Pros & Cons of the Tandem t:slim X2 w/Control IQ Insulin Pumps
Unique Advantages: Pros
- Software/features updatable through download from website
- Built-in algorithm automatically adjusts basal & administers correction boluses based on CGM data trends
- Bright, full-color touch screen
- Modern, high-tech appearance
- Compact, thin dimensions
- Rapid number entry/fastest bolus entry
- 2-Way Bluetooth (X2) allows full integration with multiple devices, including smartphones & CGM
- Displays data from Dexcom CGM
- Charges; No disposable batteries
- Can calculate boluses up to 50 units
- Site-change reminder w/customizable day & time
- Graphic on-screen history display
- Carb counting calculator
- Temp basal up to 250%, 72 hrs
- IOB & time remaining displayed on home screen
- Missed bolus reminders customizable by day of the week
- Alert for high temperatures
- Secondary “profiles” for unique basal and bolus dosing
- Limited unintended insulin movement with changes in pump position
Potential Drawbacks: CONS
- Small buttons can be difficult to activate; screen goes blank if buttons missed 3x
- Unlock procedure required to perform any programming
- No attached clip (must put in a case that has a clip)
- Tubing connector looks “medical,” can snag on clothing
- Basal & bolus settings in same time slots; may take extra steps to edit
- Extra confirmation steps with all programming
- Weak vibrate mechanism
- No meter link
- Requires charging 1-2x/week
- Lengthy tube priming procedure
I began using tandem slimline in October. Fabulous concept however has anyone who worked on this actually lived with it? My sugar levels are much better-wonderful BUT I have had approximately 10 full nights sleep since October as it keeps alarming, telling me I am LOW but on checking sugar levels by finger pricking it is actually 5.5! Then next time it tells me sugar level is 7 but felt hypo so checked and it was 2.2! Dexcom says sugar level 15 but actually 9! Something not right here. The CGM just disappeared from my pump and when I called to sort this out was quite happily told “Oh yeah, that happens”! I have altered everything I can think of to stop the alarms, increasing insulin, decreasing insulin, changing carb ratio etc etc and nothing seems to make a difference. I feel this is now controlling my life and this is not how I wish to live after 46 years of type 1 diabetes. (My life has always controlled my diabetes, working things out to fit in with my life) The other issue I have occasionally is that the set does not actually go into my skin but bends and I know nothing about this until my sugar levels soar and the pump does not alarm. Why does it alarm when it does not require a bolus or other action? I really want this to work as I think the idea is amazing and in principle would be great BuT I am getting pretty tired and frustrated. I need some unbroken sleep and not to hear alarms going off!!
I do not want to be negative!!! I know difficult to believe, but I do think this is an amazing idea but I feel it needs some tweaking or am I just being dense?
a few helpful tips to try
First is that the sensor issues oyu’re having aren’t pump or insulin related, they’re dexcom.
make sure you are keeping well hydrated, and not laying on your CGM. try wearing it on a different area of your body. Also do NOT calibrate your dexcom when your blood sugar is fluctuating, this causes it to become LESS accurate .
next is to make sure your alarms have good repeats
your low alert should have at least a 30 minute repeat, and I recommend a 2 hour repeat for high alerts
also the newest update to the X2 pump reduces the high BG alerts, which definitely are annoying. I’m not sure if that update is approved where you are yet.
for the sets, it sounds like you’re using an Autosoft 30?. holding the inserter along the sides to make sure that the base “feet” are flush against the skin and not tipping up helps ensure a 30degree angle insertion rather than missing and ending up atop the skin.
I read through a few of these reviews and skimmed past a few more. The pro/con list provided was right on. People are talking about the plastic waist. What about the insulin waist? Every time you change your site you waist 24 units of insulin right off the top. 12 for the prime and 12 when you have to change the cartridge. The 300 units is now down to 276. The technology of the pump is great. You cant really argue that control IQ is a game changer (at least for me it is). The technology is great. The livability of the pump needs some focus. I feel like tandem spent all their money in tech and forgot that people actually have to live with this pump 24/7. The battery charging is flat out STUPID. To charge the pump you have to plug it in a USB to the wall. So now you have the pump to your body and the pump to a wall (or a car). I would rather just pay for a battery and change the battery. Oh and if the battery does die everything resets you will have to change the cartridge and CGM. The connection to the cartridge and the infusion set is clunky and does allow the pump tube to fall to the side. Hang on my clothes all you want… I’m more worried about doorknobs and cabinet pulls those will give you nightmares. The technology is great just need to spend more money on the livability of the pump.
Technology is great, Dexcom much better than the Medtronic CGM, algorithm to correct or stop much much better.
Drawbacks for me are
– silly waste of insulin (and I have no insurance issue)
– black cartridge that does not allow to clearly see where you are actually injecting the insulin. Not sure I correctly remove the air in the cartridge, 3 times out of 4 I need to try several times
– no mute on alarms (very disagreeable for a concert!)
– filling the cartridge is a pain and quite long
– charging the battery is a pain, can’t do it overnight (not good for the battery) – not enough to recharge during shower even every day.
– customer service is under staffed , terribly long to wait in line, calling back function does not work properly.
– in control IQ 5 hours for active insulin is way too much for me but I can’t change it. Also, in the reports, time in range, the range cannot be customized either, my endocrinologist was very (negatively) surprised.
Right now on the phone waiting in line for customer service, it’s been over 2 hours now. I had some kind of fatal error.. Frst time in 18 months. Let’s see how they resolve this. But customer service definitely a huge issue.
Great feedback Al, I encourage you to pass it along to Tandem so they can continue to improve their product line in the future.
I agree with almost everything you said. Filling the cartridge always leaves me wondering if I have removed all the air. A black opaque cartridge with no way to see. I like the control iq but it is impossible to have a one size fits all. Why is it when you have a low BG and eat a meal, it withholds some of the insulin dose. As a busy person, I don’t always keep checking. Then you think you delivered a dose to cover the carbs carbs but an hour or two my BS is skyrocketing. I can understand delaying the dose, but not giving is not acceptable.
Control IQ really really benefits from prebolus and extended bolus skills to reduce these irritating and over compensating suspends that cause unnecessary highs.
definitely sounds like the change was not the right fit for you.
I have lots of tips for reducing the alert fatigue. Meanwhile the highs post set change and set issues sound like I could help reduce those too. We sometimes have to work around the “protections” that are put in place to live life effectively.
Only have had the pump for 90 days. Love what it has done for my blood sugar, but…………… I thought engineers were smart I don’t think any of them have actually used their product. Please use it and the go and use other competitive products. Filling the cartridge is a big looser for me. Too much to do. Charging the pump? It’s ok, but I’d rather have a AA or AAA battery to change. Keep up with the compatibility with cell phone tech so is completely works when Cell phone updates. Pump works great, but mechanically using it sucks. Plus please spend more time on customer services. Medtronics kicks ass on customer service. Take notes on customer service from your competitors you have good points with your pump, please fine tune it some and you’ll be at the top giving it 9 more months before I change.
we agree with your pointers. To be clear we don’t produce or sell the pumps, we use them just like our clients do and share info on our experiences. Tandem is definitely a much smaller company who has chosen to put more money into innovation rather than sales and their support ebbs and flows. at some times medtronic hold times are very long and their support suffers and at others Tandem will suffer, they seem to adjust and jockey in that respect over time. The cartridge fill is the biggest weakness in their system and we sincerely hope they improve this in the next iteration, their patch pump due for release next year.
Tandem’s Customer Service is surely lacking. I once AGAIN have a MALFUNCTION code, called it in, and waited. My tech call came in and the customer service agent HUNG up on me. This has happened before – the last time my pump MALFUNCTIONED only one month ago. While Minimed is not perfect, I did not have these types off problems with the 670G product. Nor did I have problems with their customer service. I am stuck with this pump and I accept that, I only want to receive my insulin according to the program. FRUSTRATING!!!!!
I’ve been pumping a while and I’m T1D since 1971. I’ll be brief. After 4 years of experience with the tslimx2, I have turned OFF Control IQ. Five hours insulin duration is absurd. Mine is 3 hours. I’ve set it to alarm when it drops to 70 or rises to 180 so I can manually bolus.
Until patients are allowed control of all the inputs affecting their care, I have stopped waiting for Control IQ to fix the problems it creates.
And here’s how I handle issues of waste. I use the steel needles, one tubing set per cartridge. The site reminder is set to remind me every other day to move the inset. I pull it out, swab a clean site, reinsert the needle and hold it in place with Tegaderm tape. Saves 3 insets and at least 60U of insulin.
I wouldn’t recommend the steel set reuse for the general public since that does increase skin issue risks, but great work arounds Melissa!
we agree that 5 hours is ridiculous, we need a lot more autonomy with our settings.
I find that I need to set correction factors a good deal more aggressive, and can also be a bit more aggressive with carb ratios in CIQ, so I recommend having a CIQ profile and a manual profile so I can easily switch between for prolonged CIQ use vs prolonged manual pumping.
It’s definitely not a “plug and play” system, it needs some adjustment.
Started the Tandem Control IQ pump August 15, 2022. Having trouble with occulation around the cannula, or somewhere within the tubing. The cannula ends get completely bent, where insulin is blocked and I get no insulin, causing very high blood sugars. Been T1 for 69 years. Thought this Tandem pump would eliminate all the dangerous lows, and 911 calls. Now with the Tandem giving me lack of insulin delivery, and extremely high manual blood sugars, my A1C’s are rising. Very long and arduous installation, waste of insulin. Am I the only one with the problem of bent cannulas, trouble with highs after a new insulin reservoir set?
the problems after the set change area almost always attributed to having air in the cartridge.
Check out my video on how to fill the cartridge for help here.
for the canula, there is no difference between how the medtronic sets and tandem sets are made, but if you changed styles of canula you can chnage back. or go to steel canulas, the trusteel.
Same issues I have. 2days after new infusion set blood glucose levels stay high even after infusing 2.5x usual insulin amounts. Very frustrating. Kinks likely in infusion set or tubing. Reluctant to update my HbA1C. You’re certainly not alone with your concerns.
i would wager you’ve got some air in the system somewhere for elevations to remain more than a few hours after a site change.
Yes, I ‘ve certainly had my fill of being wakened in the middle of the night. I would like to find a way to silence the alarms while sleeping since I had no problems sleeping without the pump. Can the engineers do something to help? Sleep is important for everyone.
Hi everyone. I have had Medtronic from 1991 to about 2014. (Previously taking shots since 1960)
Now currently considering changing to the Tandem T slim x2 from OmniPod mainly due to the cost. The pods are under pharmacy with Medicare and costs are outrageous!
After reading the Cons I’m not so sure now what to do.
Anyone suggest a different pump all together. I currently have Dexcom that I have no issues with and that is the main reason I was looking at the Tandem
My biggest complaint with the Tandem pump is that the cartridges are difficult to fill. I sometimes go through a half dozen before I get one to fill.
the cartridges are definitely problematic! if you’re having that much trouble I’d recommend trying this device: https://www.ayudalife.com/
Also here’s a link to my Tandem Cartridge refill video that might show you a new tip you haven’t tried before
I’ve had type 1 diabetes since I was 5, so that’s 48 years now. My first pump was a Medtronic about 5 years ago because my GP up to that point said I “wasn’t bad enough for a pump’ using multiple injections per day. He was wrong, using the pump (new doctor and endocrinologist this time) I’m almost a closed loop and A1Cs are much better/great now, achieving that with almost no lows.
So the Medtronic had some annoying features. The infusion set often hurt more, the adhesive would fail more and then the pump would require annoying, sleep interrupting calibrations with every new sensor. And a multiple hour delay having to charge the transmitter. However, the reason you’d consider putting up with that is: My current pump is the tandem t-slim combined with a Dexcom sensor. There aren’t the necessity to ‘calibrate’ 2+ times every 3 hours with each new sensor + the infusion sets appear identical but hurt way less and the adhesive is much more adherent (although I have contact allergies with the Tandem/dexcom stuff whereas none of those issues with the Medtronic versions). The biggest issue is with the pump, it has AI problems and support sometimes takes 3+ hours to answer the phone (if they answer it at all). So while your pump may work, and transmit, it’ll do incessant beeping errors about the transmitter ID being incorrect (even though it’s reading and transmitting BG levels, which means it is correct) and/or beeping errors that your sensor ID is wrong after inputing it right, getting confirmation and then it working for 20 mins.) So while for quality of life issues the Tandem has more convenience, and less irritations relative to set up requirements every week, the T-slim seems to have AI issues which haven’t effected the blood sugar levels really but make you wonder/worry when it’s not working right and then customer service puts you on hold for hours and/or never calls you back when looking for a solution.
your issues definitely sound like software issues with your pump specifically as I have not heard these issues consistently for other users. I would definitely recommend requesting a replacement.
Nothing is more enraging than the occlusion alarm sound. It makes me throw this piece of junk across the room.
Super annoying, but better than the screamer from Omnipod :) The occlusion is important, but they should
I just had my Omnipod alarm due to “expired” and no insulin delivery. But I haven’t had a Tandem x2 yet. Questioning if I should switch. I really like the Omnipod except it’s too costly with Medicare
expired pods are actually one of the good things about omnipod because they keep us from over using a single site.
But the Tandem system definitely has its benefits as well. Definitely work with your clinician or schedule an appointment for a clinical consultation with a member of our team to find the best fit for you.
I have used the Tandem T:Slim X2 for just over a year now, but have used insulin pumps (all Medtronic) since 2003. I know what there is to know about pump therapy. My experience with the Tandem pump falls into two categories for me: Satisfactory, and not satisfactory. On the satisfactory side, although a bit clumsy to use, it’s easy to input what’s needed. All in all, it does a pretty good job of controlling my blood glucose (my A1C’s have always been in the low 6 range). On the not satisfactory side: Well, here it goes. Having to use a syringe to refill the cartridge is ludicrous in 2022. There is a LOT of waste plastic, too. The one thing that absolutely drives me up the wall is the fact, after stopping insulin delivery to take a shower, etc., you have only 15 minutes before the pump starts a loud, wailing alarm that wakes up my whole house. That alarm can NOT be disabled, or silenced. Sorry, it’s not up to Tandem how long my showers take, and if it’s longer than 15 minutes, that’s MY choice, not theirs. I actually had one of their customer service reps tall me I should wrap the pump in a towel to help quiet it. Wait, WHAT?? Ridiculous. Last point: Tandem is dreadful to deal with, and seems incapable of shipping the correct supplies as you’ve ordered them. Will I ever get another Tandem pump? The jury is very undecided on that point at this time.
for disconnection, if you’re going to disconnect more than 20 minutes I recommend turning Control IQ off, then disconnecting without suspending insulin. This avoids those alarms. The problem there is that you are entirely responsible for remembering to reconnect.
In terms of your supply issues, typically people are actually getting supplies from third party suppliers which range from ok to just plain terrible in terms of service and delivery.
Hello Alicia, I understrand that third party suppliers can be problematic but receiving supplies directly from your company should be top priority when it comes to replacing a malfunctioning pump. For no explained reason my pump stopped working on Sunday and I called support. After waiting an hour on the phone, I spoke with someone who helped me. They were unable to restart the pump using the code given so they set up shipping for a replacement with next day delivery. In this case it would be on a Tuesday. I received no warning about potential delays and no communication from the company when the pump never showed up on Tuesday. I had to call to speak with someone and after speaking with a manager who did apologize, I was assured that the issue of shipping and replacing important equipment ie the pum itself would be mentioned to the company. I’m uncomfortable with the possibility of having future problems but am willing to give it another try. Perhaps there is another shipping company that can get vital equipment delivered on time in the future. It would certainly be helpful for your customers.
the distributor is entirely left out of warrantee replacement processes. This would be where we should call Tandem directly and they will overnight a replacement pump.
Curious – am I speaking to people in Canada or the U.S.?
All our staff and educators are currently in the US
I have been a diabetic for 15 years now and on an insulin pump for most of that time and let me say that this pump is one that is a good idea on paper, but poorly executed. Much like the other responses I’ve read thru the process of changing the tubing is extremely wasteful and takes entirely too long. It does not make sense that every time one changes an infusion set site that the pump “protocol” is to automatically run through 10 units of insulin. That may not seem like a lot- but if you are changing sites every 3-4 days that adds up quick and the price of insulin is not favorable. My biggest issue with this pump is the control IQ portion of the pump can never work properly. When I first heard about the control IQ it seemed like a great feature until I started using it in my everyday life, and found it it is not made for people with an active lifestyle like my own. My job is pretty physically demanding and I tend to have frequent low blood sugars when I am working, mostly in fault of the pump correcting me for blood sugars that should not be corrected for. That being said my doctor recommended I use the control IQ and exercise setting while I am working, which I have found does not help my case whatsoever because the pump is not meant to stay in exercise mode for long periods of time such as the duration of my working shifts. And as a result the pump on control IQ mode will give me corrective doses of insulin automatically when it is not needed because control IQ automatically sets you’re BG to 110 and can not be changed. I usually don’t notice the pump has given me a corrective dose of insulin until it is too late and I am in a constant low/high rollercoaster of blood sugars because of my pump. I would recommend anyone looking into using this pump- to strongly consider other options as I am going to do so.
thanks for sharing your experience,
It sounds like your settings need some refining and also learning ways to really optimize control IQ for different metabolic situations and exercise
it’s definitely NOT a silver bullet, and it’s not a “plug and play” system for tighter control.
I would have your Dr. help you set up 2 profiles. It sounds like you need 2 different settings. One for work day and one for your days off. The work day can have a different basal rate and correction to help you avoid lows. Some people even have different profiles for other things (period weeks, illness, etc). You should definitely let them know the exercise setting wasn’t enough to stop the lows!
I am so happy to find this website! I’ve been a Type 1 Diabetic for 53 years and on Medtronic pumps for last 30 years. Currently, my Medtronic 670G is WAY our of warranty and my G3 sensor is dying. My Endo has been pushing the T-Slim down my throat, but I’m waiting for the 780G to be approved by FDA with the G4 CGM. . . they are both in the same approval application. My issues are with extreme BG high’s from steroid bulging disc injections, my sister, also a T1D (on 670G as well) has major lows. When deciding on T-Slim vs. Medtronic 770/780G, I’m researching for both of us since she calls me all the time when she’s in trouble. My questions are:
1. Does anyone on T-Slim x2 have any experience with steroidal lumbar spine injections? Which is better for controlling/reducing extreme highs, the T-Slim control IQ or the 770/780G Auto Mode? I do know that the 780 will give correction bolus every 5″ vs. 60″ with Tandem.
2. Is there any research info saying one pump is better for controlling lows? Or extreme highs?
3. Does ANYONE have any current info as to when 780G will be approved in US?
4. Do doctors (Endos) get compensated by pump manufacturers when placing order for their patient’s pumps?
Glad you found us too!
To answer your questions
1 definitely give our office a call to schedule an appointment and we can walk you through strategies for steroid injections. I personally use the X2 and specialize in these kinds of situations
2 We are getting more and more info benefits of these systems. They continue to show improvement on the highs without increasing lows, and reducing the instance and severity of lows across the board. A recent study actually showed benefit for patients who forget to bolus entirely, resulting in severe highs. The system improved their A1Cs by 1.6% on avg and increased time in range just short of 20% on avg.
no info on the 780 from Medtronic yet.
4 NO prescribers actually can not receive any compensation based on prescribing. These are referred to as “kickbacks” and are actually against federal law. The most a prescriber can get is a free dinner from an educational event, but those are open to all clinicians and are held by all the companies.
I am almost 76 years old and have been diabetic for 66 years. I have been using the X2 since last August when my ancient Medtronic Paradigm pump finally gave up the ghost. My endocrinologist recommended that I switch to Tandem. So far I like it, with some caveats. Please note: I am not using it with a CGM as I am waiting for the Dexcom G7 with its reduced size. (I do finger sticks, 5-8 times a day, which doesn’t bother me.) X2 PROS: 1) Pump is smaller than my old Medtronic, a big deal for me. 2) Screen is easy to read and use, although I wish the History setting came earlier in Options. 3) The plastic in the syringe used to fill the cartridge seems to release the inevitable air bubbles more easily than the Medtronic plastic reservoir system. 4) Most importantly, I’m looking forward to using it with the Dexcom G7. I hope I’m not disappointed! CONS: 1) Filling the cartridge! It takes too long and involves too many steps. It is also, at least for me, very difficult to fill at night because I can’t see the air bubbles well in artificial light. Getting rid of the air bubbles can also be a pain. While I have gotten used to it, it seems way over engineered compared to my old Medtronic pump. That said, I have not had problems with occlusions and have gotten used to the refill and replacement process. I also am retired so I have time to fill a new cartridge in daylight before I need it. 2) The amount of plastic waste is DISGUSTING! The Autosoft Infusion set is particularly bad. Medtronic had a reusable inserter that was much smaller and less wasteful. I also wonder why the syringes used to fill the cartridges have to be single use. At least give us a choice. I hope this critique is helpful to someone trying to decide on a new pump!
Thanks, Anne, for your input. I’m considering switching to the Tandem x2 now.
I agree with all the waste with the t-slim. Ridiculous. Also, too much waste with insulin too. I’m using so much more insulin because I’m wasting it. The alarms are crazy loud and disturbing. I hated the pump for the first few weeks. I’m stuck with it so, no choice now. I used Medtronic before and had the pump that was defective, recalled and now I see there are being sued!!! And, they were horrible to work with too. Ugh! Especially since these pumps are life saving or ending, Customer Service should be PREMIER not mediocre
It’s definitely not manufacturer or FDA recommended but there are two options to the insulin wastage. one is to fill a cartridge with enough insulin for more than 3 days, but still change the infusion set on your body for every 2-3 day changes. So you reuse the cartridge and tubing, not taking the cartridge out during the change process. This means less wastage. however it does mean that the insulin has more time to have a slight loss of efficacy over the longer wear.
the second option is that you can “harvest” the insulin form the old cartridge by reinserting the syringe and pulling the insulin out. again not approved or recommended by the powers that be, but can be a life saving cost saver.
for the excess alerts, having alerts set properly, and obtrusive alerts silenced is key. I find that in one appointment we can adjust settings so that we target 1-2 audible alerts per day at most and minimal vibrate only alerts. We should only getting audible alerts for things we need to DO. So we are using them to support behaviors instead of training ourselves to ignore annoying noises.
I can’t stand this pump – I am constantly getting infusions set alarms. Also hate the fact that when I set my basal to less than 60%, I have to wait for a few minutes for the pump to confirm that I really do want that basal rate. No, I just entered it for the fun of it.
I am a newly diagnosed type 1 diabetic. I love the T-Slim. It took awhile to figure out how to dose via carb count but I love the freedom. So thankful that this product exists.
I have had bad hypoglycemic episodes every day in the week I’ve had it. Yesterday it said my bg was 470; it was 63. Today I’ve had to enter the numbers because it wasn’t relaying it when it should have been correcting a high bg. Yes, the changing cartridge is ridiculously hard; the buttons time out too soon but mostly its not doing what its supposed to do.
sounds like you’re having some pretty major Dexcom issues there. I’d recommend reaching out to Dexcom customer support to help with that piece for sure! and the screen time out can go up wo 120 seconds, earlier itmes outs are often a result of the “3 tap” safety feature, where tapping on 3 “random” spots will black out the screen. a safety feature to prevent us form “butt bolusing” ourselves. One of the more irritating features of the first couple days with the system.
the lows are also a huge concern, I recommend working with your Tandem rep/prescriber to get your settings adjusted. with lots of lows it may be that your correction factors need to be adjusted to keep control IQ working well (not to mention those dexcom “phantom highs”)
I can rarely trust a Dexcom in the first 6- 12 hours to be reliable enough to trust with my dosage, so I will turn control IQ off until it’s stable, and if I have a sensor that has ongoing issues i stay in manual mode and reach out to support for torubleshooting/replacement.
I have also had trouble with my Dexcom G6. Last time I was informed, when changing sites, you should wait 30 before inserting a new sensor. Hope this bit of info helps you.
true, waiting 20 minutes form the end of one sensor before starting another does help reduce issues.
Exactly. It doesn’t do what it is supposed to do. Never adjusts adequately, has too many alarms which go off constantly, including one that tells me I had a high bs 6 hours ago. I hate this thing. So many issues I don’t have the time to describe them all.
I agree – I hate the fact that I cannot shut off the stupid “you had a high reading 2 hours ago” alarm. What good is that alarm? Wakes me up in the middle of the night way too frequently.
Yes, I ‘ve certainly had my fill of being wakened in the middle of the night. I would like to find a way to silence the alarms while sleeping since I had no problems sleeping without the pump. Can the engineers do something to help? Sleep is important for everyone.
Yes, this is extremely frustrating.
I have been using the Tslim X2 for about 6 months now. I am not overly impressed, but it is a step up from the previous Tslim I had. I do have a few complaints about the X2. There is no way to turn off the “high blood sugar was recorded 2 hours ago – please test blood sugar” reminder unless you turn off the high blood sugar alarm. This is so annoying, as it wakes me up during the night 2 hours after I have corrected for a high blood sugar.
I frequently switch to Temp Rate mode as I sometimes inject insulin via a syringe. Also – I don’t trust the sensor to give the signal that my blood sugar is dropping, or is already low – and to shut off the basal. When I enter a temp rate of less than 50%, I have to wait for the pump to go through it’s calibration cycle, where it once again asked me if I meant to enter a temp rate less than 50%. It takes quite a few key strokes to enter a temp rate, so there is no way that it can be entered accidentally. If you are lucky, the confirmation prompt comes within a minute or so, but it can take up to 10 minutes to get this prompt. Thus, if I make the temp rate change in the middle of the night, my sleep gets interrupted once more.
All in all the sensors are fairly accurate, but there have been many times when my pump has alarmed when I dropped below 100, and when I check my blood sugar on my meter, I am actually at 35 or so. This annoys me, as I never know when the sensor is accurate.
Finally, the holsters that come with the pump are terrible. I hate the metal clip-on type. The first time I used it it sheared off the ribs that hold the metal clip on. The clip that allows you to rotate the pump ($29) – is flimsy – just like all holsters. The gussets that secure the clip pin break on the slightest bump. I usually go through about 6 or 7 holsters a year. All they really need to do is beef up the gussets that secure the pin – but then they would lose the additional revenue of holster purchases. Right now I use a Minimed holster, but they are not much better. For paying over $10,000 for a pump, the least they can do is provide a decent holster – or give us free replacements. I have complained to Tandem dozens of times, but nothing happens.
I’m with you on the annoying alerts. Unfortunately those are less a tandem issue and more an FDA issue, they require pumps, and particulalry HCL enabled pumps to give a ton of alerts. I turn all the alerts form my pump to vibrate so they are less intrusive.
When it comes to CGm, I try to keep in mind that in the grand scale of things this is still really new tech, so it’s still got room for improvement. I typically don’t use CIQ for the first 6-12 hours of a new sensor due to accuracy issues.
this is round one of HCL tech, so with developments in CGM, algorithms, and FDA backing off its hyper vigilance a bit we should get more dynamic, less burdensome systems to come.
Brian, Did you really pay $10,000 ???? Or is that the cash price and you don’t have insurance? I was told by a Dexcom rep that the pump alone was $4,000 before insurance, hope I don’t get screwed and somehow get sucked into a different amount. Too many pros and cons between Medtronic and Dexcom, how do I choose?
HI Amy, cash value on pump systems range from les than 2000 for 30 days of omnipod use to just over 4000 for a tubed pump. but with insurance they are significantly less, however with deductibles etc it varies widely. Your sales rep can quote you the exact out of pocket cost before your pump sends so you are not on the hook for more than you are prepared for. and they all have interest free payment programs available as well.
I have been using my new X2 for a week. I LOVE THIS PUMP! I was previously using a Medtronic 670G and a Dexcom sensor. I quit using the Guardian sensor as I found them to be horribly inaccurate. Therefore, I could not use the closed-loop ability of the Medtronic 670G. After working diligently with my Dr., my insurance company permitted me to get the Tandem pump in place of the preferred (Medtronic) pump. I do find the filling of the reservoir more complicated than it needs to be and the amount of insulin making it in the pump is nowhere close to what seems to be in the reservoir. I have set the vast majority of the alarms to vibrate as to not interrupt my day/sleep. I have experienced 1 occlusion alarm that seemed to resolve itself when I resumed insulin. This occlusion alarm occurred when I only had 6 units of insulin left in the reservoir; maybe that had something to do with it? The Control feature is working extremely well for me. I have not had a single low since I started with this pump. I am used to having several with my 670G. I am also using a significantly less amount of insulin to maintain optimal control. I am hopeful this pump keeps working in this manner for me. I love it so much, I’d love to work for this company!
I’ve had my t:slimx2 for almost a year. After eating I always go high despite entering the correct carb amount. My BG eventually goes down but I do get alarms that I am too high with a large amount of insulin still on board. Why does it take so long for the insulin to be delivered which makes my BG go high? It sometimes takes several hours to get it back in normal range. I there a way to set the pump to deliver the insulin faster? With injections it one push and it delivered.
it sounds like what you’re dealing with is an insulin timing issue. The solution is to match the timing of the absorption of the food with the timing of the absorption of your insulin (Though getting the bolus in faster is not the right fix, this would buy you seconds, when what you’re looking for is more like many minutes) Here is one article on the topic, but we have a number of them.
I started using my new Tandem t-slim insulin pump about 4 months ago and really liked it. I also got occlusion alarms but was ok with that. However, what I am really upset and disappointed about is that over 2 weeks ago, I got this “Data Error” message on my pump, and noticed that all of the insulin dosage history had been wiped out. Normally you can see the basal and bolus histories over a period of time, but that was wiped out. And as if that wasn’t bad enough, now the pump is not tracking my basal – and sometimes my bolus insulin – properly. The insulin history is very intermittent – sometimes you see it, and sometimes you don’t. I never, ever had that problem during the 20 years that I used Medtronic pumps. So anyway, I called Tandem’s customer service about the issue and they told me that normally the basal history self corrects – after a couple of minutes!!! Ha Ha Ha – it’s now been a couple of weeks and has not corrected. Tandem’s customer service said that the only thing they could do at this point is send me a refurbished pump. Sorry, my Tandem pump is only 4 months old, it’s almost new. I don’t want somebody else’s refurbished pump – I want a new one, just like the one I bought. And BTW Tandem, how is it that you have SO MANY refurbished pumps hanging around to give away??? Too many junky pumps!
OUCh I’ve heard of a few people with strange data retention issues on the pumps, No insulin delivery issue, but data loss is problematic!
that I know of all companies send out refurbished products for in warranty replacements these days, insulet’s PDMs may be new, but it’s become the industry standard unfortunately.
I have been on the TSlim for almost a year. I loved my Medtronic Mini-Med better but am getting used to this one. My biggest complaint is like everyone elses – alarms, alarms, alarms! Not fun in the middle of the night. I have been known to take the whole thing off and wrap it in a towel and put it in the bottom of my bathroom cupboard until morning. Between the pump going off and then triggering the CGM, I absolutely hate that part of it. Then there is the issue of occlusions. Never had an occlusion until about a month ago and now I’ve had three. Overall, It’s a huge pain, more expensive, harder to change out, too many pieces, dumbest reservoir holder I’ve ever seen……but my A1C is actually waaaay lower with this new pump. I went from 8.9 to 7.2 in six weeks. It works, it’s troublesome, but it does help me more than the Medtronic did. I hope they find a way to help with the occlusions and stop some of the alarms – I have stopped some but others – there’s no stopping!!
HI Nancee, I find that with a little support and education most clients can dramatically reduce the alert burden.
I hear you Mason. I actually take off my Tandem pump for several hours during the day, just to get a break from the all the alarms. Some days, I just use my Dexcom app on my phone and my old back Medtronic pump. I turn off ALL Alarms in the app except BG low. When I want to know how I am doing, I look at the app. No nags for a day or two is great.
Perhaps if the developers of these products were ACTUALLY living with T1D, maybe the products would be less annoying.
Yes, the alarms are definitely a problem. Living with them is horrible. I agree that developers should have to sleep with them for atleast a month. Might bring a change.
I find that pump and cgm setup often had a lot to do with alerts and alarm fatigue with the X2. Not to mention that the more stable the blood sugar the fewer the alerts. In one appointment i can usually help users reduce to one audible alert per day and far fewer vibration alerts. Feel free to give our office a call to setup an appointment.
You can now select High, Medium, Low/Soft or Vibrate for each individual alarm category.
I changed most of mine to VIBRATE and I can sleep through the night. More importantly, my wife can sleep undisturbed by my pump alarms, which I can feel.
@Nancee in FL…I too have had middle of the night alarms. Mostly occlusions. When I investigate, the pump is delivering. So I change the part I insert in my body and I still get occlusion alarms. Figure that one out. The weird part is that sometimes it will alarm once or twice then stop, just enough to wake me up and make me angry so I can’t get back to sleep. (and no…I wasn’t laying on the tubing.) In the 4 years I’ve had this pump, I’ve only had 2 occlusions in the daytime hours. The rest are in the middle of the night. I have done the same thing as you…removed the pump in disgust and frustration, wrapped it in a towel and put it in another room just to be able to get SOME sleep. I had a mini-med pump for 7 years and NEVER had one single occlusion…day or night. My biggest complaint though, is that it never…NEVER…uses all the insulin in the reservoir, yet the pump says it’s empty. I have actually taken a hypodermic needle and removed as much as 15 units from the so called ’empty’ reservoir. Figure that waste over a period of a year time 4 years. I am retired and on a fixed income and cannot afford this waste. When my mini-med was empty…it really was empty. When my warranty runs out I’m going back to Medtronic. I hate this pump.
Nancee, I too found the alarms, alerts dreadful. My most hated is the empty cartridge loud beeps every 3 minutes. Sometimes it is not convenient to change immediately, I am not in any danger, lol. I set every alarm/alert to vibrate, if not then low. There is a way to completely power off the T-Slim in special situations. (caution of course) 1. Must plug in a USB power source as if charging. 2. Hold down the T button for 40 seconds. You will hear 3 beeps then power off. When restart just press the T button again. Pump settings not lost.
DO NOT GET THIS PUMP!!!! The constant buzzing and alarming makes me want to smash it – I cannot wait until the warranty expires and I can go back to Medtronic. Here are some examples of constant buzzing:
1. Pump has lost connection with CGM – BUZZZZZ – what exactly am I supposed to do about that? Why are you notifying me to tell me this? It will likely regain connectivity quickly – just do it, quietly.
2. Your blood sugar is raising and we’re increasing the basal rate – BUZZZZ. Again, what am I supposed to do about this? That’s why I bought this pump – it should just work quietly. Thanks for the unnecessary reminder that I’m diabetic.
3. This bolus was not delivered – BUZZZZ – b/c it’s easy to mistakenly hit the bolus button, you don’t notice and put the pump back in your pocket – BUZZZZZZZZ – UGH. DIE
4. Occlusion alarm – BUZZ BUZZ BUZZ ALARM ALARM ALARM – No way to turn the alarms off. Thanks for the embarrassing reminder to EVERYONE that I’m diabetic and it sounds like I can’t take care of myself.
5. Stop insulin delivery – BUZZ BUZ BUZZ ALARM ALARM ALARM – I deliberately stopped the pump. Why do I want an AWFUL loud alarm reminding me?
I cannot tell you how much I loathe this pump. Seriously, if you like the constant buzzing in your pocket, this pump is for you. It buzzes so much when I’m trying to sleep that I sometimes just bury it in a drawer so I can sleep in peace. Just awful.
HI Mason, the majority of your nuisance alerts and alarms can be easily avoided. I recommend giving a call for an appointment and w can walk through how to reduce and eliminate these tiresome burdens form your world.
Unfortunately we are often trained on how to use these devices, but not how to live with them effectively!
You can’t disable the audio alarms for “Stop Insulin Delivery,” which is absolutely enraging because it’s the only alarm that has no business being there in the first place! Why are alarms for events that are literally a matter of life or death (e.g. low blood sugar) able to be shutoff with a click but this one (which nearly all users will engage at least once a day) can’t even be set to vibrate? What genius was responsible for that design decision?
Agreed QC, we should at least be able to change the volume or timing of this one
my work around is to turn off CIQ, then disconnect form the pump without actually suspending.
With CIQ on we are forced to announce our disconnected time so we don’t mess up our IOB.
Unfortunately the designers consider no insulin delivery from a suspend the same as no insulin delivery from being out of insulin. A sign the design was not by people who live with diabetes. Though the FDA is also partially to blame with their nonsensical “safety” requirements
I had this same issue with the new Medtronic 770G. The alarms drove me nuts and 95% of the time made no sense or there was no need for an alarm. It’s lunacy how they make these new insulin pumps and don’t seem to consult actual diabetics about what we want. It also wasn’t compatible with Dexcom and has a very painful insertion process along with countless other issues. I had to go back to my Medtronic Paradigm 751 and I felt peace again. I talked with Medtronic about my issues and how I wanted to return the 770G, so they got someone else to call me and tell me to stick with it because “the statistics prove it’s a better pump”. I tried it out for 2 more weeks like I was asked and still wanted to smash the pump to pieces I hated it so much. So I called again saying I wanted to return it and it was past the 30 day return period so they wouldn’t let me. Medical device companies are getting slimy and it’s disgusting. Thanks for saving me wasted money and my sanity, I will not be buying the t slim now either.
If anyone uses a pump that is compatible with Dexcom, alarms that can be fully self set, and has no insertion or delivery issues, please respond and let me know. Is that too much for a diabetic to ask for?
Unfortunately there is no pump on the market that doesn’t have insertion issues, and at this time only the Tandem system is compatible with the Dexcom. The omnipod 5 system is slated for release sometime later this year so keep an eye out for that option. No system is perfect, it’s all about finding the best fit with the fewest head aches for the individual.
My son uses Dexcom G6 with his Medtronic 670g. Not sure why they state that Tandem Is the only one on the market that is compatible with Dexcom and no insertion issues ever after 5 years of use…..(??)
The Tandem is the only pump currently interoperable with the Dexcom G6. Any pump can be used along side any CGM, but they don’t work Together (“talk to each other”)
I have been having the occlusion alerts all week and it’s driving me crazy, I keep changing all of the pump cartridges, insertion sets, everything and nothing seems to work. The Tandem support suggested some trouble shooting but the super loud alerts continue, it’s very stressful. does anyone have any suggestion ?
Hi Traci, you may also be having problems depending on your insulin type as some insulins (like fiasp and lyumjev) have been tied to more occlusion issues.
Hi. So great to see others in the same boat as me! I was on Medtronic insulin pumps for over 15 years. Was so excited about the TSlim. I love the dexcom G6 and the fact the pump coordinates with it. The Control IQ is also a great feature. Cons: The pump is ridiculously heavy. The clip is awful. The worst! It’s a thin piece of metal that stretches out and does not hold. If you wear a thin waistband or workout shorts, it just falls to the ground and pulls your cannula out! The inclusion sets are the worst!! There are way too many pieces, way too many steps, and the cannulas do not stay in your skin. I am beyond frustrated. I have inclusions 80% of the time. Unnecessary highs after eating or during the night. Changes sites every 1-2 days. I so wanted to like the TSlim, but I am done!!
Plus….the TSlim wastes so much expensive insulin!! It’s just ridiculous. I have to fill the cartridge but only use about 20 u it’s a day. Such a waste! Please come up with a better system, better clip and better infusion sets!
we don’t manufacture devices, just review them.
one tip is that you can put 6 days worth of insulin in the cartridge and use it for 6 days, changing the infusion set on the body every 3 or fewer days. This can reduce the insulin wastage at least.
Yes, You are preaching to my choirs. I feel the exact same way. I get a lot of inclusion alarms as well after just changing my sites. I also hate how many pieces it takes to get connected to yourself and Why is the insulin chamber not clear/visible so you can see how much is left like Medtronic. I too feel a bunch of insulin is wasted in this device. I also get way to many repeats for being high after eating something and will comply with the device and correct it but it continues to alarm me grrrr. My blood sugar does not drop instant with the highs but they do eventually come down. If I correct as many times as this things tries to get me too (which I did the first week I had it) I got multiple extreme lows… I’m still trying to like it but so far not a fan after having this for a 45 days. I really miss my Animas pump with the Dexcom ; (…..
there is a new clip for the Tandem pump that I like 100x more!!
I would also recommend checking out different infusion sets. the Tandem and Medtronic all use the same kinds of sets (Check out the packaging both made by the same company Unimedical) sounds like an angled set would reduce your canula issues and occlusions, or a steel set.
The cartridge refill process on the Tandem is a work of idiocy for sure! but hopefully some helpful tips can make your Tandem use experience a little better.
There a new product out that at least helps keep the syringe and cartridge in place while you’re refilling: https://www.ayudalife.com
Might be worth checking out.
wow really specific tool! thanks for the info will check it out and share
I agree. This is my first pump and I detest it. It falls off constantly and alarms endlessly and for the most ridiculous of reasons.
Thanks for sharing your struggles, First time pumping comes with a lot of potential pit falls. Working with an educator with first hand life experience can make a big difference. Most of your alarms can likely be avoided or set to reduce burden and the falling off can be eliminated with either with a change of infusion set, or the right under prep or over tape.
I switched over to the Tslim from Medtronic over a year ago. I like the tslim pump, however I want to kick it to the curb just due to the fact it only works with Humalog Insulin (Humalog is not a top shelf rapid insulin for pumpers). If your not aware Tslim has FDA approval for Humalog only due to other Insuline tends to occlude in the tubing. I have tried Apidra and Fiasp and both will occlude the tubing? Does anyone know why? And is Tandom thinking of correcting this issue?
Tandem is approves for use with novolog and Humalog,
most pumps aren’t approved with Apidra though we have users who have used it well with a 2 day infusion set change
there is not likely to be FDA approval for fiasp or lyumjev in pumps as studies have shown little benefit and increase site related issues with these insulin so it doesnt profit the companies to pursue that approval. However we have lots of patients who use “off label” insulins when pumping with success.
And if all infusion sets and tubing are made by the same company, why would my FIASP suddenly cause problems? Why would the Mio/Autosoft 90 suddenly cause irritation requiring daily set changes? Same insulin, same sets, different results: bad on Tandem and fine on MiniMed. That’s what took me to this website, looking for answers.
many people have problems with infusion sites on Fiasp. IT seems to be that the niacin molecule added to the insulin molecule to speed absorption may irritate the capillary bed for some users causing the absorption to actually be slowed rather than sped up (there is a fine line between irritation and inflammation) this can take time to become an issue. Some users see it almost immediately, some within days, weeks, months and others never have an issue. Some of the complexities and also some of the unknowns that we struggle with in management.
I’m actually relieved to see so many folks here having similar problems as I am with the X2. All I could find on message boards until now is how great it is. I switched to the X2 to escape Medtronic’s customer service about 2 months ago, with high hopes for added convenience, reliability and lower A1C. Sadly, I have experienced none of these. The ONLY positive I have experienced thus far has been the eliminated need for checking blood sugar twice daily. The negatives are numerous. The charging necessity is inconvenient and ridiculous. Occlusions are frequent. I exercise a lot and have to replace my infusion set on a daily basis with the X2. Most of the time when I remove the set bubbles are clogging the tubing under my skin. I read here that some folks have constant highs when the cartridge is below 50 units. This would make sense for me, as I usually only require 30 units daily so I am almost always in this range. Every meal I spike to around 300 and most nights I can’t get it to come back down without changing the set entirely.
The clip wouldn’t stay on my belt and the case broke in 3 days. The cartridge refill process is shamefully wasteful of insulin. The software requires the user to verify every adjustment, which is fine, but there is one very annoying exception. When you access the “Load” menu to clear bubbles from your tubing, don’t accidentally hit the change cartridge button on the sensitive touchscreen. There is no verification prompt so you’re stuck wasting at least 12 units of insulin, and if your cartridge is below 50 units you have to replace it.
I gave Tandem an honest go, I truly did. I hate this pump and (never thought I’d say this) I’m going back to Medtronic.
Hi Ej, sorry to hear about the troubles
I find most of the issues people have with highs with the Tandem are related to the cartridge fill process not being trained on properly or control IQ needing setting adjustments (And some times poor site rotation practices by users)
the clip is awful they just came out with a new clip a lot like the old Medtronic holster clip with a gator style swiveling clip that I like a lot more.
I agree with the default requirements of the set change process being obnoxious and really hope they change this in future products too!
The pump and CGM linkage with Dexcom is great, when it works.
However the consumables for this pump are the worst I’ve had to deal with in my 20 years of insulin pumps.
I would personally avoid this pump, and wish I had for the Medtronic (cause they were always simple to use)
Also the associated Dexcom G6 is pretty glitchy so don’t bet the farm on the CGM combo.
I was diagnosed in 1963 with type 1 diabetes. I have been using an insulin pump since 1982. I began using a T-slim X2 in January because I am getting close to Medicare age and I learned the sensors for the Medtronic pumps are not covered. If I could have reordered a Revel I would have. I’m blessed to still have a working Revel as my back up pump. In January my new T-slim X2 died. The pump had to be replaced. I had only one occlusion in the 4 weeks of use. Tandem has replaced by pump 3 times now. I have used two different infusion sets from Tandem and I still get occlusions. Sometimes the occlusion happens on day one. Sometimes 2 times in one day. My frustration is that the sets are always blamed. However, if I wear my Revel I have no occlusions – EVER. My choice of sets with the Revel were the Mio 5mm and so I was given the Autosoft 6mm because they are supposed to be the same set…NOT. I’m now using the Trusteel (I still get occlusions). I can now tell when an occlusion is on the way. One day I took the t-slim off, placed on the counter, and let it run on its own off of my body. It occluded about 2 hours later! I hate this pump. :) I’m used to A1c’s at 6.3. I’m trying to avoid complications. This pump is a nightmare for me.
WOw Kim, thanks for sharing! That is really problematic!
I had an X2 that did have some occlusion issues, it was replaced and the issue never happened again. I do know that fiasp users and Apridra users do report a big increase in occlusion issues with the x2, probably related to the difference in cartridge design.
I hate this pump too. The occlusion issue is such a joke. My pump, which is relatively new (about 6 months), constantly registers occlusions. When I called customer support, they tried to blame room AND body temperature and the fact that I don’t use a supported brand of insulin – both of which are obviously ridiculous excuses, as when I change the infusion set – miraculously the occlusions stop. To make matters worse, the occlusion alarm is SO LOUD and you can’t disabled the sound – so I have a pump that has occlusion errors constantly, which occur in public, so it appears that I have some embarrassing dangerous medical emergency happening. And of course you can’t disable the alarm for a stopped pump, so you can’t stop the pump for a shower, or going in the pool, without ALARMS ALARMS ALARMS so you leave it unstopped, still pumping insulin and thus having a miscalculation for how much insulin is in your body.
Also, it appears that once insulin amount in the pump gets down to about 50, my blood sugar goes up and remains there until I refill the pump. It must be like an air thing, or it’s not properly administering insulin. And of course when you fill it up, it doesn’t tell you how much it’s actually logging (it always says “240+”) – so you know you’re just wasting expensive, precious insulin.
I cannot wait to go back to Medtronic. I’d rather just use my phone CGM app and then manually pump insulin. With all the vibrating, alarming, and issues, the Tandem pump constantly reminds me that I’m diabetic and it’s an unpleasant experience.
I had a similar experience with a Tandem pump and I found that an entire lot of infusion sets needed to be replaced. I also found that this happened a lot more with Fiasp than it did with novolog, and the end of reservoir highs were fiasp related as well. So you might want to consider switching insulins. The issue seemed to be that I was having an inflammatory or autoimmune response to the fiasp. It seemed to cause intermittent occlusions at the end of the canula. Not devaluing your experience in the least, that is SUPER furstrating it was maddening when it would happen to me too, just sharing an experience and fix that might work for you. I also switched to autosoft30 infusion sets and have not had any occlusion issues since.
Meanwhile good news is that Medtronic just announced their 770 pump is coming to market.
I feel your pain. Worst decision I ever made was getting the T slim
Please send me information on the Tandem T slim 2 how its works and how it works with a Dexcom G6
I recommend reaching out to the tandem website, we do not sell pumps or cgms.
I have used a Medtronic pump for 6 years. My dr. said she thought I would like this T Slim x2. it is a terrible design for filling. It is so awkward to use I can’t believe the design was not perfected. It seems like they rushed it before perfecting the design. It takes 3 times longer or more to go through all the steps to fill it. Very poorly design. I got the distinct feeling they were trying to rush it to make more money. SHAME ON THIS COMPANY. they obviously don’t care About the ease or convenience to he patient. it needs easier way to remove the back off which is what you must do every 3 days. I had to go find a neighbor to remove the front from the back to fill it. Terrible design.
Agreed! Though the design was largely a space saving measure in an effort to make a smaller pump, it is cumbersome and error prone to use. However it is also part of life with pumps that there is no perfect option, they all have benefits and drawbacks and so finding the right set up for each individual is important.
I agree Betsy! The Medtronic reservoir can be filled with one hand, and the Tandem requires two hands and a third hand would be nice! Tandem should have tested this pump with existing pump users.
unfortunately their goal was the smallest pump on the market, so the cartridge is quite convoluted. there is a company that makes a device that holds the cartridge and syringe together so at least it’s a 2 hand job . it’s called Cierta.
Just started on the Tslim x2 two weeks ago. My sugars are significantly higher. Has anyone who’s experienced this problem been able to solve it? Did you change any settings on the pump like duration of insulin action etc? I’ve been using temp basals at 200-250% and I’m still high. Correction boluses aren’t working properly to reduced sugars. Thought it may have been my infusion sites so I changed them, or bad vial of insulin so I started a new one, but it looks like it’s something specifically with the pump. Maybe it’s algorithm? If I can’t bring my sugars back to normal values, I will send the pump back. An observation I’ve made is that my sugars are running high all around, but even higher right after I charge the pump. Wondering if the heat generated from charging is affecting the insulin.
This is often an issue realted to cartridge refill procedures and being left with air in the cartridge. You also definitely do not want to dive straight into control IQ use after starting the pump to be sure that is not another factor as any issues it has will be hugely magnified with cartridge or set issues.
the pump should not heat while charging, if this is happening contact Tandem
Your insulin could be an issue
We do a good deal of troubleshooting and training to reduce issues with our patients if you’d like to call the office to make an appointment.
I have experienced the same issues, after having come from the Medtronic 670g pump, where I good control. However my Dr. switched me to the X2 with IQ , because I had too many other issues with recalls and 5 replacements in one year.
1st if your Diabetic educators did not instruct you to insert the syringe into the reservoir and draw out the excess air.
2nd you may need to change insulin sensitivity with Dr approval, I did mine on my own, but I am a medical professional.
3rd you can have your Dr. increase the basal rate based on whether you have frequent lows or not.
4th and most important, give the pump (as a new X2 user) approximately 3 to 4 weeks to allow the IQ tech to completely learn your insulin use and habits.
5th make sure that if using the IQ with the G6 that you change your weight amount in My pump under the IQ tab, if it goes up or down more than 5 pounds in a short previous of time, ie: thanksgiving and the weight stays on or you’ve been sick for a lengthy time and weight drops significantly, ie: the flu
I am in the top 3 percent of type 1 diabetics that have severe difficulties with control no matter what I do or what diet and exercise I follow, but now the pump keeps good control. My reason for changing pumps was because while both pumps are supposed to “ mimic” the pancreas, I had problems with frequent rapid lows, the 670g was supposed to stop delivery but it never stopped before I would actually get to 60 or so. The X2 has actually prevented those lows and unlike the Medtronic 670g the X2 lets you know delivery has stopped.
Thanks for all your comments. I’m considering the t:slim x2 + Dexcom G6, mostly because of issues I’ve had with Medtronics, and the overall pairing of tslim x2 + Deccom G6 seems to show better control. I liked my previous 530g, which integrated with CGM. The transmitter cracked and they no longer produce them, so they “upgraded” me to the 630g. I don’t like the concept of the infusion set loading process for the Tandem (Medtronics is MUCH simpler), but for all the complaints I’ve seen on here about the Tandem, the 630g (and 670g is basically the same other than the auto adjustments) have most of the same issues. Don’t base you choice on the clip, because the 630g clip breaks the first time you bump against something, then repeatedly falls off. My biggest annoyance is the warnings – the 630g is constantly warning about something. And if you can’t calibrate the pump with a fingerstick in time, the 630g just stops giving you any reading. I’d rather have it show be a rising/lowering trend than to just completely stop reading. I keep my pump in vibrate mode, because I use it during the day, expect alerts during meetings and such if I’m getting high/low, but at night if you leave it on vibrate and my blood sugar gets low beyond the danger point, it only vibrates. So I either have to remember to turn on volume at night and turn them off in the morning, or have the stupid thing beeping all day. The 530g was smart enough to vibrate and alarm in that circumstance. Two real questions I have are 1) does anyone use the tslim x2 with Apidra? Tandem says only use Humalog or Novalog, and although similar, Apidra seems to work better for me 2) Does anyone take their tslim x2 through the normal metal detectors at the airport? Not the full body scanners, but the old style metal detector. My Medtronic device has no issue with the normal metal detectors, so I only have to get a pat-down if something else sets off the metal detector. In any case, don’t assume switching to Medtronic is going to fix your woes, because it sounds like all devices have their own issues.
I have no used Apidra myself, but I have a couple patients who do and have not had issues with it, but they do change sets more frequently than 3 days.
I have worn my X2 through every kind of security screening without issue, it is not FDA approved beyond a metal detector though. I have had some go off and other not, but that has been true of all my pumps, even occasionally my steel sets. But I’ve never hd any issues with security (in airports, government buildings, and lock down facilities)
I’ve just started using the Tandem X2 pump.I like the basil iq technology and am waiting for the Control iq technology to be approved. The problem I have noticed is the loss of data from the G6 transmitter to the pump. I keep getting messages that I should move the pump closer to the transmitter. This happens often during a 24 hour period and I lose the connection for up to 1.5 hours per incident. I realize this is Bluetooth technology, but my transmitter and pump are at most 18 inches apart. I’ve called Tandem and was told to move the devices closer together and make sure the back of the pump is facing the transmitter. This is really unacceptable because if, during the night, my blood sugar goes low and the suspend feature is activated, it will start giving me insulin again if the connection is lost. Need Tandem to correct this.
I had similar situations, and I actually had to replace my Dexcom transmitter.
The hard part is that Dexcom thinks its a Tandem issue, and Tandem thinks it’s a Dexcom issue, so getting it solved is frustrating for certain.
I HAVE BEEN USING PUMPS FOR 20 YEARS AND THIS IS MY FOURTTH ONE BUT MY FIRST TSLIM,I HAVE NEVER WORN ANY PUMP ON MY BELT ALL DAY,ALL MY T SHIRTS HAVE A POCKET AND MY PUMP HAS A LONG 23’CORD (CANT THINK OF THE RIGHT WORD FOR IT RIGHT NOW) AND NEVER HAVE A PROBLEM WITH IT GETTING DAMAGED OR SCRATCHED ON MY BELT AND NEVER HAD A PROBLEM WITH INSULIN GETTING SPOILED DUE TO BODY HEAT AND AT NIGHT I USE THE OLD MEDTRONIC BELT WITH THE VELCRO POUCH AROUND MY WAIST AND IT WORKS GREAT.I PUT A SNAP ON IT BECAUSE THE VELCRO WORE OUT OVER THE YEARS (WORKS GREAT).
I ALSO HAD A PROBLEM WITH HIGH BLOOD SUGARS WITH THE INFUSION SETS BUT I WAS USING THE 6MM SET AND I FOUND THE NEEDLE WAS BENDING AGAINST THE SKIN UPON INSERTING AND I COULD NOT TELL THAT IT WAS HAPPENING AND IT WAS BY SHEAR LUCK THAT I CAUGHT IT,I CHANGE TO THE 9MM AND THE PROBLEM CLEARED.JUST MAKE SURE THE SET IS HELD PERFECTLY STRAIGHT UPON INSERTING.
I STILL HAVE A PROBLEM WITH MY PUMP WIPING OUT THE DATA BUT NOT MY SETTINGS EVERY FEW MONTHS (THANK GOD FOR CLARITY) MY DOCTOR CAN STILL RETRIEVE THE INFO.I BROUGHT
THIS ISSUE UP WITH TANDEM BUT IT DOESN’T SEEM TO WANT TO KNOW ABOUT IT SO I WILL SOON TAKE IT TO THE FDA
Thanks for sharing your experience William,
True that 90 degree sets are very particular about getting the right angle for insertion. be sure you’re rotating locations well because when we see the sets not wanting to insert, that can be an indicator that you’ve got some thickening of the tissue density that may indicate scarring at or under the surface.
I’ve seen a few issues with data loss on Tslim sets recently, this is occasionally due to interoperability with downloading software like glooko, diasend or tidepool and can be super frustrating.
I HAVE BEEN USING TSLIM X2 FOR ONE YEAR AND MY ONLY PROBLEM HAS BEEN TWO TIMES IN ONE YEAR MY PUMP HAS RESET IT SELF WHERE I LOST ALL MY DATA THAT WAS IN THE PUMP EXCEPT MY PERSONALIZED SETTINGS WHICH TANDEM JUST BRUSHES IT OFF AS NOT AFFECTING THERAPY,I WONDER IF THE FDA WILL PICK UP ON THIS AND MAKE TANDEM FIX THIS PROBLEM BECAUSE IM SURE THIS IS JUST A SOFT WARE PROBLEM,OTHER THEN THAT THE PUMP WITH DEXCOM G6 IS GREAT
I have been a Type 1 diabetic for almost 50 years. In 1999, I began using a Disetronic insulin pump. This worked great for me until my doctor recommended the Medtronic insulin pump. I made the change and used it for several years without many issues. Earlier this year, my doctor again recommended a different brand of insulin pump…the Tandem t:slim x2. The company is supposed to be on the cutting edge of insulin pump therapy with many perks that other pump companies do not have (i.e., updates for the pump as opposed to buying a new one, friendlier screen viewing, no calibrating with the CGM). I have owned the Tandem pump for 5 months now. I HATE IT! I have had multiple issues: higher (unexplained) blood sugars (my A1c jumped from 8.5 to 9.2 in 3 mos. with no changes other than the new pump), multiple occlusion alarms (due to site, tubing) and now I am dealing with my CGM sensor not reading back properly to my pump (I have used 2 new sensors in 2 days). I, too, have had high blood sugars at night with no explanation as to why. My guess is that the pump is somehow not supplying the insulin properly.
I fully agree with Payton’s comments above…Tandem is awful! I’m going back to Medtronic.
sorry to hear about your struggles, we have heard from a few peole about these kinds of issues. I would definitely recommend two things. first is to ensure thatyouare following the cartridge refill procedure carefully, it is eeasy for air to get trapped int he cartridge and for this ti cause insulin to under deliver
The second would be to make sure oyu are using the right infusion set for you. issues with occlusions and set issues are common if the worng type of set for your body, physicality and insulin needs is being used. Also reusing cartridges with the tandem will typically cause a lot of occlusion alerts and issues (a habit many of us got into using medtronic, animus and diesetronic supplies)
I am beyond frustrated with my new Tandem tslim pump. I am back to multiple daily injections, and my control is far better than what I could achieve with my new Tandem pump. I had used Medtronic pumps for twelve years, and it was time to upgrade. I had no problems with Medtronic, but I was enticed by the Tandem story and my endocrinologist’s recommendation. With Tandem, I deal with occlusion alarms, defective infusion sets (Tandem has replaced at least a dozen defective infusion sets.), and uncontrollable blood sugars. Yes, I have also dealt with the Dexcom sensor out of range alarms. The Tandem telephone service is ineffective, requiring callbacks hours later, rather than someone answering the phone.
One more thing. My endocrinologist strongly recommends Fiasp insulin. Fiasp insulin is not approved for use in a Tandem pump, so using Fiasp insulin in a Tandem pump is off-label. That would have been helpful to have known when dealing with the Tandem sales team.
If I knew in December 2019, having met my out-of-pocket medical max and needing a new pump, what I know now, I would have NEVER purchased the Tandem pump.
I see the value of the Tandem story and closed-loop pumping. Does anyone have any recommendations?
Sorry to hear about your experience with your pump.
I have had a couple of patients experience problems with an entire lot of infusion sets. We’ve passed info on ton Tandem for Quality improvement.
Tandem has certainly been inundated with calls recently as we often see with new product roll outs, which is always unfortunate.
We would be happy to discuss the different hybrid closed loop options and which would fit your needs best. You can give our office a call to schedule a consultation.
I am pretty new to the Tandem tslim pump.
I am visually impaired and have some neuropathy in my hands due to diabetes.
I am having an incredibly difficult time with the infusion sets! I have tried the Autosoft 90, the TruSteel, and am now using the VariSoft. I haver issues with all of the tape and small parts on the sets. More importantly, it is nearly impossible for me to attach / detach the infusion set.
I have searched the internet for some kind of replacement, but the tlock is exclusive to Tandem.
I have reached out to Tandem, no help there.
Can anyone offer some helpful advice??
I hate that you are having this struggle, because it is so common and diabetes tech manufacturers just are not listening!
the trouble you are having with infusion sets would be the same with any set out there because no matter what pump they work with, infusion sets are all pretty much the same. The sure T is the simplest and easiest to insert, but connection is still a struggle.
I would actually recommend the Insulet Omnipod as this eliminates the infusion set entirely, you simply fil the pod, remove the adhesive from the pod, stick it where you want it and use the Dash touch screen controller to insert it and start insulin delivery. there is less to see and less to manipulate physically. However there are also limits to the Omnipod’s use. These can be overcome for most patients. But whether you could get the Omnipod and Dash controller would depend on insurance coverage. i recommend reaching out to Insulet Omnipod for assistance.
I am also visually impaired. I use the Autosoft XC. This is much easier to attach and unattach. Good luck!
I dislike my Tandem TSlim. Although the touch screen seemed nifty for the first hour or so the novelty wore off quickly. My trainer (who was a type 2 diabetic and not a pump user) told me during training that the pump charged in roughly 20 minutes and recommended I plug it in to charge while I showered. My pump takes at least an hour to charge from 20%. I love being hooked up to an outlet for an hour at a time! Furthermore, I have higher blood sugars using a the Tandem than I did using Medtronic products. Nothing about my treatment has changed though – my basal rates, carbohydrate and blood sugar correction ratios have all remained the same. My weight has also been consistent. Although my highs aren’t as scary as others listed above, having a 200 – 215 blood sugar when I’ve taken what always was an adequate amount of insulin with a Medtronic pump pisses me off. I can cope but I’ll be using more insulin for the next four years to achieve the same treatment using this inferior product. I’ll never buy another and when I see my endocrinologist in September I’ll make sure I relay all the details to her.
It is definitely strange for a pump to take that long to charge. I recommend reaching out to Tandem regarding the cord you’re using or possibly the pump itself being slow to charge.
for the highs, I know one common thing I see with people switching to the Tandem pump is not purging all the air from the cartridge during set changes. this is a VERY annoying step in the process that can lead to elevated blood sugars, sometimes dangerously so. It’s important to make sure that this, and canula fills are not being missed since it takes an extra step not present with Medtronic pumps.
I have been on the Tandem X2 pump for 6 months and so far am not overly impressed with it. While I understand that it is “state of the art” technology and that it is a very good pump, the cartridge and infusion change process is LONG and I find that I am still referring to the chart sheets to be sure that I do every step ( there are A LOT of steps ) properly. I have been on pumps for years, and the last 15 years on the Medtronic pump which was much more user friendly in my opinion. I have just learned that Tandem has a manual insertion set that I am anxious to try, as I am having difficulty with the the Autosoft X2 . I always inserted the infusion set manually with my Medtronic pump and knew that it was truly inserted and I have high hopes that using the manual insertion will solve a lot of problems.. For the past several days my blood sugars have been over 500 and I continue to change infusion sets. .I always see the drops at the end of the clip, and I am extremely careful to insert correctly. I can understand the occasional problem ,which I have had before, but am in a panic about this latest development.as I now will run out of infusion sets long before my next order. arrives. My doctor is extremely pump savvy and feels this is the best pump on the market– and I am on the Dexcom G5 CGM ( which I LOVE) . Anxiously awaiting the fall when it is expected Medicare will cover the G6 CGM which will than be a closed loop system with the Tandem pump. I am hoping to iron out these issues with my Tandem pump before then! I do like the colored screen. I cannot do a bolus or look at the screen with it attached with the clip because it is upside down and clipped on TIGHT. Have to remove the pump ( doesn’t unclip easily AT ALL ) and then turn it right side up and around to see the face properly. While these seem minor issue, they are annoying when you want to just bolus or look at your pump. With continued hope, I will soldier on expecting the a manual insertion set might work wonders.,
I’ve been an X2 user for a couple years now and the cartridge fill process is the WORST part to me! You’re right, it’s long and tedious and if you don’t have good manual dexterity you can easily end up with a lot of air in the cartridge which could lead to a lot of high blood sugars and even increased risk of ketones.
Did anyone show you that you can change the angle of the belt clip? this might make it easier to wear, and getting the right tension on the metal clip is a pain (It was their way of fixing the ever snapping medtronic plastic clip)
Finding the right infusion set for oyu is key to good management with a pump so hopefully it has worked out well.
There are a lot of great Tandem X2 benefits, but everyone should be made aware of a design flaw with the insulin cartridge. It requires an additional 20 units of insulin. All of which cannot be used as active insulin. When you look at how often you need to change a site, this adds up to a lot of lost insulin. Please take this into account when deciding which device to get.
This is an issue I have observed as an X user as well jon, thanks for sharing.
I NEVER DISPOSE OF THE CARTRIDGE WITHOUT FIRST DRAWING OUT THE UNUSED INSULIN.
I SIMPLY USE THE SAME SYRINGE USED FOR FILLING THE CARTRIDGE, THEN I DRAW THE REST
OF THE INSULIN I NEED FROM A VIAL-IT’S JUST CRAZY TO DISPOSE OF PERFECTLY GOOD
INSULIN, TANDEM REALLY NEEDS TO ADDRESS THIS REDICULOUS CARTRIDGE ISSUE.
I don’t think you are waisting all 12 units of the prime, you are only wasting the droplets. To my knowledge (having been using pumps of different brands for 15 years) the tube gets filled when you prime and stays in the tube as the next push of insulin from the pump now feeds to the filled canola. So you’re only wasting what you push out to remove air.
I would recommend avoiding Tandem Insulin pumps at all costs. Since switching to a Tandem pump, most of my sites have failed prematurely. The reservoir/cartridge will stop delivering consistently at 25 units, which (if you’re like me) and need to stretch out your supplies as long as possible, is a serious detriment. Every single time you change the cartidge/tubing, you are REQUIRED to waste Ten units of Insulin for Priming (for those of us doing the math at home, that’s 100 units every ten sites, a HUGE waste and frankly very greedy move by Tandem). The touch screen was described as “innovative”, but it is extremely sensitive. I regularly (we’re talking more than 3/5 days of the week) wake up to find that rolling over in my sleep has suspended my pump by accident. We’re talking about bloodsugars of 400+, essentially ruining my A1C for an option the user cannot change! The cases provided to me by Tandem were too tight-fitting, and required the sheer herculean force of two adults to remove when I next needed a cartridge change. If you forget to charge your insulin pump electronically (an option so annoying I would rather use syringes, and may have to since one box of supplies is 600+ for Tandem, which is two week’s pay for me), the Tandem pump will erase all saved settings. The charge time is very close to one full hour, which means that (unless you feel comfortable just not having insulin for an hour), you are LITERALLY attached to an outlet and can’t move around (which frequently drives me to actual tears, as it makes me feel like a cyborg rather than an accomplished Diabetic with choices).
Other pumps give you a low battery warning that starts days before you truly require a change, but Tandem gives you a few hours if you’re lucky. I started to cry the first time my pump died, especially since that feature was never disclosed to me by my trainer. The tubing segment (or whatever ridiculous name Tandem gave it) is far from environmentally friendly, and so much as sneezing on one will cause it to set off the tubing-insertion piece early, ruining the site unless you feel like being a mad scientist and lumping your medical supplies into acceptable condition. If your bloodsugar is high, and you’re crying from the pain, this makes even a simple site change a horrible experience. Once, I changed my site THREE TIMES in one day, all correctly, and found that ALL THREE picklines into my body had failed. That could easily have been a hospital trip if I hadn’t realized the problem, and almost was regardless.
Travelling through an airport requires a full-body search, as Tandem pump trainers warn you the device will fail under ANY scanner.
This over-priced machine is irritating, the supplies over-priced and low-quality, and the features are far outstripped by the cons. Do NOT choose Tandem under any circumstances.
Now, if you’ll excuse me – I have to change a DAY-OLD SITE because it stopped working, AGAIN. When I removed the “old” one, it was in perfect condition with a straight pickline, brand new tubing, and new cartridge with more than 100+ units of Insulin.
STAY AWAY FROM TANDEM!
HI payton, I wanted to reach out and invite you to give IDS a call. We would very much like to help you through some of your struggles.
The issues you have mentioned are dramatically different from what our patients report.
The Tandem X2 requires a series of three specific touches to unlock the pump and then suspending insulin delivery would require a minimum of three additional touches. Three random screen touches deactivates the screen and locks the pump for safety. The infusion sets and insertes used by Tandem dataDiabetes are largely the same as others on the market, with the exception of the Tlock attachment.
Charging typically is needed every 3 days with sensor use and weekly without it, and takes about 20 minutes for a full charge. You should get an alert when your battery falls below 20%, roughly a 12 hour period, if you are not getting alerts your pumps settings may be set to vibrate and are not being felt as the vibration is overly weak. A complete battery drain should not cause data loss (I have had a total battery drain happen a couple of times when I’ve ignored earlier warnings to recharge of just forgotten!) The only data loss was from my CGM session needing to be restarted when the pump restarts (because I do not have my Dexcom on my phone) The issues you are having sound very extraordinary and we would like to work with you to resolve them and facilitate an improved pumping experience.
You can pull the insulin out of the cartridge if your site fails, and you can also just change the site, not having to change the entire set up.
I don’t know how it is suspending in the night, I’ve had mine 4 years and have never had that happen. Did you disable the lock somehow?
I flew from St. Louis to San Diego in September and had zero issues with my pump and Dexcom.
I agree on the wasted insulin due to priming, but that would happen with any system except Omnipod. You have to prime the tubing or you would be giving yourself air for the first 12 or so units.
The clip – they do have lots of room for improvement, but I don’t keep my pump in it’s case. I just slip it in my pocket.
Diabetes sucks, but I personally love my Tslim X2 and couldn’t imagine having to go back to multiple injections and blood sugar checks. Hope it works out better for you.
Payton, I’m so sorry to hear it’s not going well with your Tandum pump. Diabetes is high maintenance enough. This technology is supposed to help us, not make things more stressful. I just got my Tandum Tslim X2, and I am also having trouble with my blood sugar going over 400 many nights, and the same thing happened when I laid down during the day.
Did you ever find out why your blood sugar was going so high at night? I wonder if their plastic cannula is not holding up when we’re laying down? I have to assume that is how it would suspend, without you pushing 5 different buttons in the appropriate time. I am only wondering this after reading your post. I’ll let you know if I find out anything on my end, but I certainly can’t continue to have this issue either. I am 5’6″ and 160 lbs, I use my lower abdomen as my infusion site, and I’m a side sleeper. I’m going to look into this because I know they have a steel cannula option that we may want to look into. Good luck to you. I hope you get the customer service you need to address these concerns, and it gets much easier.
I paid a lot of money for the Tandem pump and in less than a years it stoped working and had to wait til I called back a second time and they sent me a (new) one. Well it wasn’t new it was refurbished and now a month later have issues with this one always showing 100 % on batterie charge and my blood sugars are high so now the pump is malfunctioning and all the technicians keep say let’s wait and see if the battery changes in 2 more hours and it’s already been 24 hours. Wow really! Called everyone I had numbers for from when I bought this pump a year ago and NO ONE! Can help! I spent a lot of money for a pump that lasted a year! And maybe technicall support will finally send a refurbished one ( someone else’s old broken pump). I will be saving for a new pump from Medtronics!
Tina, I see your problem is over a year old and hopefully it’s been solved by now, but if not I would gladly trade you my year old Medtronic 670g pump along with the CGM system for your Tandem T-slim X2. 517 nine two seven-0859′ leave a message.
I wear tandem have for over a couple of years I have had issues a couple of times your tech team is horrible you guys don’t back your product it takes to elements in a company to be successful witch is product and customer service you lack at the customer service people like me type one diabetics rely on you guys to do your jobs when your product fails to replace it not to tell me lets see if it happens again that plain stupid
To clarify, Integrated Diabetes Services does not sell Tandem pumps. WE are an independent diabetes education and consulting company. We are not affiliated wih any device or pharmaceuticals companies.
I’ve been wearing a Tandem pump for nearly 4 years. I liked it very much until the nice case with an alligator clip broke and I got one of the new style cases you are using for your new pumps. It’s AWFUL !!!! It’s hard to clip on my waist band. Makes it impossible to push the on off button. But worst of all, it took dynamite to get my pump out to change the cartridge. I took it off and hoped the new cases when I get a new pump would be better. Just talked to my friend with a brand new system. SAME problem. She could not deliver a dose when she was high. The pump faces away from her when clipped to waist, and she cannot get it off. I won’t buy the new one this fall unless this is corrected.
To clarify IDS does not produce the Tandem pump or cases :)
We agree the metal clip on the current case was largely a response to pump wearers that many other clips have plastic parts that break. but the static wear angle and tightness are an issue. We do find that the button issue does get easier to press with use, but it is very stiff when new.
I have the new X2 TSlim pump by Tandem, with the slip in case and a metal clip. The clip won’t break, but it lets go much too easily. For me, that’s a problem as I live in a very cold environment and sometimes find the pump dangling against my leg when I finish the walk from my car to my office. Needless to say, insulin doesn’t like sub-zero temps very well. My solution for now is to put the pump in my pocket. When it’s time to get a new pump, I’ll be evaluating any other options, though the Tandem pump will still be a choice as I really like the functionality of the pump itself. The mention of the connector is also a problem. I like Medtronic’s connector much more than Tandem’s.
agreed on all counts
the clip is often either too tight, or too lose (You can tighten it up by giving it a pinch with some pliers since it’s just a bent piece of metal (Like a paperclip) Or you can use a secondary holder like an old school phone case etc. Myabetic makes one that fits the X2 nicely.