This content material initially appeared on diaTribe. Republished with permission.
By Julie Heverly
diaTribe’s Julie Heverly had the chance to strive the brand new Tandem cellular app, which permits customers to manage insulin boluses instantly from their smartphones. Here’s her take on the method and app.
I’ve been ready virtually 20 years for this! It’s lastly right here and it’s residing as much as my expectations!
In 2002, 4 years after my analysis, I bought my first insulin pump, a Medtronic Minimed.
As somebody who had a worry of needles (I handed out on the mall after I bought my ears pierced at 16 years previous), I used to be relieved to not need to handle my diabetes with six-plus each day injections anymore. The new expertise meant just one needle each three days, and ever since, I vowed I’d by no means return to a number of each day injections.
My insulin pump was welcomed and great, nevertheless it did create a query I had not anticipated: the place to put on the pump. At the time, most company apparel for ladies consisted of clothes and skirts that didn’t have pockets. So, I needed to get inventive.
I keep in mind making an attempt numerous objects that had been out there on the time – a thigh garter with a pocket, a calf sleeve, and a cami with a sewn in pocket. None of those labored; on the stroll from my automobile to my workplace, the pump fell out of these contraptions extra instances than I may depend. There was just one place that was secure for this life saving system: my bra. So for the higher a part of the final twenty years, that’s the place I’ve saved it.
However, when you’re 25 years previous, making an attempt to construct a profession in public affairs, and have the chance to have lunch with Larry Rockefeller IV or Barbara Bush, there’s nothing extra mortifying than reaching into your bra and pulling something out. So I didn’t. I might wait till after lunch conferences and go to the restroom to take my insulin. I didn’t know the significance of bolusing earlier than meals on the time, and my glucose ranges had been negatively impacted by these delays in dosing.
Even after I left company America and joined the diabetes world, I used to be by no means comfy with the shock to others when pulling my insulin pump out of my bra. Most days, I bolused in personal, pre- or post-public meals. At conferences or all-day conferences, I must put on sure outfits that did have pockets or standard entry to my pump. Thankfully, vogue evolves, and together with pockets in ladies’s apparel benefited these of us who’ve to hold medical units. But it’s nonetheless not a straightforward or excellent state of affairs, however the skill to bolus from a telephone is a large step ahead!
In February 2022, the FDA cleared Tandem’s updated t:connect app to permit customers to ship or cancel boluses instantly from their telephones. On June 15, scrolling via social media whereas treating a low in the course of the night time, I noticed that Tandem was beginning a restricted launch of the brand new telephone app with the cellular bolus function, and I instantly signed up.
The skill to bolus from the identical system I store, financial institution, and monitor my glucose from has been on my want record for the final 20 years. The subsequent morning, I acquired an electronic mail stating that I had been accepted into the early launch and that I might be getting extra info in “the coming weeks.” A week later, I began checking my emails and spam folder daily.
After a number of weeks of anticipation, studying all the things I may discover in regards to the launch from individuals who had been sharing, I lastly bought an electronic mail notification on July 13 from Tandem. The software program replace for my t:slim X2 pump was out there! I took my lunch break and began the required coaching.
Things to find out about cellular bolusing and the t:connect app
There are two self-paced coaching classes. The first takes lower than 10 minutes and focuses on just a few updates to the pump. The second coaching is 30-45 minutes lengthy and goes via the cellular app to bolus insulin. The coaching walks you thru the up to date screens on the telephone and pump, BEFORE you get them on your units. You can’t get the replace till you end the coaching (I noticed lots of chatter about this on social media). However, you possibly can entry the coaching and information afterwards should you nonetheless have questions. Both coaching classes have quizzes on the finish, and it’s important to reply each query accurately to get your replace hyperlink. Luckily, should you miss a query, you’ll be able to retake that portion of the quiz till you enter the proper response.
Tandem urged downloading your pump’s knowledge to t:connect BEFORE putting in the brand new software program. For pumpers who don’t incessantly add this knowledge, this could be a prolonged course of because of the sheer quantity of data that’s being transferred. If you do add commonly, it ought to solely take a few minutes.
The replace, identical to the replace to Tandem’s automated insulin supply system, Control IQ, requires eradicating the cartridge and restarting the pump and CGM. I used to be grateful to have had a full cartridge when my replace got here via. I did have to offer the pump the phantasm of re-priming my tubing and cannula. As a reminder, 10 items of insulin via the tubing is the minimal for a restart. The coaching reminds you, and so will I, to be sure to are disconnected so that you don’t get all that additional insulin in your system. I additionally discovered it useful to have my present CGM 4-digit code out there to me, as after the replace, I wanted to activate the myCGM perform on my pump to renew ControlIQ mode.
I already had the t:connect app on my telephone, which is obtainable for each iOS and Android. The bolus function was not beforehand within the app, however as quickly as I accomplished the coaching and up to date the app, it appeared on my display screen!
Similar to the pump, there are quite a few options to make sure nobody by accident boluses from the cellular app. The consumer should click on via three affirmation factors (subsequent, verify, ship bolus) to validate the intention to ship insulin. The bolusing motion can be protected by Face ID or a password. There is a 10-second delay earlier than the dose is run, giving time to cancel the bolus if wanted.
I’ve been utilizing it for the previous a number of weeks. It’s straightforward and handy. As proven under, the cellular app shows present CGM studying and a 3-hour graph, insulin on board and Time In Range metrics for the previous 24 hours. When bolusing, you’ve the choice to incorporate the correction dose, enter your carbs, and/or override items manually if it is advisable.
Image supply: diaTribe
The solely options that I take advantage of usually on my pump display screen that the cellular app doesn’t have are the carb calculator, the prolonged bolus function, and the alarm silencer. The carb calculator is a device of comfort. As an grownup, it has been a easy adjustment to make; I do surprise if it’s an even bigger difficulty for younger adults nonetheless studying carb counting and finetuning their math abilities. As a ControlIQ consumer, there isn’t an incredible want for prolonged bolusing. I solely use that function 3-4 instances a month and may simply seize my pump at these instances. The largest difficulty for me, and plenty of others I’ve seen in group boards, is the lack to silence alarms from the cellular app. Since the replace, I’ve discovered myself in church and the viewers of a dwell theatre efficiency STILL having to take away my pump from my bra to silence alarms. There additionally appears to be a brand new sensitivity within the pump and corresponding alarms for incomplete boluses.
Since the replace, I’ve used the cellular app for dosing most meals. The app is handy and straightforward. I predominately solely attain for my pump now to silence alarms or when it’s time to alter my website or CGM. This has additionally decreased the quantity of instances my pump has fallen to the ground or collided with my foot. My tubing hasn’t been uncovered and caught on doorknobs.
Being in a position to remotely handle my diabetes is even higher than I may have imagined. I simply bought my first turtleneck sweater gown, one thing that I’ve not been in a position to put on for the previous 20 years as a result of I wouldn’t have entry to my pump for bolusing.
Unfortunately, alarms do nonetheless have to be silenced from the pump display screen. This is an inconvenience, however I take advantage of it as motivation to bolus early and keep in vary, so I don’t need to clear any alarms.
A few days after the obtain, I had the prospect to offer suggestions, and I shared all of this within the Tandem survey. I hope everybody else shares sincere and constructive suggestions too. Perhaps future updates to the app will embrace a number of the objects talked about above. One can all the time hope.
I’m grateful to Tandem for this replace and was thrilled to be a part of the restricted launch. It’s nice information that the cellular app is now out there for everybody! While the change could seem small to some, it’s massive to others. The skill to bolus from one’s telephone makes illness administration extra accessible and additional integrates it into the actual world that individuals with diabetes exist in. I can’t anticipate extra folks to get the replace and for future upgrades that cut back the burdens of managing diabetes.
