The T:slim has a bolus limit of 25 units, after that is delivered you can have the option of 25 more for a total of 50 units but that's it.
Here is an example of how the problem effects me. I am using an insulin to carb ratio of 1:1.5. For breakfast if I eat a bagel (50 carbs) along with an average size apple (38 carbs) and 8oz of Milk (13 carbs) that comes to a total of 101 carbs so with my ratio I would need 67 units of insulin. The T:slim pump will not allow this much for a bolus. I thought about delaying a bolus but to deliver the initial 50 units would take close to 10 minutes and a delayed bolus has to wait a minimum of 15 minutes before it will begin. This means that the total bolus would take up to 25-30 minutes. This seems to be unacceptable not to mention it would be a big pain in the a$$ to have to do this every time I need to bolus more that 50 units.
I talked to Tandem and they told me that the FDA has set this limit and they cannot change the programming of a pump to accommodate my issue.
I have only had the pump for a few days now and did not see this coming.
I have been out of commission with a major foot problem that had me in a cast for 14 months and now I am looking at surgery in spring. In the mean time I have a lot of pain. I know more exerciser would help my insulin usage but it will be another year before I might be back on my feet (pun intended). Of course loosing weight will help too but find it hard being off my feet.
I Just needed to share my frustration but I'm sure things will work out soon. Low card diet, here I come!
I'm no doctor or educator or nutritional or anything important, but being the problem you have, could you try cutting one or the other out? For example day one have a bagel and milk, Day two have apple and and milk? Again, I'm no doctor but I personally am afraid of blousing that much insulin. As it sits now I take about 160-180 carbs per day and I'm at a 1:4.
Thanks for all your suggestions on this. Spreading out the carbs and making better chooses is the way I'm handling it. I'll get by :-)
The 25 unit limit is not easy to get around so I have to bolus twice any time I eat 38 carbs or more. This makes it easy to forget if I don't hear the reminder. A 25 unit bolus at 1 unit per 20 seconds will take 8 minutes to deliver, that's enough time for me to forget when I don't hear the warning (I have a hard time hearing my pumps in my pocket sometimes).
I will get used to it and be just fine, but it was just something I wasn't aware of and would have liked to know it ahead of time while making my decision on what pump I wanted to go with.
I do love the pump!!!
I would love to have a ratio of 1:7, it would make things a little nicer!!! All those type 1's that have a 1:25 ratio or better, I can't image :-)
This is my 5th pump and have been counting carbs for a long time. Some periods of time over the years I'm very good at it and my A1Cs are around 5.8 and other period of times I have A1Cs in the 9 range. I am currently and have been in the past being treated for an eating disorder, when the disorder really kicks in I stop counting carbs and ignoring my diabetes, but it is killing me (literally). I've had dozens of hours in dietary training but knowing and doing are 2 totally different things.
Thanks for the support and I do love my pump too :-)
I sometimes forget too. I use vibrate instead of audible alarm, which I always feel in my pocket when it confirms delivery is completed
I did not know this either. My bolus using MDI is 1:1. I try to keep my carb intake very low because I've found that the insulin just doesn't work as well if I eat a lot of carbs, but even so, that's frustrating. I would never eat the breakfast you eat, though. Your breakfast would be a full syringe of insulin for me.
I did not know of this limitation. Since I tend to eat very low carb anyway (I try to stay below 30 carbs a day) then it shouldn't effect me often, but occasionally it will.
Yeah, that's what I was thinking. I usually eat less than 10 carbs a meal and since I graze more than I eat meals I expect managing stacking will be a bigger issue for me. Occasionally, though, I want some fries! :D