¹ Estimation since Aug 31, 2012 ,as of February 28, 2019, assuming 20-day battery life of disposable batteries when used in other insulin pumps. Data on file.

² Medical waste is incinerated, not recycled. 

San Diego, April 19, 2019 – Tandem Diabetes Care, Inc. (NASDAQ: TNDM), a leading insulin delivery and diabetes technology company, today announced its sponsorship of Beyond Type 1’s “Beyond Type Run,” an official charity partner of the 2019 TCS New York City Marathon.

“It is inspiring to see how people with diabetes can thrive, especially when they have the best diabetes management technology,” says John Sheridan, President and CEO of Tandem Diabetes Care. “Tandem Diabetes Care is proud to sponsor Beyond Type Run, and wishes all the runners well as they train for an exciting race day.”

Beyond Type Run has sent a team of athletes all living with type 1 diabetes to participate in the TCS New York City Marathon since 2017. As part of its sponsorship, Tandem will offer t:slim X2™ insulin pumps with Basal-IQ® technology for up to 30 marathoners with type 1 diabetes for use while training and during the race which takes participants through the five boroughs of Manhattan.

"Beyond Type 1 is thrilled to field our third and largest Beyond Type Run team for the TCS New York City Marathon, and is incredibly grateful for the support of Tandem Diabetes Care,” says Thom Scher, CEO of Beyond Type 1. “Insulin pump technology, like that developed by Tandem, supports athletes living with type 1 diabetes with tools to help them train for the big race and live beyond their diagnosis.”

The marathon takes place on November 3, 2019.
Applications to join the Beyond Type Run team are now being accepted.
For more information visit:  beyondtype1.org/2019-tcs-nyc-marathon  

Tandem Diabetes Care periodically provides sponsorships and grants for educational and empowerment programing in the diabetes community. Grants are awarded to qualified non-profit organizations with the mission to empower people with diabetes, and to assist local initiatives, events, and programing that support Tandem’s mission, its employees, and corporate citizenship.

About Beyond Type 1

Beyond Type 1 (www.beyondtype1.org) is a nonprofit organization changing what it means to live with diabetes. Through platforms, programs, resources, and grants, Beyond Type 1 is uniting the global diabetes community and providing solutions to improve lives today. Founded in 2015 with a focus on education, advocacy and the path to a cure for Type 1 diabetes, Beyond Type 1 has grown to also include programs for those with Type 2 diabetes. A new model of philanthropy, Beyond Type 1 aims to change what it means to live with chronic illness.

About Tandem Diabetes Care, Inc.

Tandem Diabetes Care, Inc. (www.tandemdiabetes.com) is a medical device company dedicated to improving the lives of people with diabetes through relentless innovation and revolutionary customer experience.  The Company takes an innovative, user-centric approach to the design, development and commercialization of products for people with diabetes who use insulin. Tandem’s flagship product, the t:slim X2™ Insulin Pump, is capable of remote software updates using a personal computer and features integrated continuous glucose monitoring.  Tandem is based in San Diego, California.

Follow Tandem Diabetes Care on Twitter @tandemdiabetes, use #tslimX2 and $TNDM.

Follow Tandem Diabetes Care on Facebook at www.facebook.com/TandemDiabetes.

Follow Tandem Diabetes Care on LinkedIn at www.linkedin.com/company/TandemDiabetes.

Tandem Diabetes Care is a trademark of Tandem Diabetes Care, Inc., registered in the U.S. and other countries. t:slim X2 is a trademark of Tandem Diabetes Care, Inc.

Tandem Diabetes Care Contact Information:

Media: Steve Sabicer, 714-907-6264, ssabicer@thesabicergroup.com

San Diego, April 18 2019 – Tandem Diabetes Care, Inc. (NASDAQ: TNDM), a leading insulin delivery and diabetes technology company, today announced its sponsorship of BlueLoop, a care coordination resource for children with type 1 diabetes. BlueLoop, powered by the non-profit MyCareConnect Foundation, is a tool to help improve a family's ability to manage a child’s diabetes when the child is at school or away from home.

“At Tandem Diabetes Care, we understand the challenges of diabetes management, especially for families,” said John Sheridan, President and CEO at Tandem Diabetes Care. “We are proud to support the MyCareConnect Foundation, to help them bring BlueLoop, to more families impacted by diabetes who are working hard to help their children thrive at home and at school.”

“I created BlueLoop to help communicate with my school nurse after our daughter was diagnosed with type 1 diabetes 16 years ago at age six. Little did I know it would become a resource for thousands of families, schools and endocrinologists,” said Pam Henry, Founder of BlueLoop and the MyCareConnect Foundation. "Our foundation provides BlueLoop free of charge. Tandem’s sponsorship enables us to reach more families in need of better, more effective diabetes care coordination.”

BlueLoop® is an online and mobile solution for children with diabetes and their parents who worry. BlueLoop provides care coordination among caregivers, improving a child's and family's ability to manage diabetes, especially when the child is at school or away from home. BlueLoop uses instant notifications via email/text to keep caregivers – parents, nurses, teachers, etc. – informed. Caregivers can also put information like BGs, carbs, insulin, and notes into their child's account. BlueLoop also documents current dosages, and is an effective way to collaborate with your Endocrinologist. BlueLoop is available online and as a mobile app.

People can sign up for BlueLoop online at blueloop.mycareconnect.com, by phone at 302-4OurKids (302-468-7543), or by emailing support@mycareconnect.com.

Tandem Diabetes Care periodically provides sponsorships and grants for educational and empowerment programing in the diabetes community. Grants are awarded to qualified non-profit organizations with the mission to empower people with diabetes, and to assist local initiatives, events, and programing that support Tandem’s mission, its employees, and corporate citizenship. 

About MyCareConnect

A 501(c)3 based in Dallas, Texas, MyCareConnect’s mission is to support the physical and emotional well-being of children with diabetes, and those who care for them, by facilitating communication among home, school and clinic. blueloop.mycareconnect.com

About Tandem Diabetes Care, Inc.

Tandem Diabetes Care, Inc. (www.tandemdiabetes.com) is a medical device company dedicated to improving the lives of people with diabetes through relentless innovation and revolutionary customer experience.  The Company takes an innovative, user-centric approach to the design, development and commercialization of products for people with diabetes who use insulin. Tandem’s flagship product, the t:slim X2™ Insulin Pump, is capable of remote software updates using a personal computer and features integrated continuous glucose monitoring.  Tandem is based in San Diego, California.

Follow Tandem Diabetes Care on Twitter @tandemdiabetes, use #tslimX2 and $TNDM.

Follow Tandem Diabetes Care on Facebook at www.facebook.com/TandemDiabetes.

Follow Tandem Diabetes Care on LinkedIn at www.linkedin.com/company/TandemDiabetes.

Tandem Diabetes Care is a registered trademark and t:slim X2 is a trademark of Tandem Diabetes Care, Inc.  All other third-party marks are the property of their respective owners.

Tandem Diabetes Care Contact Information:

Media: Steve Sabicer, 714-907-6264, ssabicer@thesabicergroup.com

Investors: Susan Morrison, 858-366-6900 x7005, IR@tandemdiabetes.com

# # #

In 2003, Pam and John Henry’s 6-year-old daughter, Sarah, was diagnosed with type 1 diabetes. Once the initial shock wore off, Pam’s maternal instincts took over. She needed a better way to stay on top of Sarah’s care. Since then, she founded  BlueLoop, a place for logging medical information, getting reminders, or keeping caregivers in the loop.

Q. What is the biggest change you’ve seen in yourselves since Sarah’s diagnosis? 
It’s been 16 years since Sarah’s diagnosis, so the gradual transition of responsibility from parent to child has been most significant, beginning with something as simple as finger poking with independence, all the way to where Sarah is today, learning the ins and outs of insurance, ordering supplies, and eventually paying for them herself. Sarah’s independence has reduced our stress, but to be honest, the stress never goes away completely.  There have been many stages to this process of her gaining independence.

Q.  How does diabetes affect your family’s daily life? 
When Sarah is at college, she’s six hours away, which means we don’t have much daily interaction about diabetes. Because she’s good at self-management, we only get a call if she needs someone to talk to, especially if she doesn't feel well, or needs help troubleshooting. The ability to "share" data through the Dexcom app lets us into her world during these times. I think occasionally sharing data helps her to know someone has her back. This is very different from the early years in her diagnosis, when we were very involved.

Q.  Why BlueLoop?
After Sarah’s diagnosis, our challenge was wanting to know what was going on when she was not under our direct supervision, especially at school. We also discovered some communication challenges with her school nurses. We created BlueLoop to solve those problems. It gave us an instant communication channel with Sarah, her teacher, and the school nurse. There are tons of examples of the benefits we experienced from BlueLoop. Most important was that we no longer greeted Sarah when she came home from school by asking what her blood glucose numbers were that day, what she ate for lunch, or when she last checked her blood glucose level. Because we received updates throughout the day, we greeted her at the door with, “How was school today? Did you have fun painting in art class?” etc. Getting back a little normalcy meant a lot to all of us.

Q.  Whom is BlueLoop for?
BlueLoop is ideal for newly diagnosed families, because it’s the only tool available from day one that logs activity and coordinates care among home, school, and clinic. It’s also helpful for parents of young children since the system sends instant notifications, providing much-needed peace of mind. With the recent release of our insulin dose calculator and built-in CGM adjustments, learning the elements of dosing insulin is safer and easier.

Q.  Does BlueLoop support pump users?
While many of our families are newly diagnosed and injecting insulin, we have pumpers who use BlueLoop for the back-and-forth communication between school and home. Sarah started pumping when she was in first grade. We liked the idea that she could administer insulin more independently with a pump. She was already checking her blood glucose levels and treating lows in the classroom. Now, with her pump, she could also administer insulin without going to the nurse’s office, because syringes weren’t part of the process.

During the transition to pumping, we depended on BlueLoop notifications to know how she was doing throughout the day. It’s all about peace of mind and the ability to get a more comprehensive view of what’s happening throughout the school day. We received information on her insulin dosing alongside how ketones were being handled, the tummy ache she shared with the nurse, or logistics around her diabetes for a field trip to the zoo next week. It’s all about enhancing the communication about all aspects of life with diabetes. 

Q.  When you meet a family with a newly diagnosed person, what is your advice to them? 
We’re fortunate to be in contact with families every day. Most are newly diagnosed, and we’re often the first non-medical people they’ve talked to about diabetes. First and foremost, they need to hear – from another parent – that their child is going to be okay. Parents need to also make sure their child knows they’ll be okay, especially since many will undoubtedly hit the internet and find misinformation. Also, many parents have false expectations that blood glucose levels will always be within range if they focus on a list of doctor’s orders. We talk to parents about the impact of their reactions around checking blood glucose levels and help parents understand that there are simply too many factors outside of their control to expect “perfection.” Our message is this: Treat blood glucose readings as merely data that tell you what to do next. Blood glucose readings should never be described as good or bad, and we encourage language like, “I’m so glad you checked your blood sugar. Now we know what we need to do next.” With our daughter’s permission, we like to share the story of how her blood glucose spiked every time she sat next to a cute boy in class. The moral of the story: Fluctuations are the norm. Any one blood glucose level is not a measure of how well you’re managing the disease; it’s an indication of what to do next – such as give insulin, treat hypoglycemia, or do nothing.

Q.  What’s next for you and BlueLoop? 
We did a lot of development last year, adding several insightful reports and a sick-day tool that all really help families. This year we’re focused on new ways of educating families on insulin pumps, CGMS and a host of other great resources.

Q.  How do people get involved?
People can sign up for BlueLoop through our website, blueloop.mycareconnect.com,or call us at (302) 468-7543 to sign up over the phone. Our foundation provides BlueLoop free of charge, and we’re available to families 24/7. Families can reach us via phone or support@mycareconnect.com to ask questions, get connected to resources, or simply talk parent to parent. Now, we can share important information with our families on several relevant diabetes topics through our mobile app as well as online.

Dexcom is either a registered trademark or trademark of Dexcom, Inc. in the U.S. and/or other countries. CM-000881_A

Quick Bolus Button

Tandem's Quick Bolus button can be programmed to enter either units of insulin (in 0.5, 1, 2 or 5-unit increments) or grams of carbohydrate (in 2, 5, 10, or 15 gram increments) without needing to look at the screen, or even take your pump out of your pocket. And with your choice of audible or vibrating confirmations, no one needs to know if you’re checking for your keys or bolusing for a snack.

"LITTLE BLACK DRESS" BOLUS

"I'LL JUST HAVE ONE" BOLUS

"AS LONG AS I'M HERE" BOLUS

"GOING TO FINISH THAT?" BOLUS

"YES, I'M STILL LISTENING" BOLUS

This video from our Tech Tip series

For more information, please visit: https://www.tandemdiabetes.com/support/documents

San Diego, April 11, 2019 – Tandem Diabetes Care, Inc. (NASDAQ: TNDM), a leading insulin delivery and diabetes technology company, today announced its sponsorship of the Beyond Type 1 Snail Mail Club. Percy, the official Snail Mail mascot, will begin using the t:slim X2™ insulin pump from Tandem Diabetes Care as part of the new partnership.

“Tandem Diabetes Care has always been impressed with the way Beyond Type 1 has supported people with diabetes, and their ongoing efforts to help people in the community connect with each other,” says John Sheridan, CEO of Tandem Diabetes Care. “We are excited to support this initiative, and we’re looking forward to hearing what Percy the Snail has to say about the t:slim X2 insulin pump.”

Beyond Type 1’s Snail Mail Club is a pen pal program for people with type 1 diabetes around the world. Currently in 50 different countries with nearly 7,500 participants from 1 to 80 years old, the program offers a global community of support for those living with type 1 diabetes.

“Beyond Type 1's Snail Mail Program brings the magic of the type 1 community offline, connecting kids and families in an entirely different way. The idea for a pen pal club came straight from the community, and has grown into a program that connects thousands across every continent except Antarctica,” says Thom Scher, CEO of Beyond Type 1. “With Tandem's partnership, the Snail Mail Club can continue to grow, to connect even more children and families, and to remain 100% free. And of course, Percy the Snail is excited to get a new t:slim X2 pump too." 

Snail Mail Club subscribers receive a starter kit with everything needed to send four letters (if in the U.S.) or postcards (if outside of the U.S.) to a new Snail Mail Club Pen Pal. Each club member receives an information sheet with a brief bio to help write the first letter.

For more information about the Snail Mail Club, visit www.beyondtype1.org/snail-mail-club

Tandem Diabetes Care periodically provides sponsorships and grants for educational and empowerment programing in the diabetes community. Grants are awarded to qualified non-profit organizations with the mission to empower people with diabetes, and to assist local initiatives, events, and programing that support Tandem’s mission, its employees, and corporate citizenship.

About Beyond Type 1

Beyond Type 1 is a nonprofit organization changing what it means to live with diabetes. Through platforms, programs, resources, and grants, Beyond Type 1 is uniting the global diabetes community and providing solutions to improve lives today. Founded in 2015 with a focus on education, advocacy and the path to a cure for Type 1 diabetes, Beyond Type 1 has grown to also include programs for those with Type 2 diabetes. A new model of philanthropy, Beyond Type 1 aims to change what it means to live with chronic illness.

About Tandem Diabetes Care, Inc.

Tandem Diabetes Care, Inc. is a medical device company dedicated to improving the lives of people with diabetes through relentless innovation and revolutionary customer experience.  The Company takes an innovative, user-centric approach to the design, development and commercialization of products for people with diabetes who use insulin. Tandem’s flagship product, the t:slim X2™ insulin pump, is capable of remote software updates using a personal computer and features integrated continuous glucose monitoring.  Tandem is based in San Diego, California.

Follow Tandem Diabetes Care on Twitter @tandemdiabetes, use #tslimX2 and $TNDM.

Follow Tandem Diabetes Care on Facebook at www.facebook.com/TandemDiabetes.

Follow Tandem Diabetes Care on LinkedIn at www.linkedin.com/company/TandemDiabetes.

Tandem Diabetes Care is a trademark of Tandem Diabetes Care, Inc., registered in the U.S. and other countries. t:slim X2 is a trademark of Tandem Diabetes Care, Inc. All other third-party marks are the property of their respective owners.

Tandem Diabetes Care Contact Information:

Media: Steve Sabicer, 714-907-6264, ssabicer@thesabicergroup.com

Investors: Susan Morrison, 858-366-6900 x7005, IR@tandemdiabetes.com

By Ben Tzeel

It’s time for a vacation to somewhere exciting!

Or maybe you just have a work trip for a few days (hopefully there’s time to do something fun, too).

Maybe you’re flying to your next destination, or maybe you’re going on a road trip. No matter what, you are going to be thrown off your normal routine, which will require a little extra thought during the planning process to provide you with peace of mind around your diabetes

… and ensure the trip is as amazing as possible.

Without further ado, here are some things to consider for your next trip:

1. If you’re flying, prepare to assist TSA.

Your device is safe for use during air travel and complies with FAA wireless transmission standards. It is also designed to withstand common electromagnetic interference and can be safely carried through metal detectors.

Some TSA agents are more knowledgeable than others. You can help by knowing your pump’s needs. Before you go, be sure to review Tandem Diabetes Care’s screening recommendations and access their air-travel note that you can carry with you and share with the TSA or airport representative.

2. Have low snacks WITH you at your seat.

I can already hear it.

“Well, if my blood sugar goes low, the flight attendant can just get me some juice or some soda, and I’ll be fine.”

Sure, that could be the case, but what happens if your blood sugar goes low during takeoff or landing, when the flight attendants must be seated? Or if there is an extended period of turbulence, and they’re unable to get you a sugary beverage?

I’ve had a similar conversation with people who say, “I have a dollar on me. If I go low, I’ll find something at a vending machine.” When you get down to it, you can’t eat the dollar to help your blood sugar.

Have glucose tabs, a granola bar, regular soda, or SOMETHING that can raise your blood sugar at the very least, in the bag underneath your seat.

3. When flying or driving, consider a temporary basal rate.

Pop Quiz: What do a long flight and a day-long car ride have in common besides transporting you from one place to another?

If you answered, “Extended periods of inactivity” or “Lots of sitting,” you win!

Yes, unfortunately, on a plane or in a car, there’s not much of a chance to move.

When one moves less than normal, the body doesn’t respond in the nicest way. In fact, it tends to respond in the form of higher blood glucose.

This can also lead to dehydration. These two are more related than you may realize.

When you fall short on fluids, the blood glucose in circulation becomes more concentrated, and high blood sugar can cause you to urinate more, which results in even more dehydration.

Throw in the fact that if you are flying, the altitude and conditioned air also dehydrate you. It’s a vicious cycle, and not one you want to be part of.

This is where a temporary basal increase could pay HUGE dividends for helping maintain blood sugar in the target range.

Setting that temporary basal for the duration of your transportation may be a great start.

Tandem has a video that shows you how to do it.

The amount of insulin required depends on your unique needs. It’s important to talk to your healthcare provider to go over your travel plans.

4. Extended boluses may be your best friend at restaurants.

Eating is one of the many awesome things about traveling, especially when you travel to an area that is well known for its food (think: NYC, New Orleans, etc.).

If you visit a restaurant where the food is high in fat and carbs, you may experience stubborn high blood sugars hours after the fact.

Enter: The Extended Bolus feature. (That's an earlier blog I wrote about it.)

Is it easy to be perfect? No. Should you still make smart choices when eating away from home and try to stay on your nutrition plan? Of course.

Should you also enjoy the cuisine around you? Absolutely.

5. Try to squeeze in some form of exercise.

Exercise can help with your insulin sensitivity. If you are on an extended trip and do NOT exercise as much as you usually do, you may notice your blood sugars start to trend higher than you’d like.

The major keys here are going to be prioritizing and being creative when need be. It is SUPER easy to throw exercise to the wayside and just “relax,” but sticking to your usual routine as well as possible will pay off in the long run.

Staying at a hotel? It likely has some sort of gym with basic cardio equipment and weights.  Not staying at a hotel? Remember you can be active outside or do a body-weight workout.

There are ways around everything if you want it enough.

6. Pack 2-3 times the insulin pump supplies you think you’ll need. 

If you expect to do two site changes during your trip, bring enough supplies for six.

If you expect to do four site changes, bring enough supplies for 10.

This may seem excessive, but as we all know, the key to thriving with diabetes is to expect the unexpected.

If your site fails, falls off, or is ripped out by accident prior to your trip being completed, having double to triple the amount of supplies means you won’t have to worry about a transition to injections for a few days. You should always bring backup insulin just in case you get separated from your pump supplies.

“Well Ben, wouldn’t eight be a LOT of infusion sets to have when I only anticipate four site changes?”

Sure it is, but have you ever had a time where you’ve gone through three sets in a day due to fluky circumstances? It’s uncommon, but I have in my 16 years of being on a pump.

It is better to be over-prepared than under-prepared when you are away from home and away from your stash of supplies so you don’t find yourself calling the (amazing) Tandem support team in the middle of the night from a city halfway across the country because you don’t have enough sets to do a site change.

Oh, and Tandem offers a traveler loaner program for additional peace of mind. If you will be traveling to areas outside of the US (or Canada if you live there) or where you can’t easily receive shipments, you can take a second pump with you. For more information, give them a call at (877) 801-6901.

Implementing these tips and tricks should help your mind be at ease, keep you prepared, and have you ready to enjoy your next trip to the fullest!

More on the blog: Travel Easily with Tips from Kerri Sparling!

Author Bio: Ben Tzeel has lived with type 1 diabetes since 1999. He has a master’s degree in nutrition from the University of North Carolina at Chapel Hill and is a registered dietitian. He is a Certified Strength and Conditioning Specialist (CSCS) through the National Strength and Conditioning Association, is a published fitness model, and writes about exercise and nutrition.

Ben Tzeel was compensated by Tandem Diabetes Care for his contribution on this topic. However, he created the content and it is based on his personal knowledge, experiences, and observations.

From time to time, we may pass along: suggestions, tips, or information about other Tandem Insulin Pump user experiences or approaches to the management of diabetes. However, please note individual symptoms, situations, circumstances and results may vary. Please consult your physician or qualified health care provider regarding your condition and appropriate medical treatment. Please read the Important Safety Information linked below before using a Tandem Diabetes Care product.

IMPORTANT SAFETY INFORMATION

On February 14, 2019, we announced that the t:slim X2™ insulin pump is the first toreceive approval in a new device category called alternate controller enabled infusion (ACE) pumps.

The FDA has now established special controls for ACE pumps; requirements for assuring the accuracy, reliability, cybersecurity and clinical relevance; as well as descriptions for the type of studies and data required to demonstrate acceptable pump performance. The recent ACE designation for the t:slim X2 pump states that it is capable of reliably and securely communicating with compatible external devices, and dosing software. We are very proud of this!

You may have heard people talk about iPumps … iPump was the assumed name for this category, but ACE pump is what the FDA ultimately named it. When the FDA named the interoperable CGM category “iCGM” last year, people began referring to the future interoperable pump category as “iPump.” ACE pump is the correct name of this new category.

What this REALLY means for our customers and the diabetes community:

This new designation does not represent a new product launch or any notable changes to the basic t:slim X2 insulin pump hardware. In-warranty t:slim X2 pump users will continue to have access to future software improvements and enhancements via remote software updates as they clear the necessary regulatory requirements.*

This new category of devices will make it easier for separate companies to integrate their products into advanced automated insulin delivery systems without having to resubmit each of the components and their associated clinical data every time. It’s a great move on the behalf of the FDA to make it easier for companies with leading-edge technologies to more quickly develop and deliver innovations for the diabetes community.

What this may mean for future uses:

It is too early for us to speculate on what this ACE designation means for future product development or integrations with non-Tandem-automated insulin delivery algorithms. We don’t currently have plans to make the t:slim X2 pump an open-platform device. At this time, our development resources are 100% dedicated to the products currently in late-stage development. Even with the new interoperable designation, integration with new algorithms would require some meaningful software development efforts and user interface adjustments. We will require that our business relationships allow us to provide Tandem pump users with adequate technical support and continue to meet regulatory reporting requirements for any integrated systems that include our technology. Because of this, we plan to be very purposeful and deliberate about how and when we partner on integrated system components to ensure our customers have the best possible experience.

The designation does not impact our current products in development. We have been working closely with the FDA on previous and ongoing submissions and have been incorporating their thoughts on interoperable device standards into our activities.

We have been getting a lot of questions about phone control for pumps, and what impact this new ACE pump designation could have for us on this front. Currently, no pumps on the market can be controlled by a smartphone, but it is high on the list of things all insulin pump companies would ultimately like to deliver. As you can imagine, given the variety of phones out there, the FDA has a number of security and safety questions that would have to be addressed before control of a pump using a smartphone could be approved. While the regulatory path has not yet been determined, it is of great interest to us and is something we are certainly looking into. This new ACE pump designation is a first step in that direction.

We believe this designation further establishes the role we have as a key innovator in the insulin pump industry, having launched the first touchscreen pump in the United States, the first pump capable of remote feature updates, the first pump approved as iCGM compatible, and now, the first in this new interoperable pump category.

Many thanks to everyone who is following this journey!

* A prescription and/or additional training may be required to access certain future software updates, and charges may apply. The determination regarding cost will be made individually for each software update.

In April 2018 we received CE Mark for our t:slim X2™ insulin pump and have announced distribution agreements for the following countries: Australia, Bahamas, Czech Republic, Denmark, Italy, New Zealand, Norway, South Africa, Spain, Sweden, and the United Kingdom.

Then in October 2018 we received a Heath Canada Medical Device License for the t:slim X2 insulin pump with Dexcom G5® Mobile CGM integration.

For Canadians looking to purchase a pump through private insurance, we are able to assist with insurance verification at this time for shipment to any province. We currently have approval for reimbursement from provincial health programs in Ontario, Manitoba, and Saskatchewan. Anyone interested in getting the process started can reach our Canadian team at 1-833-509-3598, then press option 2.

Canadian residents interested in staying up to date on our activities in Canada can sign up to receive updated information as it becomes available.

On our site you will find contact info for our distribution partners in the other countries; A.Import.CZ (Czech Republic), AMSL Diabetes (Australia), Air Liquide (United Kingdom), Ethitech (South Africa), Family Medicine Center (Bahamas), Movi Group (Italy), NZMS Diabetes (New Zealand), NovaLab (Spain), and Rubin Medial (Denmark, Norway, Sweden).

We encourage you to reach out to them directly, because they will be best able to share product updates for your country.

The image above features our first shipment outside the United States!

As I opened my eyes and got out of bed, I found it hard to navigate the room. The sun had not risen yet and my mind was a bit foggy waking up much earlier than normal. But it was no normal day waking up for work. On this special day, my wife and I were going snowboarding. We hadn’t been in a few years (you know how life can get hectic), and this would be my first time ever snowboarding with an insulin pump!¹

While I was very excited to get back into nature and experience the wonder of snow-covered mountains, there was still a part of me that was a little nervous. 

Let’s get back to waking up. In my pump's active Personal Profile I've programmed a higher basal rate a few hours before I wake up (this is different for everyone, consult your medical team to find what works best for you). This elevated basal rate takes care of my “dawn phenomenon” and allows me to wake up with perfect blood sugars almost every day, something that I never was able to master when I was on multiple daily injections. This effectively handled my dawn phenomenon and any additional adrenaline from preparing for the trip. I bolused for my breakfast in the car and had perfect blood sugars with the sun rising to the east, peaking over the grass covered hills.

We arrived at the mountain and it was time to gear up for snowboarding. Since the parking lot was already full when we arrived, we had to park in the overflow lot. This meant we had to haul all our gear half of a mile to get to the slopes. Basal-IQ® technology to the rescue! We started walking and I started slowly dropping, but the feature suspended insulin and kept me steady between 80 and 100! We hopped on the ski lift and took our first run.

Being the adrenaline seeking adventurer that I am, I wondered if going off jumps or grinding on rails would be hard on my infusion set. But, I was committed to going snowboarding, and decided I’d take it easy on the first few runs down the mountain to build up my confidence.

I am happy to report that I had full range of motion and my pump site was comfortable. 

I gave it a good test too. I was trying to show off in front of my wife and I crashed hard trying to do a trick. (I hadn’t been snowboarding in a few years, I was rusty, ok?) But, guess what...Still good! One run down and I knew I could jump right back in. We were off to a great start!

I had my pump in my pocket close to my skin and under layers. I kept my alarms and alerts on for safety and was mindful about how I was feeling. I made a decision for the day, and that decision was to enjoy every moment by trusting in my wearable diabetes technology. Even after bolusing for a big lunch I was able to jump right back out and tear up the freestyle park without having the fear of low blood sugars ruin a perfect day. It had just snowed a ridiculous amount and both my wife and I were in awe at what a wonderful day it had been in a winter wonderland. On our last run of the day, we took a moment to appreciate the snow covered forest, the sounds of nature, and the fresh air that had allowed us to escape the hecticness of life.

I never dropped below 83 mg/dl.² At the end of the day when I was looking at my CGM graph, I can say that without the Basal-IQ feature, I would have seen some lows with all of the exercise from snowboarding.

Diabetes never stops, and because of Basal-IQ technology, my adventure doesn't have to stop either.

Responsible Use of Basal-IQ Technology

Systems like the t:slim X2 insulin pump with Basal-IQ technology are not substitutes for active diabetes management, as there are common scenarios in which automated systems cannot prevent hypoglycemia. The Basal-IQ feature relies on continuous CGM readings and will not be able to predict glucose levels and suspend insulin delivery if your CGM is not working properly or is unable to communicate with your pump. Be sure to always use your pump, cartridges, CGM, and infusion sets as instructed and check them regularly to make sure they are working properly. Always pay attention to your symptoms, actively monitor your glucose levels, and treat according to your healthcare provider’s recommendations.

Matt Vande Vegte is a certified personal trainer, nutritionist, and type 1 diabetic whose biggest goal in life is to help people with diabetes around the world live their lives fearlessly. Looking for an online health coaching program to help you live your best life? Click the link below to learn more about his program for people living with diabetes, focused on helping you reach your goals while living a happier and healthier life. Join the Tribe today!

Matt was compensated by Tandem Diabetes Care for his contribution on this topic. However, he created the content, and it is based on his personal knowledge, experiences, and observations.

From time to time, we may pass along: suggestions, tips, or information about other Tandem Insulin Pump user experiences or approaches to the management of diabetes. However, please note individual symptoms, situations, circumstances and results may vary. Please consult your physician or qualified health care provider regarding your condition and appropriate medical treatment. Please read the Important Safety Information linked below before using a Tandem Diabetes Care product.

IMPORTANT SAFETY INFORMATION

Leigh Vosseller, chief financial officer and executive vice president at Tandem Diabetes Care, was recognized in the Medical Design & Outsourcing November 2018 Special Edition: Women in Medtech! It’s about time we featured this important person behind our pump. We caught up with her about her work. 

The people! I was incredibly excited to learn that there was an opportunity for me at Tandem to reconnect with the best and brightest colleagues from a former company. I knew the kind of culture those folks had built in the past and was excited to have the opportunity to be part of that team and that type of environment again. Even now that we have grown substantially since I began (~4X the number of employees), it’s awesome to see that the culture has remained the same. 

Then, the fun part: the update itself. 

Actual time to update the pump: roughly 10 minutes.

Total time spent updating knowledge and pump: 70 minutes.

Not too shabby for the newest technology, but still a chunk of time you need to set aside.

Testing out Basal-IQ technology

The first day, I felt my pump vibrate - I’d activated the optional suspend and resume alerts after doing the training. Since it was my first time, I opted to keep these alerts on in order to learn as much as I could about all of the feature's activities. And, the Out of Range alert would let me know of potential situations where Basal-IQ technology wouldn't suspend, like if connectivity to my CGM was lost. When I looked at my pump, I had a message on the screen saying insulin was suspended because the algorithm predicted my blood sugar could go low in the next 30 minutes.

I was 125 with a partial down arrow.

“This seems excessive,” I thought to myself. “I’m not low, and who’s to say I will be low later on?”

But my insulin resumed shortly after and my blood sugar stabilized at 95 mg/dL.

An hour after that, I was still sitting between 90 mg/dL and 97 mg/dL.

Without further ado, here are my main takeaways from this experience:

Top Four Takeaways:

• The prevention of nighttime lows was HUGE.

You may or may not experience a similar situation, but typically my blood sugar drops at nighttime while I’m asleep.

This could be due to the large amount of physical activity earlier in the day, or due to an over correction at night, or a million other possible reasons.

Some days, it settles around 80-90 mg/dL, and other days, it becomes a legitimate low.

Basal-IQ technology was able to prevent lows almost every single time.

Did the vibrations occasionally wake me up? Yes. (Remember I kept optional alerts on overnight so that I would know if my CGM connectivity was affecting Basal-IQ technology.)

Was it 100% worth it? Yes.

The alternative would be crashing, correcting, possibly overcorrecting, and then ending up with a higher blood sugar that could take a while to come down.

• Hyperglycemia concerns eased.

I often set temp basal rates prior to exercise, and occasionally I see a high blood sugar later, maybe the temp rate was off, or my insulin needs were higher than expected during the workout. I worried about this using Basal-IQ technology.

Hyperglycemia only happened to me three times while using the feature. There were a few instances where Basal-IQ technology suspended for 30-60 minutes, and I was a higher after. But, it was only a few times out of a possible 28 automated suspensions. And if I’d been low and eaten, I might have been even higher later than I was after the suspension.

• Bonus: I needed fewer calories to avoid and treat lows.

I’m a registered dietitian, so I think about food about 90% of the day. I also tend to treat lows rather conservatively. I will eat three glucose tabs and wait rather than ravage the fridge. However, with Basal-IQ technology reducing the incidence of hypoglycemic episodes, I was ingesting even fewer calories to correct these lows.

I’m on a well-designed nutrition plan and these calories add up. It’s annoying to have to add low snacks to my overall meal plan … and ultimately take away from other delicious foods I’d rather be eating.

For someone that overeats for lows, this could save hundreds of calories per week …

• It’s stupid easy to use.

Once it is set up and activated, you legitimately don’t need to touch the pump to keep the algorithm working for you in the background. The system takes care of itself, provided your Dexcom G6 CGM is working properly and can communicate with your pump.

Basal-IQ technology is an absolute GAMECHANGER for anyone on a t:slim X2 insulin pump willing to use CGM.

Responsible Use of Basal-IQ Technology

Basal-IQ technology is not a substitute for active diabetes management and does not prevent hypoglycemia in all scenarios. Basal-IQ technology will not be able to predict glucose levels and suspend insulin delivery if your CGM is not working properly or is unable to communicate with your pump. Always pay attention to your symptoms and blood glucose levels and treat according to your healthcare provider’s recommendations.

¹Forlenza GP, Li Z, Buckingham BA, Pinsker JE, et al. Predictive low-glucose suspend reduces hypoglycemia in adults, adolescents, and children with type 1 diabetes in an at-home randomized crossover study: Results of the PROLOG trial. Diabetes Care. 2018;41(10):2155-2161.doi:10.2337/dc18-0771.

Author Bio: Ben Tzeel has lived with type 1 diabetes since 1999. He has a master’s degree in nutrition from the University of North Carolina at Chapel Hill and is a registered dietitian. He is a Certified Strength and Conditioning Specialist (CSCS) through the National Strength and Conditioning Association, is a published fitness model, and writes about exercise and nutrition.

Ben Tzeel was compensated by Tandem Diabetes Care for his contribution on this topic. However, he created the content and it is based on his personal knowledge, experiences, and observations.

From time to time, we may pass along: suggestions, tips, or information about other Tandem Insulin Pump user experiences or approaches to the management of diabetes. However, please note individual symptoms, situations, circumstances and results may vary. Please consult your physician or qualified health care provider regarding your condition and appropriate medical treatment. Please read the Important Safety Information linked below before using a Tandem Diabetes Care product.

Important Safety Information

We are excited to announce the highly anticipated day-by-day Therapy Timeline printed report, now available through the t:connect^® Diabetes Management Application.

When you print the Therapy Timeline report, it is automatically formatted in this weekly summary view, displaying useful pump, insulin, and glucose data in a clear and actionable form. No updates are required; simply log into t:connect^®

For questions about the t:connect^® Diabetes Management Application or this new report, contact your local Tandem representative or call our Customer Support team at (877) 801-6901.

The t:connect^® Diabetes Management Application is intended for use by individuals with diabetes mellitus who use Tandem Diabetes Care insulin pumps, their caregivers, and their healthcare providers in home and clinical settings. The t:connect^® Application supports diabetes management through the display and analysis of information downloaded from Tandem Diabetes Care insulin pumps and specified blood glucose meters.

It was a crisp morning in the secluded mountains of Big Bear, California, as I sat down to read a new book and sipped on my coffee among the birds and the trees. I was on vacation with my wife for the first time all year, and we were enjoying a quiet morning at the cabin before heading out for the day. We had a full day of fun plans ahead of us, which included a peaceful bike ride along the lake path in the morning, going to the local farmers market to grab some food for lunch, and a quick hike up the mountain to take in the incredible view up top.

The bike ride reminded me why I need to get out of the city more often and explore nature. The farmers market was quaint, and it reminded me to slow down in life to enjoy the moment and have meaningful conversations with those around me. Lunch was delicious and taught me to savor the moment … and the meal. It had been an incredible day so far, but the day was about to become even more memorable and exciting when I took my phone out to check my blood sugar before our afternoon hike.

I took a peek at my Dexcom G6® Continuous Glucose Monitoring (CGM) System on my phone and also noticed that I had an email from Tandem. I called my wife over and excitedly asked aloud, “Is it finally time for my Basal-IQ technology update on my t:slim X2™ insulin pump?!” I opened the email and nearly yelled out of happiness. Smiling from ear to ear and feeling like a kid on Christmas morning, I ran to my laptop in the office. I remembered that we were supposed to leave on our afternoon hike shortly, but my wife knew how important this Basal-IQ technology update was to me and agreed to wait until I had it downloaded and set up.      

The process of downloading and watching the instructional videos was simple and easy, and before long, I had my shiny, new algorithm that could (and would) change the way I control my type 1 diabetes. Thrilled that I now had the opportunity to test the algorithm with our previously planned hike, we jumped to action and ran out the door towards the mountains.

The hike was short, but I knew it would be intense. I’ve done it in the past and knew what to expect, so I planned ahead and had my blood sugar sitting around 180 mg/dL to give me some wiggle room in case I dropped low. Climbing over rocks and pushing through the brush along the way, we powered our way up the mountain. I had my trusty backpack full of sugar just in case, but I wanted to test out the Basal-IQ update; the sugar was a safety cushion. As we neared the top I took a peek at my blood sugars. 140 mg/dL slanted down. The next reading would show an arrow down. I was a little nervous, but chose to enjoy the moment and let Basal-IQ technology work as it was meant to, and guess what? It had already shut off my basal insulin once the algorithm picked up on my quickly dropping blood sugars! It was helping my blood sugars in the background without even making a peep. We took our time taking in the 360-degree viewpoint of the forest, the mountains, and the lake. It was breathtaking.

Heading down the steep mountain was still strenuous, and my blood sugars let me know that. However, while they continued to drop, I noticed that they were slowing down. I put my phone away and enjoyed the rest of the hike back to the cabin before pulling out my stash of sugar. Back at the cabin, I was positive that I would need to have at least a few carbs to stop the drop from the hike, but I took a look at my sugars first. I was now slanted down (instead of arrow down which means that it was slowing down) at 103 mg/dL. I faced an important decision: Wait and see what happens with the Basal-IQ suspension, or respond like I normally would and prepare to treat a low blood sugar. I chose to trust the software and wait it out, which turned out to be a great decision because the next reading was a stable arrow at 106! I ended up stabilizing at 112 mg/dL and staying there until dinner.

I was blown away at how well Basal-IQ technology worked and at the whole new world of possibilities this opened up to me. Basal-IQ technology had allowed me the opportunity to take in the beauty of nature that surrounded me on that perfect day, without having to stop to eat any sugar.

Matt Vande Vegte is a certified personal trainer, nutritionist, and type 1 diabetic whose biggest goal in life is to help people with diabetes around the world live their lives fearlessly. Looking for an online health coaching program to help you live your best life? Click the link below to learn more about his program for people living with diabetes, focused on helping you reach your goals while living a happier and healthier life. Join the Tribe today!

Responsible Use of Basal-IQ Technology

Systems like the t:slim X2 insulin pump with Basal-IQ technology are not substitutes for active diabetes management, as there are common scenarios in which automated systems cannot prevent hypoglycemia. The Basal-IQ feature relies on continuous CGM readings and will not be able to predict glucose levels and suspend insulin delivery if your CGM is not working properly or is unable to communicate with your pump. Be sure to always use your pump, cartridges, CGM, and infusion sets as instructed and check them regularly to make sure they are working properly. Always pay attention to your symptoms, actively monitor your glucose levels, and treat according to your healthcare provider’s recommendations.

Matt was compensated by Tandem Diabetes Care® for his contribution on this topic. However, he created the content, and it is based on his personal knowledge, experiences, and observations.

From time to time, we may pass along suggestions, tips, or information about other Tandem insulin pump user experiences or approaches to the management of diabetes. Please note, however, individual symptoms, situations, circumstances, and results may vary. Please consult your physician or qualified healthcare provider regarding your condition and appropriate medical treatment. Please read the Important Safety Information before using a Tandem Diabetes Care product. www.tandemdiabetes.com/important-safety-information.

Al has been with Tandem for six years, starting as a territory manager in Austin, Texas. Al transitioned into the role of Regional Sales Manager of the Gulf Coast in 2016. Al manages both sales and clinical specialists in the gulf coast area and is looking to add a passionate and dedicated salesperson to his team. Al has lived with diabetes for 40 years and views helping patients with diabetes as his personal and professional mission in life. 

Tandem has been named a “Best Place to Work.” What do you think makes Tandem a great place to work?
Our approach of putting the patient first is something that is evident in every way. Tandem does this in a way that is captivating, but also energizing! Regardless of who you speak with from the Tandem family, whether it’s Inside Sales or a Territory Manager, you feel the passion and love for what we do.

Describe the Sales hiring process at Tandem.
We look for entrepreneurs who have the hunger and drive to make a difference in improving the lives of people living with diabetes. Our amazing Talent Management team works very closely with senior leadership to cultivate searches based on who is right for the company, not just the territory.

Other than strong sales experience, what does Tandem look for on a candidate’s resume? What makes an applicant stand out as someone you want to interview?
The ideal candidate is someone who has a dynamic personality and the ability to adapt to the fast-changing diabetes industry – having that hunger and passion for diabetes care is a MUST! This is an organization where you have the opportunity to not only do well financially, but also do GOOD in the way we care for our patients.

Do you ever consider candidates without medical device experience? What advice do you have for someone trying to break into the field at Tandem? 
Yes, we do. The most important thing for me is how eager you are to learn. Every interaction with healthcare providers is an opportunity to learn more about them, their practice, their patients and where our portfolio fits into their desired treatment regimen. If you bring your heart and hunger, you will absolutely be someone with whom we want to speak.

What mistakes do you see candidates making during the interview process? 
Most people are too focused on providing “the right answers” vs. what they truly feel. Interviewing is a naturally stressful situation, but if you are true to who you are and what you want to accomplish, then the stress level tends to drop.

What characteristics do most successful Territory Managers have in common?  
A passion for making a difference coupled with strong goal-setting and the ability to execute them are key factors. It is so important to feel enthusiastic and determined to make a difference in a patient’s life, but you also need to be able to plan how to get there and accomplish the goals you set for yourself.

What’are coolest things someone will learn or get to work on by coming to work at Tandem?
It’s incredible to be exposed to so many bright minds. We are a rapidly growing company, yet you can reach out to the highest level of Manager/Marketer/VP and truly connect with them. At Tandem we are all united and that is obvious to anyone who has interacted with us.

What’s the coolest thing about working in our South Houston territory?
South Houston has been a top-performing Territory for years, and yet, it still has so much untapped potential!  If you have the commitment and hunger for getting it done, then this is a territory where you can step in, make a difference, and see the results almost immediately.

Any final words of advice for professionals seeking a Territory Manager role at Tandem? 
If you want to step outside of your comfort zone, stop checking boxes by sticking to your routine, stop the mundane conversations that you do not feel inspired by, and really want to join an organization with the most  innovative products and most robust pipelines in diabetes care, then step up! We are looking for you….

Find out about careers at Tandem here.

This post was originally published on 2/9/2017 and has been updated.

This content was originally posted 2/8/2018 and has been updated since.

Diabetes is complicated, but managing data shouldn’t be.

Compatible with both Macs and PCs, and accessible by both patients and providers, the t:connect® Diabetes Management Application is a fast, easy way to access and save data from pumps, supported glucose meters¹, and Continuous Glucose Monitors. 

Patients who regularly log in, and review data spend more time in range, ² and sharing reports before appointments with healthcare providers can help to make the most of time spent with a physician. 

But, don't take it from us! We asked Kerri Sparling, creator and author of Six Until Me, one of the first and most widely-read diabetes patient blogs, and mother of two. Even with all that Kerri has going on, Kerri finds time to upload her data.

Q1. How often do you upload/sync data to t:connect? 
I upload at least once a month, but am trying to do it every two weeks as part of my diabetes New Year resolutions. Since I use my Dexcom 24/7, I feel like I’m getting a good sense of my trends on a day to day basis, but there’s something very powerful about seeing 30 days of data, all color coded and presented in an organized way that keeps me from feeling overwhelmed and instead inspired by the data.  

Q2. What features on t:connect that you use the most? 
The dashboard is the feature I use most, because it gives me a global snapshot of where my management is, and helps me set quick goals on where I want to focus.  

Q3. How do you and your physician share and use the data to make treatment decisions?
I have shared the dashboard with him during our visits so we can start our appointment knowing where my management style stands.

Q4: What else do you like about t:connect?
Honestly, I like that plugging my t:slim X2 into my computer to download the data also charges my pump. Managing my data is a decision I benefit from twice…and that’s a rare thing. 

As Kerri mentioned, with the new HCP Portal, clinicians can now upload, view, and print your data from one user-friendly webpage.

Note: Don’t forget to protect your t:connect password. Treat it like your other important data-sf-ec-immutable="">

If it's been a while since you uploaded, here are simple steps to upload your data today: 

1. Plug in your pump or BG meter to your computer. 
2. Open the t:connect Uploader and click Start Upload. Upload times will vary depending on the number of records since your last upload. 
3. The “Upload Successful” message is displayed after the data has successfully been transmitted. 
4. Click View Reports or Save Reports to be taken directly to the t:connect Application.

Don’t have a t:connect account?
New Tandem pump users should follow the steps in our Get Started Guide. 

Healthcare providers interested in the HCP Portal should reach out to their local Tandem representative or give us a call at (877) 801-6901. Or visit our website for more information.

¹ The t:connect Application is compatible with the following meters: OneTouch® Verio® IQ, OneTouch UltraMini®, OneTouch Ultra® 2, FreeStyle® Lite®, FreeStyle Freedom Lite®, ACCU-CHEK® Aviva, ACCU-CHEK Compact Plus.
² Data on file. Tandem Diabetes Care, Inc. 

From time to time, we may pass along: suggestions, tips, or information about other Tandem Insulin Pump user experiences or approaches to the management of diabetes. However, please note individual symptoms, situations, circumstances and results may vary. Please consult your physician or qualified health care provider regarding your condition and appropriate medical treatment. Please read the Important Safety Information linked below before using a Tandem Diabetes Care product.

IMPORTANT SAFETY INFORMATION

We've created a series of short instructional videos to highlight some of the features of the t:slim X2™ insulin pump. Check out the first videos in this series below!

Extending a Bolus

Here are the steps for programming an extended bolus.

Unique Bolus Calculator

The bolus calculator has another calculator built in, so you can add up multiple carb values to help calculate your total bolus amount.

Entering a Dexcom G6 CGM Transmitter ID

Here are the steps for entering a Dexcom G6 CGM Transmitter ID.

Home Screen Shortcut

The "T" on the front of Tandem pumps is actually a shortcut to the home screen! It takes you straight back home, eliminating any additional taps before your desired next step.

Manually Resuming Insulin

Here are the steps for manually resuming insulin delivery.

Setting a Temporary Basal Rate

Here are the steps for setting a Temporary Basal Rate.

Quick Bolus Button

This button can be programmed to enter either units of insulin or grams of carbohydrate without you looking at the screen, or even taking your pump out of your pocket!

Unintended Touch Protection

In order to guard against unintended inputs, the pump automatically turns off if it detects 3 taps on inactive areas of the touchscreen. This does not impact insulin delivery.

Understanding the Colored LEDs

For more information, please visit: https://www.tandemdiabetes.com/support/documents

Additional Resources: 

For more on the Extended Bolus: 

Extending meal coverage with the Extended Bolus feature.

Using the Extended Bolus Feature in Real Life with Ben Tzeel.

For more on the Home Screen Shortcut: 

Touchscreen Shortcut - Get back to the Home Screen with just one tap.

For more information on the Quick Bolus: 

We have a bolus for that!

We're proud to announce we have been named a top workplace in San Diego by The San Diego Union-Tribune and awarded a “Future Forward” 2018 Top Workplaces honor!

The honor went to Tandem Diabetes Care® because our employees topped other companies in San Diego on a question about the future of the company, answering “I believe this company is going in the right direction.”

The Top Workplace list is based solely on employee feedback gathered through a third-party survey administered for the San Diego Union-Tribune by research partner Energage, LLC. The anonymous survey measures several aspects of workplace culture, including alignment, execution, and connection.

Energage shared with us that employee confidence in the direction of an organization is really, really important. In fact, of the employees in the San Diego area they surveyed this year, “I believe this company is going in the right direction” was the most important factor in their workplace satisfaction. 74% said it was important to them, the highest of all 24 factors they measured.

Our employees have created a culture of passion, creativity, and drive that makes our company a success in an increasingly competitive industry. We are incredibly proud that employees keep giving Tandem such high marks.

Find out about careers at Tandem here.

Picture this: It’s Friday night. You’re at a restaurant for dinner with a bunch of your friends. You’re craving something delicious after a hard week.

You decide to go fancy and order some surf and turf with vegetables and cheesy cauliflower mash. The group orders some oysters to share. Your mouth is watering.

Low carb, right? Your starting blood glucose is 104 mg/dL. 1 unit of insulin is taken for the veggies.

You go to bed at 11:30 PM with a blood glucose of 135 mg/dL. Nothing to worry about, right?

You wake up at 4:00 AM and your blood glucose is 265 mg/dL for no good reason. What went wrong?

Enter: Bolusing for high-fat meals.

How Fat (and Protein) Affects Blood glucose
I won’t nerd out and go all biochemistry on you, but for simplicity, fat has no real impact on blood glucose levels in isolation. 

What it does do, however, is delay gastric emptying, aka slows digestion. This can occur over a period of HOURS.

Why this matters: You are likely NOT consuming fat in isolation (if you are, more power to you). Instead, in this scenario, you are consuming it concurrently with protein.

**We interrupt this section for a quick word on protein.**

When consumed with carbohydrate, protein can augment the way the carbohydrate affects your blood glucose, though minimally. Unless you consume an excess amount of protein, you likely won’t notice much of an effect at all. When protein is consumed in the ABSENCE of carbohydrate, however, it will break down the excess into glucose during a process called gluconeogenesis.

On average, each excess gram of protein will break down into roughly 0.6 grams of glucose.¹  

Now, imagine the meal above. If you are eating 50-plus grams of protein, that potentially has the effect of 30 grams of carbohydrates on your blood glucose.  

**Back to your regularly scheduled program.**

The effect of the glucose from the protein won’t be seen immediately. It may take an hour or two to even notice any increase in blood glucose. Now, add fat to the equation, which will slow the increase in blood glucose even more. Then a CGM graph will reveal a steady increase in blood glucose levels over a period of many hours.

Let’s set this scene up again:

• high fat, high protein, low carb meal
• if we assume 50 grams of protein, it could impact blood glucoses similarly to about 30 grams of carbs
• fat slows digestion, so the ~30 grams of carbs aren’t even seen in total until hours later
  

How Do We Solve This? 

There are two real options to consider, one of which is more sensible: 

1. Set an increased basal rate for two to eight hours after the meal
2. Set an extended bolus to cover the meal for two to eight hours…

 **Disclaimer: The two- to eight-hour range is NOT a range set in stone – you will need to experiment with what works for you and what does not.**

While the first is simpler, it is not optimal because:

1. Basal rates fluctuate through the day and night, so the amount of insulin to be increased is not consistent
2. There is a max rate of basal one can receive per hour, and your needs for the meal may exceed this rate.
   

Thus, let’s talk extended boluses!

What is an extended bolus?

The t:slim X2 Insulin Pump’s extended bolus feature allows the user to take an amount or dose of bolus insulin over a longer duration of time. Humalog and Novolog peak quickly (between 30 min to 3 hours), and last approximately two to five hours. The effect on lowering blood glucose may be out of the body too early to help avoid this delayed increase in blood glucose. Additionally, their peak may be too soon and lead to hypoglycemia...BEFORE the effect of the high fat meal kicks in!

However, with an extended bolus, pump users can take some insulin up front and then have the rest administered at a consistent rate over whatever time period they choose. For example, one could take 20% up front and then 80% over four hours.

Ideally, this strategy can be used to combat the delayed blood glucose increase by allowing users to have a higher amount of insulin active when their blood glucose starts to rise, and ideally blunts that possible spike or prevents it from even happening.

Read more about extending meal coverage with the Extended Bolus feature.

For more information, please visit https://www.tandemdiabetes.com/support/documents

What Percentages Do I Need to Use? 

This, my friends, is the beauty of diabetes: There is no “one size fits all.” There is no right answer. What works for me may not work for you and vice versa.

There are, however, some tips for success you may want to consider:

1. Track, log, or journal about how each attempt goes! It takes work, but it may help you get closer to the ideal up-front percentages, extended percentages, and ideal time frames that work for you.
2. Alter ONE variable at a time! If you change more than one variable at once, such as time frame and percentages, and it works, you won’t be sure which variable caused the success. Changing one variable at a time takes longer, but it can help you better identify what works and doesn’t work for you.
3. If something doesn’t work as expected once, don’t give up. We all know about diabetes, what works one day may not work the next – despite everything being same – so try not to get discouraged. Think of it as a learning experience.
   1. Note: If your strategy repeatedly doesn’t get you the results you need, then it may be time to try something else.

Bonus Question: What if I Ate Carbs with a High Fat Meal? Does that Change Anything?

Answer: Yes and no. The carbs will raise your blood glucose as anticipated, but the fat may prevent your blood glucose from dropping as easily.

Why? The delay in gastric emptying is almost like a consistent flow of glucose being released in the blood over many hours. OR, you could choose to see it as the fat making one more insulin resistant.

Either way, the end result is the same: elevated blood glucose levels for many hours, requiring more insulin than usual to bring it down.

Author Bio: Ben Tzeel has lived with type 1 diabetes since 1999. He has a master’s degree in nutrition from the University of North Carolina at Chapel Hill and is a registered dietitian. He is a Certified Strength and Conditioning Specialist (CSCS) through the National Strength and Conditioning Association, is a published fitness model, and writes about exercise and nutrition. 

Ben Tzeel was compensated by Tandem Diabetes Care for his contribution on this topic. However, he created the content and it is based on his personal knowledge, experiences, and observations.

¹Oexmann MJ. T.A.G.: A Diabetic Food System. New York, NY: William Morrow & Co.; 1989.

If you’ve never used the extended bolus feature before, talk to your healthcare provider about strategies for using it to make this holiday season a little easier to manage. This information is a summary only, if you’d like to learn more please reference your pump’s User Guide for further information.

From time to time, we may pass along: suggestions, tips, or information about other Tandem Insulin Pump user experiences or approaches to the management of diabetes. However, please note individual symptoms, situations, circumstances and results may vary. Please consult your physician or qualified health care provider regarding your condition and appropriate medical treatment. Please read the Important Safety Information linked below before using a Tandem Diabetes Care product.

IMPORTANT SAFETY INFORMATION