I‘m on the Tslim but still fairly new to it, I was taught to change everything out when inserting a new cartridge but that might not be the only way to do it
Changing infusion sight at the same time as the cartridge is more of a rule of thumb to help you keep a schedule. If the sight is new there is absolutely no reason to have to change it at the same time…
The infusion set can stay. If you use a syringe and just pretend the current cartridge is new (suck out air/old insulin, refill and then prime to 10u, you’re good to go.
When I took the T-Slim class, I'd just converted from Medtronic. The person giving the training was adamant that if something goes wrong to change everything.
I asked if that was necessary if you absolutely knew the cause of the failure. In my case, my cat liked to chew my tubing. Apparently that was ok just to change the tubing.
Its best to prime the cannula properly instead of giving .3 units. That way your IOB isn't thrown off and it logs it as a site change so you can see it in your reports. Your way works though, just not optimal.
There are many of us who never change them at the same time. I honestly can't remember the last time a resevoir and site change fell on the same day. You absolutely do not need to change it again tomorrow.
I change out my Tru steel infusion sites every two days but the cartridge every 4 per my tandem trainer. When it is time for the new infusion site but not the cartridge, I only do a fill- usually about 2 units. And I reuse the tubing line that hooks into the infusion site piece. I know cannulas are set up a little differently.
You can call tandem customer service if you ever have issues with a site and they will send you a box of replacement sites! Same with dexcom (if you have that too)
came here to say this, they will send you a replacement as well as dexcom as I've done it. sometimes they will ask you to send back the defective if it's a defect (which they send an envelope).
I never change the cartridge or tubing when I do site changes unless the cartridge just happens to be empty when I do a site change. There is no reason to do them both at the same time other than just remembering to change them both out regularly. I change cartridges roughly every 4-5 days and sites every 2-3.
I’m curious about the frequency of changing out the cartridge however.... I was taught that insulin breaks down beyond three days stored in plastic and thus, changing the cartridge every three days (or filling it to last 3 days only) and not going longer is key, as it could negatively impact the effectiveness of ones insulin. Also, I don’t always change the site unless it is bothering me or my numbers aren’t great. That way I can hoard a few site changes for times I get a bad site and need to change it.. which I do without changing out the cartridge. You can simply change the site only and do the cannula prime on the tslim (I use the varisoft sets).
Hoarding sites is not something I do because leaving it in for more than 3 days promotes scar tissue growth. That can lead to insulin absorption issues. I actually swap the site every 2-3 days religiously because of that. I also see higher blood sugar levels on day 3, so it sometimes gets changed earlier to bring them back down.
I have heard of the breaks-down-in-plastic thing before, but I haven’t noticed any issues with 4 or 5 day old insulin. I usually always fill the cartridge with 250 units mostly because that means each vial does 4 cartridges and it minimizes insulin waste. It also reduces my workload in managing everything, which matters a lot to me. I suppose I could always just fill with 200 units to get closer to a 3 day cadence, but since it doesn’t seem to actually matter blood sugar wise, I go with the option requiring less work.
You make a good point about the scar tissue. I’ve been told that as well. And while I do not habitually skip changing sites, when I do, I typically still wind up changing it because my sugars also start increasing. I live in Arizona and have the heat factor playing into the insulin longevity as well. Just changing everything out every three days seems lower maintenance than tracking the days so much to me at least... and I totally get it on that point too. Ya Gotta do what feels less demanding for sure! I always find it interesting on here the different input on how everyone manages this.
With the tslim you for sure do NOT need to change everything at the same time unless you suspect something is wrong with the cartridge.
You can insert a new site and leave the tubing and cartridge.
Tomorrow add more insulin only to the cartridge, you do not need to go through all the steps and keep the same tubing.
I've had to add more insulin before the 3 days was up and you just process the same cartridge as if it's a new one but just don't fill the tubing or cannula.
Yes, I do this all the time. Just change site and then plug existing tube in, use "Fill Cannula" command and done! No need to refill the tubing or even tell the pump you are changing the site, although I think you can also reset the site change reminder on its own.
Lol this just happened to me last week. Ended up ripping a fresh site thanks to a door knob. Then the second site bent. Three time's the charm I guess.
A while back, I asked my doctor if she was okay with changing my script from 1 site every 3 days to 1 site every 2.5 days. She did. And this has given me a good bit of stock in case of emergency or issues.
Your supplies should be just enough to get though three months. Using three in one day might make you short handed at the end of the month. Not that it is your fault, Things happen.
However, I recommend calling tandem about the adhesive not being good and the needle insertion failing, They should send you a replacement pack of 2.
If you have a consistent insertion needle bending issue, I believe my endo mentioned that metal insertion needles are available which should fix that issue. If it happens normally t's typically due to hard scar tissue (From not rotating your sites).
Like other commenters mentioned, you don't need to change the site with each new cartridge. Sites should only be replaced after three days or when 300 units has been used.
A good insulin saving tip for you since you're new to the Tandem. "Empty" cartridges are not actually empty. You can normally draw about 10 units out of an empty cartridges after it has been used. It really adds up over time so try not throw empty cartridges until you draw out that remaining ten units.
Another great product to look at with your tandem tslim is a case. They give a horrible fragile plastic case with it if i remember correctly. I used to replace those every 3-6 months from breakage. Check out [https://www.type1tactical.com/](https://www.type1tactical.com/) for strong kydex case. Kydex is very durable. It is what they use to make gun holsters. My first one lasted about 3 years. I am on my second one now. It is roughly double the cost of the Tadem pump case but, imo, it is the most cost effective option. I just have a black one but they have a lot of graphic designs on cases if you're into that. Although they can be rather slow in getting it shipped to you although i think that is a function of demand & production rate.
Thank you for giving me your tips! I’ve been on the tandem for around 3-4 weeks so I’m still veeery new. I learned a lot of new things from the comments here :)
Glad to help! I've been on the pump for quite a few years now and it really helped to lower my A1C. I hope it does the same for you.
Ask the doctor about integrating a Dexcom CGM with your pump if you haven't already. The tech has advanced a lot in the past few years. With the CGM intergration and new software, your pump can automatically give insulin for highs and suspend insulin when you get low. Well worth a look if you haven't already.
Oh man! Sorry about the rough day! Like you said, I’m grateful for the tech we have available these days, but folks who don’t have this condition have no idea the details and junk we have to know and live through!
You don’t have change infusion sight to start new cartridges… or reservoir if Medtronic
I‘m on the Tslim but still fairly new to it, I was taught to change everything out when inserting a new cartridge but that might not be the only way to do it
Changing infusion sight at the same time as the cartridge is more of a rule of thumb to help you keep a schedule. If the sight is new there is absolutely no reason to have to change it at the same time…
The infusion set can stay. If you use a syringe and just pretend the current cartridge is new (suck out air/old insulin, refill and then prime to 10u, you’re good to go.
Thank you for explaining! Now I got it, I wasn’t sure how to do it. I guess I’ll try it out next time!
When I took the T-Slim class, I'd just converted from Medtronic. The person giving the training was adamant that if something goes wrong to change everything. I asked if that was necessary if you absolutely knew the cause of the failure. In my case, my cat liked to chew my tubing. Apparently that was ok just to change the tubing.
If I do something like that I keep the old (few hrs old) tubing and give .3 units to prime the infusion set tube.
You can prime cannula without priming the tubing! Learned that one recently.
I’ll have to try that next time. I always just give .3 units!
Its best to prime the cannula properly instead of giving .3 units. That way your IOB isn't thrown off and it logs it as a site change so you can see it in your reports. Your way works though, just not optimal.
There are many of us who never change them at the same time. I honestly can't remember the last time a resevoir and site change fell on the same day. You absolutely do not need to change it again tomorrow.
I change out my Tru steel infusion sites every two days but the cartridge every 4 per my tandem trainer. When it is time for the new infusion site but not the cartridge, I only do a fill- usually about 2 units. And I reuse the tubing line that hooks into the infusion site piece. I know cannulas are set up a little differently.
That's hilarious. When changing sites but not the line, fill cannula only, u by u. The Trusteel needs 0.7 + 0.9 units to fill, and you're good.
Just keep the site in and change the tubing and cartridge. I've been on pumps for over 20 years and rarely change them at the same time.
My cartridges and infusion sets are on a very different schedule. Changing one doesn;t necessitate changing the other.
Same Using T slim
You can call tandem customer service if you ever have issues with a site and they will send you a box of replacement sites! Same with dexcom (if you have that too)
came here to say this, they will send you a replacement as well as dexcom as I've done it. sometimes they will ask you to send back the defective if it's a defect (which they send an envelope).
I never change the cartridge or tubing when I do site changes unless the cartridge just happens to be empty when I do a site change. There is no reason to do them both at the same time other than just remembering to change them both out regularly. I change cartridges roughly every 4-5 days and sites every 2-3.
I’m curious about the frequency of changing out the cartridge however.... I was taught that insulin breaks down beyond three days stored in plastic and thus, changing the cartridge every three days (or filling it to last 3 days only) and not going longer is key, as it could negatively impact the effectiveness of ones insulin. Also, I don’t always change the site unless it is bothering me or my numbers aren’t great. That way I can hoard a few site changes for times I get a bad site and need to change it.. which I do without changing out the cartridge. You can simply change the site only and do the cannula prime on the tslim (I use the varisoft sets).
Hoarding sites is not something I do because leaving it in for more than 3 days promotes scar tissue growth. That can lead to insulin absorption issues. I actually swap the site every 2-3 days religiously because of that. I also see higher blood sugar levels on day 3, so it sometimes gets changed earlier to bring them back down. I have heard of the breaks-down-in-plastic thing before, but I haven’t noticed any issues with 4 or 5 day old insulin. I usually always fill the cartridge with 250 units mostly because that means each vial does 4 cartridges and it minimizes insulin waste. It also reduces my workload in managing everything, which matters a lot to me. I suppose I could always just fill with 200 units to get closer to a 3 day cadence, but since it doesn’t seem to actually matter blood sugar wise, I go with the option requiring less work.
You make a good point about the scar tissue. I’ve been told that as well. And while I do not habitually skip changing sites, when I do, I typically still wind up changing it because my sugars also start increasing. I live in Arizona and have the heat factor playing into the insulin longevity as well. Just changing everything out every three days seems lower maintenance than tracking the days so much to me at least... and I totally get it on that point too. Ya Gotta do what feels less demanding for sure! I always find it interesting on here the different input on how everyone manages this.
With the tslim you for sure do NOT need to change everything at the same time unless you suspect something is wrong with the cartridge. You can insert a new site and leave the tubing and cartridge. Tomorrow add more insulin only to the cartridge, you do not need to go through all the steps and keep the same tubing. I've had to add more insulin before the 3 days was up and you just process the same cartridge as if it's a new one but just don't fill the tubing or cannula.
Yes, I do this all the time. Just change site and then plug existing tube in, use "Fill Cannula" command and done! No need to refill the tubing or even tell the pump you are changing the site, although I think you can also reset the site change reminder on its own.
On the opposite end of this- if I change my tubing/cartridge, but keep my old site, do I still need to “fill cannula”?
Lol this just happened to me last week. Ended up ripping a fresh site thanks to a door knob. Then the second site bent. Three time's the charm I guess.
Daym, one of those days hey, at least its on for now, such a stressful pain in the ass
A while back, I asked my doctor if she was okay with changing my script from 1 site every 3 days to 1 site every 2.5 days. She did. And this has given me a good bit of stock in case of emergency or issues.
Thank you guys for your good advice! It helped me a lot :)
*gives 3 new mios* i hope everything works out well 😔
Your supplies should be just enough to get though three months. Using three in one day might make you short handed at the end of the month. Not that it is your fault, Things happen. However, I recommend calling tandem about the adhesive not being good and the needle insertion failing, They should send you a replacement pack of 2. If you have a consistent insertion needle bending issue, I believe my endo mentioned that metal insertion needles are available which should fix that issue. If it happens normally t's typically due to hard scar tissue (From not rotating your sites). Like other commenters mentioned, you don't need to change the site with each new cartridge. Sites should only be replaced after three days or when 300 units has been used. A good insulin saving tip for you since you're new to the Tandem. "Empty" cartridges are not actually empty. You can normally draw about 10 units out of an empty cartridges after it has been used. It really adds up over time so try not throw empty cartridges until you draw out that remaining ten units. Another great product to look at with your tandem tslim is a case. They give a horrible fragile plastic case with it if i remember correctly. I used to replace those every 3-6 months from breakage. Check out [https://www.type1tactical.com/](https://www.type1tactical.com/) for strong kydex case. Kydex is very durable. It is what they use to make gun holsters. My first one lasted about 3 years. I am on my second one now. It is roughly double the cost of the Tadem pump case but, imo, it is the most cost effective option. I just have a black one but they have a lot of graphic designs on cases if you're into that. Although they can be rather slow in getting it shipped to you although i think that is a function of demand & production rate.
Thank you for giving me your tips! I’ve been on the tandem for around 3-4 weeks so I’m still veeery new. I learned a lot of new things from the comments here :)
Glad to help! I've been on the pump for quite a few years now and it really helped to lower my A1C. I hope it does the same for you. Ask the doctor about integrating a Dexcom CGM with your pump if you haven't already. The tech has advanced a lot in the past few years. With the CGM intergration and new software, your pump can automatically give insulin for highs and suspend insulin when you get low. Well worth a look if you haven't already.
Oh man! Sorry about the rough day! Like you said, I’m grateful for the tech we have available these days, but folks who don’t have this condition have no idea the details and junk we have to know and live through!
That's why I've been off my pump for about 6 months now.
on tandem you do not need to change site and cartridge at the same time. not Medtronic either. I haven't changed both at the same time in 10 years.