no longer have that issue. I'm overall quite happy with my system.

[@alisha8705]

Now I will have to be pay attention to what happens at less than 50units. I know with about 15 left I have issues, I think because it dosent want to do a bolus correction and run out? So that's frustrating because I want to use up every last drop I also would love to be able to set my own target blood sugar.

[@DrMikeHerring]

For me it’s somewhere between 50 and 25. I agree setting my own target would be great!

[@dwightl5863]

I have the x2 and it warns when it is getting low on insulin. A few times I have had it bolus when there wasn't enough insulin in the cartridge. The pump delivered what it could and then gave an error message that cartridge was empty. One needs to pay attention to the alerts.

[@timmiles672]

Make a small hole in your pocket , it helped with the door knob catches.

[@rudolfreck6108]

Hi, did you try the „sleep activity“?

[@DrMikeHerring]

Hey! Yep!

[@joeybasa3795]

Been on tslim for months Last 50 units doesn’t work well for me too. I guess it has something to do with humolog efficacy, especially on room temp for a couple of days 😔

[@dwightl5863]

I understand that Novolog is less affected by the heat.

[@pallavimishra1843]

It's good

[@ugg1353]

Does anyone feel 110mg/dl is far too high, I usually aim for 80-100 - the pump looks convenient but does not seem healthy

[@DrMikeHerring]

No, 110 is fine. The reason they don’t aim lower is the dangers of hypoglycemia. If you manage to keep your sugar at 90, it’s not going to change anything the pump does

[@GR8-Z]

I use tslimX2 and I use Nova - rapid insulin I did use to use pens and Lantus Nova rapid . I use to call my Lantus long acting insulin pen Lantus the lizard 🦎 I just never liked the grey boring colour of the insulin pen … now I love my tslimx2 pump and it’s pink 🤖and his name is Tate my artificial pancreas😍😅

[@DrMikeHerring]

ha i never thought to name my pump

[@nathalielarochel9350]

Hey Mike! What made you choose the T-slim instead of the Medtronic one? Since 2008, I use the Medtronic insulin pomp. I have the 670G since last summer. Do you know if yours go in the water?

[@DrMikeHerring]

I was already using a Dexcom G6 and love it. Didn’t want to switch up my CGM. And I’m not sure if it can go in the water!

[@CubNan]

Have Medtronic 670g. Looking at switching.

[@DrMikeHerring]

Never used the Medtronic so I can’t speak to it

[@marymorris8185]

I have the Metronic 680G . I have had it for 15 years. Dr wanted me to switch. I do not like the Dexcon feature . I watched a video , 3 times , it says your BG is 10 ?? I do not understand how you can have a BG of 10. I usually get 70- 150 BG . I a going for training next week . The Tandum pump suppliers were the stupidest , most incompetent people I have ever seen. They told me my co pay was $720 , I told them that sounds high . Lady checked on it , then said it was $230. I said no. She then emailed me later to say it was $520. I called my insurance back and they told me , as before , there was NO copay for me . This took over a week to get it corrected. Now I am getting training at 7 weeks after seeing my doctor. I never had this trouble with Metronic.

[@sues22en]

Mike . My husband is 76 and on the T-Slim x2 for 2+ years. Neither one of is tech savy or buttom pushers . (I am a little more than he is. ) and as much as I love this thing my husband gets so flustered and hates it. Please axplain to me how to help him. When his BS goes up high after eating we may have estimated carbs incorrectly how do we bring it down. If we enter a bolus to correct, it continues to be high showing insulin on board for hrs and hrs later it comes finally come down often showing low. How an we correct and bring down within a hour or 2 and not hours. Did i say he is not very patient. At this time i won't even get into updating this thing . We have tried and after hrs we shut the computer down. Help is not in this area. No representatives. Not even at dr office's. Phone assistance just tells us to go online. Company should relize a lot of patients are old and not computer savy. Sorry this is a bitch section but have no idea where to turn

[@francisburns3101]

We’re young parents with a tech savvy teenage daughter and this pump is such a pain in the butt compared to our old one. You’re not alone.

[@beibeili9442]

nice

[@hansmekenkamp5777]

This is really a wunderful pump. Unfortunately the filling of the reservoirs/ cartridges is lots of work and you can’t store prefilled reservoirs for a few days. While at work or on the road by public transportation is this too much. Otherwise I would choose this pump.

[@DrMikeHerring]

Yeah it is tough bringing supplies every time I'm out of the house for more than a day, but I do still think it beats the pens!

[@jociyageorge52]

Thanks for your valuable information, I'm also a type one diabetic patient, I want 58 units of insulin evey day, insulin name is human mixture 30HM penfill (biphasic isolated insulin I P), this pump available in India?

[@DrMikeHerring]

I’m not sure if this is available in India!

[@SuckItYouTube19]

The "reasoning" for the low aggressive action on should be obvious to YOU, Doc. Medical types are always super conservative in treatments. The problem with this is worse with pumps. Instead of just one perimeter being cautious, all are. And when you add them up, they compound.

[@vishnnea]

Очень хочу такую, но у нас не купить😩

[@mercedeslozano319]

👍😊

[@DrMikeHerring]

👏🏻

[@SuckItYouTube19]

3 or 4 day battery life?? So that give Medtronic 670G the win for one item.🤣🤣🤣

[@SuckItYouTube19]

The 110mg/dL target isn't a problem when you consider the number is garbage to begin with. What do I mean? Unless you are walking around with a YSI on your back or work in a lab where you can draw blood multiple times a day, you are stuck with glucose meters. Those are jot up to snuff for accuracy. You bg reading from a meter could be +/- 20%. So pretend you meter says 100... that means it could be 80 or 120.😂😂😂😂 That should finally kill the target of 110 needs to be lower arguments.😂😂😂😂

[@SuckItYouTube19]

Hold on!!! Your wishful thinking A1c goal was 5?!!!😂😂😂😂GTFO

[@DrMikeHerring]

Yeah I wanted it in the 5's but that almost killed me so low 6s it is lol

[@brianfontenot8264]

he might be a doctor but he is not a very kind person, and not very bright. He was rude on facebook and he accepted my friend request but told me that he did not know why he accepted it. IS REALLY THAT STUPID. NO COMMON SENSE WHATSOEVER. I'VE been a juvenile diabetic for over 35 years and it would have been great to talk to someone who is a diabetic like I am and get his input on things as a diabetic. BUT TOTALLY IGNORANT AND RUDE.