Slim and Dexi hookup with my iPhone

Living with Type 1 diabetes and my Dexcom G6 and t:slim X2 is like having a tiny, bossy robot that's constantly whispering secrets in my ear and occasionally saving me from eating that extra slice of cake.

It's an uncommon occurrence to receive a Type 1 diabetes diagnosis in one's early 40s, but such is life's capricious nature. My journey with Type 1 diabetes started in June 2001.

Imagine Type 1 diabetes as an unwelcome lodger that refuses to leave. I often liken my body to a bustling metropolis, where insulin serves as the gatekeeper, ushering glucose into cells for sustenance. However, in Type 1 diabetes, the body's immune system, typically vigilant against harmful invaders, goes on a drunken rampage and targets the insulin-producing cells in my pancreas. Consequently, insulin production halts, leading to glucose accumulation in the bloodstream. Mishandled, this scenario can pave the way for severe health complications1 like neuropathy or vision impairment.

In contrast, Type 2 diabetes is like a city where cell doors have rusty locks. Despite insulin's persistent attempts to unlock them, these locks (cells) resist, causing glucose to accumulate in the bloodstream. While Type 2 diabetes primarily affects adults over 40, it's increasingly prevalent in younger demographics. Factors like obesity, familial diabetes history, or a sedentary lifestyle often play roles in its development.

Type 1, an autoimmune puzzle with no known preventative measures, usually manifests in childhood or young adulthood, necessitating lifelong insulin therapy. Conversely, Type 2 diabetes can often be mitigated or managed through lifestyle adjustments and medication. Despite their disparities, both types demand meticulous oversight to maintain healthy blood sugar levels and ward off complications.

Once dubbed juvenile diabetes, Type 1 diabetes seemed an improbable diagnosis for adults back in 2001. It took the medical community decades to shed the juvenile label, recognizing that Type 1 diabetes didn't care if patient was too old for high school. My online web searches introduced me to fellow adults, recently christened with the diagnosis, who referred to it as Type 1.5 diabetes. These unfortunate souls had been misdiagnosed with Type 2 diabetes, underscoring the entrenched misconceptions surrounding Type 1 diabetes.

A Continuous Glucose Monitoring System (CGMS), my digital guardian angel, meticulously monitors my glucose levels round the clock, dispatching updates to my phone or insulin pump. Farewell, incessant finger pricks; hello, streamlined diabetes management. While my trysts with CGM systems date back to 2010, the Dexcom brand, particularly the Dexcom G6 Continuous Glucose Monitoring System (CGM), is my favourite. Designed to render glucose monitoring less intrusive and more continuous, it affords me a clearer snapshot of my glucose levels sans the incessant finger pricks.

The Dexcom G6 comprises a petite sensor snug against my skin, measuring glucose levels in the interstitial fluid (the fluid between my cells). This sensor, tethered to a transmitter, dispatches real-time glucose readings to my iPhone and insulin pump. Sleek and discreet, resembling a quarter in size, it requires replacement only every ten days, a welcome respite from the daily rigmarole of traditional blood glucose testing.

The Dexcom G6 is a quantum leap in the quality of life for people with Type 1 diabetes, offering more autonomy, less guesswork, and a deeper comprehension of how various factors sway glucose levels. In short, it gives me enhanced control and confidence in navigating the diabetes labyrinth.

The Tandem t:slim X2 insulin pump, sleek and user-friendly, streamlines diabetes management. Among its attributes, its integration with my Dexcom G6 continuous glucose monitoring (CGM) system stands out. This symbiotic relationship enables real-time glucose data transmission, laying the groundwork for features like Basal-IQ and Control-IQ technology, elevating insulin delivery to new heights of sophistication.

My tech squad, Dexi2 and Slim2, comprising the Dexcom G6 and Tandem t:slim X2, join forces to keep my diabetes demons at bay. Picture a personal assistant, perpetually on call, scrutinizing my blood sugar levels and relaying updates to my insulin pump. That's Dexi, keeping tabs on my glucose levels 247, nudging my pump with the latest updates every few minutes.

As for Slim, it's no slacker either. Endowed with the brainy Control-IQ technology, it processes intel from Dexi, analyzing glucose trends to forecast future trajectories. Much like a weather forecaster gauges atmospheric shifts before deciding on carrying an umbrella, Slim preemptively adjusts insulin delivery, forestalling glucose spikes or dips. This collaborative effort translates to fewer frets about glucose levels and more focus on living life to the fullest.

The peace of mind and adaptability afforded by this dynamic duo are beyond measure. The realization that my pump and CGM maintain an incessant dialogue emboldens me to embrace spontaneity. Whether hitting the hiking trail or enjoying meals, I can go about my daily activities without diabetes constantly intruding. My diabetes management is on autopilot, allowing me to live my life more freely.

The insights I glean from this system are invaluable, facilitating informed decisions and keeping me on track and in control.

A closed-loop system like the Dexcom G6 and Tandem t:slim X2 partnership makes diabetes management more seamless, efficient, and less intrusive to my daily life.


  1. Nerve damage and loss of sight are among the complications. 
  2. Dexi and Slim are common nicknames for these devices. 

The Hybrid Closed-Loop System: Evolution and Practical Applications

This paper validates some of my experiences using this insulin pump over the last 16 months.

Abstract
Achievement of well-controlled blood glucose is essential for preventing complications in patients with type 1 diabetes. Since the inception of continuous subcutaneous insulin infusion, the aim has been to develop an artificial pancreas, with the ability to use an automated algorithm to deliver one or more hormones in response to blood glucose with the intent to keep blood sugar as close to a prespecified target as possible. Development and rapid improvement of continuous glucose sensor technology has recently allowed swift progress toward a fully closed-loop insulin delivery system. In 2017, Medtronic began marketing the 670G insulin pump with Guardian 3 sensor. When in auto mode, this is a hybrid closed-loop insulin delivery system that automatically adjusts basal insulin delivery every 5?min based on sensor glucose to maintain blood glucose levels as close to a specific target as possible. Patients receive prandial insulin by entering carbohydrate amount into the bolus calculator. Early studies show improvement in HbA1c in both adults and adolescents with this technology. Initial safety trials showed no occurrence of diabetic ketoacidosis or hypoglycemia. The utility of this device is limited by blood glucose targets of 120 and 150?mg/dL that are unacceptably high for some patients. Notwithstanding recent advances, we are far from a system that is able to replicate islet function in the form of a fully automated, multihormonal blood glucose control device.The Hybrid Closed-Loop System