New to the t:slim insulin pump

My ten-year-old daughter has been on the t:slim pump for 5 months now. Though my six-year-old daughter has continued with her pump with a remote device that I use to bolus her insulin, for my older daughter this was a good time to switch to a pump where she could take more control of bolusing herself.

The t:slim pump is smaller than her previous pump so it fits more comfortably in the belt around her waist. It is so slick looking that while she was in the nurse’s office at school, an adult told her to put it away, thinking it was an itouch. (My daughter said she told her it was her insulin pump and the adult apologized profusely.)

The t:slim’s quick bolus feature is very helpful. You can set the quick bolus for a certain number of carbs or for a certain number of units of insulin. Hers is set for 15 carbs, and it is so easy to use this feature that this is the way she usually boluses. For example, if she is having a 15 carb snack, she presses the quick bolus button to activate it and then pushes it once more for the 15 carbs. The pump vibrates back and then she pushes the button again to deliver the insulin bolus. For a 45 carb meal, she does the same thing but pushes the button 3 times to reach 45 in 15 increments. It is simple to do and discreet.

Although she could swim with her previous pump attached, the t:slim needs to be disconnected. She tried swimming with it and an altitude alarm would suspend delivery. She now prefers to disconnect for gymnastics as well. When you have not disconnected for any activities including showering for the past 5 years, disconnecting becomes challenging because now you must remember to reconnect the pump. You might be surprised as to how many times I remembered by finding the pump in my purse or pocket. Once after gymnastics, we even bloused via the pump only to realize later that it wasn’t even connected. And while it is disconnected, there is always the risk of it being lost or stolen.

The t:slim doesn’t need batteries but requires a recharger. While initially this made me nervous on trips, fearing I might forget to pack the charger, I like not needing to buy batteries for the pump of course. One night I recharged it while she was asleep and the infusion set disconnected when she rolled over while the pump and recharger were attached to the wall. Because I don’t have a remote device to use to give a correction bolus of insulin during the night if needed, I have to fish the pump out from her belt under the bedcovers. She usually wakes up when I do this and is then robbed of a full night’s sleep.

The insulin cartridge holds 300 units, more than the previous pump, and if needed we can change the infusion set without changing the cartridge. The t:slim cartridge comes with an attached section of tubing that connects to the tubing of the infusion set outside of the pump. There have been a couple of times where the tubing became disconnected to the pump at the tubing connection site without our realizing it, causing high blood sugar levels.  It also means longer tubing which could then more easily get caught on something.

Compared to the previous pump, the t:slim makes a noise while delivering an insulin bolus, kind of like a cat purring. It also delivers a bolus slower than the previous pump, so if you want to bolus again for more food sometimes you have to wait until the previous bolus is completed, which was less of an issue with the previous pump.

Thankfully the screen on the pump works like a calculator, so it is so easy to use and easy to add up the carbs. It’s hugely refreshing from her previous pump which did not prepopulate the recommended insulin dose which required me to hit the up arrow over and over (or hold down the up arrow, always passing over the small amount needed for a child, and then having to push down the arrow down over and over to get to the right number) which was time consuming.

Pressing the 1, 2, 3 buttons to access the screen has been no problem either. It just becomes second nature and can be completed very quickly. And we have had no issues with buttons inadvertently getting pressed. For one thing, it’s a touch screen, so there are no buttons (other than the quick bolus button on the side). You can also press the T on the touch screen to go directly back to the home screen.

For the extended bolus, you must move through a few screens to implement it, and I would prefer it if the extended bolus screen would revert to the last used extended bolus, since I tend to use the same extended bolus parameters over and over. Currently the extended bolus screen always suggests 50% now, 50% later, over 2 hours.

Sometimes the screen does seem to time out very quickly, especially when we are changing the cartridge, even though we have the screen timeout set for 90 seconds. After changing the cartridge, you have to remember to resume the insulin. Because the reminder screen to resume insulin has a slight delay and because the previous pump did not require restarting the insulin, we have changed the cartridge and the infusion set and put the pump in the belt without resuming the insulin. Now we know to wait and make sure the insulin has restarted.

In summary, the t:slim pump is small, cool looking, and easy to use. The quick bolus has been the most useful feature for us. If the t:slim also had a remote device to use to bolus insulin, I would switch my 6-year-old daughter to the t:slim as well.


Disclosure: I have no financial interest in any pump company and have received no money or gifts to write this blog post. Please keep in mind that these are just my juicy experiences with the pump and my experiences will probably vary from someone else’s experiences.