Assorted tandem tslim questions

[EllieM]

I've been using the tandem tslim x2 for about 5 months and on the whole am happy with it (certainly don't want to go back to MDI) but have accumulated a number of queries.

In no particular order

1) bubbles when filling a new tslim cartridge. I quite often find I have to draw air twice in order to get all the big bubbles. Do I have poor technique or is this a known issue.

2) insulin to blood sugar ratio. My DN has mine as 100/ttd (total daily dose) but though this isn't too bad at levels below 6 once I go over 8mmol/L I become insulin resistant and have to manually add bolus if my levels go up to 10. Is this a known issue and is this calculation accurate for someone on a lowish carb diet (circa 70g per day)?

3) Night time levels. If I put the pump on sleep with a level of 8 it'll probably be there in the morning. Should I get it down first?

4) Does the "target bg" on personal profiles make any difference? I am assuming it is used by basal iq but not by control iq .

Not asking for medical advice but other people's experiences. And if anyone has any links on adjusting the tandem profiles they would be gratefully received.

 

[Juicyj]

Heya Ellie,

Fellow T Slimmer here ! I get loads of bubbles so I just continuously tap the vial and squeeze air out until it looks goodish, tbh I don't have a massive issue with bubbles as you still prime the fill and so I just wait for a few drops to appear before confirming, it's no issue imo.

Yes insulin resistance happens with higher levels, I find my threshold is around 11 mmol/l and will ghost carb to nail it, I think a low carb situation can make this worse as the lower I have been with carbs the harder I find resistance with higher levels and so any extra protein will add to this level of pain. I think alot more research is being done around high levels/insulin resistance as there are contributing factors to the insulin resistance wall we hit when taking insulin and the way exercise/diet/weight etc affect it, so it's a personal experience but felt by many of us.

I don't do sleep mode as my pump will naturally bring me down to around 6 mmol/l over night, I haven't used it for night time as I think the bottom range is increased for overnight protection, i've not found it necessary to use sleep mode.

Yes your target BG should make a difference, mine is set at 6.1 as I need a good buffer for driving, i've never tweaked it down as don't want to run lower.

Hope that helps.

 

[searley]

I was told only draw bubble once, as you could do it 100 times and still draw some.. I’ve never had an issue

Night time… I always hover about 8 too.. even if I start the night with a lower level I still raise to about 8

Personal target levels are ignored they are only for basal iq as you thought

 

[sninge]

I never really have any issues with air bubbles, I am old school and originally learnt to draw insulin up in syringes 40 odd yrs ago so perhaps experienced!
I mostly run my pump on sleep mode, day and night. It suits me because it does aim to keep your sugars slightly lower and because I am a bit of a control freak struggling to let go I prefer to click on bolus and get a top up bolus if I feel I need it. Like many my life can be erratic and I don't want a correction bolus if I'm about to go for a long dog walk or hit the dance floor.
I wake 95% of the time with my bloods around 6, if however ive had a fatty meal ( takeaway usually) in the eve then sleep mode does struggle but I usually check during the night.... Hit bolus and pump tells me what I need and I give that ( or top it up if I think I know better ) I love my tslim but the one thing I would love to change is the insulin action time, for me its only 1.5hrs so 5 hrs does not work for me!!