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. 

Disabling Auto-Mode on my Medtronic 670G

The @Medtronic 670G auto-mode is completely useless to me. My endo and the diabetes educator recommended turning it off. That's what I'm doing. I have to live 3 more years with this POS.

I currently use the 670G with the Guardian 3 CGM. Last year my endocrinologist recommended I try the 670G and I had no issues getting approval, and I started using the system in March of 2018. My A1C is worse than it has ever been. The 670G target BG is programmed to for 120mg/dL and unchangeable. My target BG has always been 90mg/dL.

But I've had too many issues with failed sensors over the last year. I have called into the support line over two dozen times since getting the 607G. I was losing my patience, and each call into the support center ended with a " ... we will send you a replacement sensor". The support reps responses made it seem that the problem was me, not the product.

No matter how carefully I insert and tape down a sensor, The sensor reading becomes unstable when I exercise. Medtronic reps told me directly, “The sensor can become unstable during vigorous exercise.” It was recommended that when this happens, I should replace the sensor. I exercise every day. What am I supposed to do?

Eventually, after numerous calls over two months last fall, I was given a link to request a new transmitter with updated firmware. That was several weeks ago, and I have not heard anything from Medtronic.

I don’t care anymore. The system is unusable to me. If I can’t exercise safely or go hiking with a CGMS, then it serves no purpose.

This week I had a long chat with my endocrinologist. She stated her other patients were doing well on the 67G and G3. They had improved outcomes, but these are patients who were never as tightly controlled as I was. She called Medtronic on my behalf. A Medtronic diabetes educator called me, and we spoke. She admitted that my A1C would be higher with the 670G system in auto-mode and recommended disabling auto-mode. So that is what I will do.

I may talk to my endo about going back to Dexcom. The G6 seems like a fantastic bit of kit.

Horizontal Case for MiniMed 670G

Does anyone have suggestions for a horizontal case for the MiniMed 670G to wear on a belt?

I just started using the MiniMed 670G closed-loop insulin pump system. The belt clip is a PITA! It's difficult to remove from belts, pockets etc. The little tip at the end snags on the whatever it is clipped to. It holds the pump vertically which means I am constantly being pocked in the stomach when sitting in the car or at my desk or on the couch.

The horizontal leather case is out of stock on Medtronic's website. I searched and found a universal cell phone case that is within the dimensions of the MiniMed 670G.

I also looked into a case for carrying extra diabetic supplies, e.g., infusion set, CGMS sensors, batteries, glucose meter, test strips, alcohol wipes, etc. But ... most of the kits are designed for people using needles, syringes or insulin pens.

Does anyone have suggestions for a horizontal belt case?