tandem_web_icon_notes

 

 
 

 
 

 
 

Indications for Use

The t:slim X2™ insulin pump with Basal-IQ® technology (the System) consists of the t:slim X2 insulin pump, which contains the Basal-IQ technology, and a continuous glucose monitor (CGM).

The t:slim X2 insulin pump is intended for the subcutaneous delivery of insulin, at set and variable rates, for the management of diabetes mellitus in persons requiring insulin. The t:slim X2 insulin pump can be used solely for continuous insulin delivery and as part of the t:slim X2 insulin pump with Basal-IQ technology system.

When the System is used with a compatible integrated continuous glucose monitor (iCGM), the Basal-IQ technology can be used to suspend insulin delivery based on CGM sensor readings.

The System is indicated for use in individuals 6 years of age and greater. The System is intended for single patient use and requires a prescription. The System is indicated for use with U-100 NovoLog or U-100 Humalog insulin.

Back to Top >>

 
 

 
 

Contraindications

The t:slim X2 insulin pump with Basal-IQ technology is not intended for anyone unable or unwilling to:

  • Test blood glucose (BG) levels as recommended by your healthcare provider
  • Demonstrate adequate carbohydrate-counting skills (preferred, not required)
  • Maintain sufficient diabetes self- care skills
  • See your healthcare provider(s) regularly

You must also have adequate vision and/or hearing in order to recognize your System alerts.

The t:slim X2 pump, Dexcom G6 transmitter, and Dexcom G6 sensor must be removed before magnetic resonance imaging (MRI), computed tomography (CT) scan, or diathermy treatment. Exposure to MRI, CT, or diathermy treatment can damage the System.

Back to Top >>

 
 

 
 

System Warnings

/!\WARNINGS: t:slim X2 Insulin Pump

DO NOT start to use your System before reading the User Guide. Failure to follow the instructions in the User Guide can result in over delivery or under delivery of insulin. This can cause very low or very high BG, which could result in serious injury or death. If you have questions or need further clarification on your System use, ask your healthcare provider or call our around-the-clock Tandem Diabetes Care® Customer Technical Support Department at (877) 801-6901.

DO NOT start to use your System before you have been appropriately trained on its use by a certified System trainer. Consult with your healthcare provider for your individual training needs for the entire System. Failure to complete the necessary training on the System could result in serious injury or death.

DO NOT use any other insulin with your System other than U-100 Humalog or U-100 NovoLog. Only Humalog and NovoLog have been tested and found to be compatible for use in the System. Use of insulin with lesser or greater concentration can result in under delivery or over delivery of insulin. This can cause very high or a very low BG.

DO NOT put any other drugs or medications inside your System cartridge. The System is designed only for continuous subcutaneous insulin infusion (CSII) using U-100 Humalog or U-100 NovoLog insulin. Use of other drugs or medications can damage the pump and result in injury if infused.

DO NOT start to use your System before consulting with your healthcare provider to determine which features are most appropriate for you. Only your healthcare provider can determine and help you adjust your basal rate(s), carb ratio(s), correction factor(s), target BG, and duration of insulin action. In addition, only your healthcare provider can determine your CGM settings and how you should use your sensor trend information to help you manage your diabetes. Incorrect settings can result in over delivery or under delivery of insulin. This can cause very low or very high BG.

DO be prepared to inject insulin with an alternative method if delivery is interrupted for any reason. Your System is designed to deliver insulin reliably, but because it uses only rapid-acting insulin, you will not have long-acting insulin in your body. Failure to have an alternative method of insulin delivery can lead to very high BG or diabetic ketoacidosis (DKA).

DO use only FDA-cleared insulin infusion sets with a tubing connector and follow their instructions for use. Failure to do so may result in over delivery or under delivery of insulin and may cause very low or very high BG.

DO NOT place your infusion set on any scars, lumps, moles, stretch marks, or tattoos. Placing your infusion set in these areas can cause swelling, irritation, or infection. This can affect insulin absorption and cause high or low BG.

DO NOT ignore broken or detached sensor wires under your skin. If this happens, please contact our 24/7 Tandem Customer Technical Support at (877) 801-6901. If a sensor wire breaks off under your skin and you can’t see it, don’t try to remove it. Contact your healthcare provider. Also, seek professional medical help if you have symptoms of infection or inflammation—redness, swelling or pain—at the insertion site.

NEVER fill your tubing while your infusion set is connected to your body. Always ensure that the infusion set is disconnected from your body before filling the tubing. Failure to disconnect your infusion set from your body before filling the tubing can result in over delivery of insulin. This can cause serious injury or death from very low BG.

DO NOT reuse cartridges or use cartridges other than those manufactured by Tandem Diabetes Care, Inc. Use of cartridges not manufactured by Tandem Diabetes Care or reuse of cartridges may result in over delivery or under delivery of insulin. This can cause very low or very high BG.

ALWAYS twist the tubing connector between the cartridge tubing and the infusion set tubing an extra quarter of a turn to ensure a secure connection. A loose connection can cause insulin to leak, resulting in under delivery of insulin. This can cause high BG.

DO NOT disconnect the tubing connector between the cartridge tubing and the infusion set tubing. If the connection comes loose, disconnect the infusion set from your body before tightening. Failure to disconnect before tightening can result in over delivery of insulin. This can cause low BG.

DO NOT remove or add insulin from a filled cartridge after loading onto the pump. This will result in an inaccurate display of the insulin level on the Home Screen, and you could run out of insulin before the pump detects an empty cartridge. This can cause very high BG or DKA.

DO NOT deliver a bolus until you have reviewed the calculated bolus amount on the pump display. If you dose an insulin amount that is too high or too low, this could cause very high or very low BG. You can always adjust the insulin units up or down before you decide to deliver your bolus.

DO NOT allow small children (either pump users or non-users) to ingest small parts, such as the rubber USB port cover and cartridge components. Small parts could pose a choking hazard. If ingested or swallowed, these small component pieces may cause internal injury or infection.

The insulin pump includes parts (such as the USB cable and infusion set tubing) that could pose a strangulation or asphyxiation hazard. ALWAYS use the appropriate length of infusion set tubing and arrange cables and tubing to minimize the risk of strangulation. ENSURE that these parts are stored in a secure place when not in use.

For patients who do not self-manage their disease, the Feature Lock function should ALWAYS be ON when the pump is not being used by a caregiver. The Feature Lock function is intended to prevent inadvertent button presses that may lead to insulin delivery or changes in the pump settings. These changes can potentially lead to hypoglycemic or hyperglycemic events.

For patients whose insulin administration is managed by a caregiver, ALWAYS turn OFF the Quick Bolus feature to avoid inadvertent bolus delivery.

If the Feature Lock is turned on, the Quick Bolus feature is automatically disabled. Inadvertent button presses or tampering with the insulin pump could result in over delivery or under delivery of insulin. This can cause very low or very high BG, which could result in serious injury or death.

/!\WARNINGS: Radiology and Medical Procedures and your t:slim X2 Insulin Pump

ALWAYS notify the provider/technician about your diabetes and your t:slim X2 Insulin Pump. If you need to discontinue use of the Insulin Pump for medical procedures, follow your healthcare provider’s instructions to replace missed insulin when you reconnect to the pump. Check your BG before disconnecting from the pump and again when you reconnect and treat high BG levels as recommended by your healthcare provider.

DO NOT expose your pump, transmitter, or sensor to:

  • X-ray
  • Computed tomography (CT) scan
  • Magnetic resonance imaging (MRI)
  • Positron emission tomography (PET) scan
  • Other exposure to radiation

The System is magnetic resonance unsafe. You must take off your pump, transmitter, and sensor and leave them outside the procedure room if you are going to have any of the above procedures. In addition to the above, DO NOT expose your pump, transmitter, or sensor to:

  • Pacemaker/automatic implantable cardioverter defibrillator placement or reprogramming
  • Cardiac catheterization
  • Nuclear stress test

You must take off your pump, transmitter, and sensor and leave them outside the procedure room if you are going to have any of the above medical procedures.

There are other procedures where you should proceed with caution:

  • Laser surgery – Your System can usually be worn during the procedure. However, some lasers can create interference and cause the System to alarm.
  • General anesthesia – Depending on the equipment being used, you may or may not need to remove your System. Be sure to ask your healthcare provider.

There is no need to disconnect for electrocardiograms or colonoscopies. If you have questions, contact Customer Technical Support at (877) 801-6901.

DO NOT use the System if you have a condition which, in the opinion of your healthcare provider, would put you at risk including any contraindication to the use of any of the devices in the System per FDA labeling. Examples of individuals who should not use the System include those with uncontrolled thyroid disease, renal failure (e.g., dialysis or eGFR < 30), hemophilia, or another major bleeding disorder, or unstable cardiovascular disease.

/!\WARNINGS: Using Dexcom G6 with Your t:slim X2 Insulin Pump

DO NOT ignore symptoms of high and low glucose. If your sensor glucose alerts and readings do not match your symptoms, measure your BG with a BG meter even if your sensor is not reading in the high or low range.

DO NOT ignore sensor fractures. Sensors may fracture on rare occasions. If a sensor breaks and no portion of it is visible above the skin, do not attempt to remove it. Seek professional medical help if you have symptoms of infection or inflammation—redness, swelling, or pain—at the insertion site. If you experience a broken sensor, please report this to Customer Technical Support at (877) 801-6901.

DO NOT use Dexcom G6 CGM in pregnant women or persons on dialysis. The System is not approved for use in pregnant women or persons on dialysis and has not been evaluated in these populations. Sensor glucose readings may be inaccurate in these populations and could result in you missing severe hypoglycemia (low BG) or hyperglycemia (high BG) events.

DO NOT use Dexcom G6 CGM in critically ill patients. It is not known how different conditions or medications common to the critically ill population may affect the performance of the System. Sensor glucose readings may be inaccurate in critically ill patients, and solely relying on the sensor glucose alerts and readings for treatment decisions could result in you missing severe hypoglycemia (low BG) or hyperglycemia (high BG) events.

DO NOT insert the sensor in sites other than the abdomen (belly) or upper buttocks (for ages 6-17 only). Other sites have not been studied and are not approved. Use in other sites might cause sensor glucose readings to be inaccurate and could result in you missing severe hypoglycemia (low BG) or hyperglycemia (high BG) events.

DO NOT expect CGM alerts until after the two-hour startup. You will NOT get any sensor glucose readings or alerts until after the two-hour startup ends. During this time, you might miss severe hypoglycemia (low BG) or hyperglycemia (high BG) events.

DO NOT use your transmitter if it is damaged/cracked. This could create an electrical safety hazard or malfunction, which might cause electrical shocks.

STORE the Dexcom G6 CGM sensor at temperatures between 36°F-86°F for the length of the sensor’s shelf life. You may store the sensor in the refrigerator if it is within this temperature range. The sensor should not be stored in a freezer. Storing the sensor improperly might cause the sensor glucose readings to be inaccurate, and you might miss severe hypoglycemia (low BG) or hyperglycemia (high BG) events.

DO NOT allow young children to hold the sensor, transmitter or transmitter kit box without adult supervision. The sensor and transmitter include small parts that may pose a choking hazard. Keep the transmitter kit box away from young children; it contains a magnet that should not be swallowed.

Back to Top >>

 
 

 
 

System Precautions

/!\PRECAUTIONS: t:slim X2 Insulin Pump

DO NOT open or attempt to repair your insulin pump. The pump is a sealed device that should be opened and repaired only by Tandem Diabetes Care. Modification could result in a safety hazard. If your pump seal is broken, the pump is no longer watertight, and the warranty is voided.

CHANGE your infusion set every 48-72 hours as recommended by your healthcare provider. Wash your hands with anti-bacterial soap before handling the infusion set and thoroughly clean the insertion site on your body to avoid infection. Contact your healthcare provider if you have symptoms of infection at your insulin infusion site.

ALWAYS remove all air bubbles from the pump before beginning insulin delivery. Ensure there are no air bubbles when drawing insulin into the filling syringe, hold the pump with the white fill port pointed up when filling the tubing, and ensure that there are no air bubbles in the tubing when filling. Air in the system takes space where insulin should be and can affect insulin delivery.

CHECK your infusion site daily for proper placement and leaks. REPLACE your infusion set if you notice leaks around the site. Improperly placed sites or leaks around the infusion site can result in under delivery of insulin.

CHECK your infusion set tubing daily for any leaks, air bubbles, or kinks. Air in the tubing, leaks in the tubing, or kinked tubing may restrict or stop insulin delivery and result in under delivery of insulin.

CHECK the tubing connection between your cartridge tubing and infusion set tubing daily to ensure it is tight and secure. Leaks around the tubing connection can result in under delivery of insulin.

DO NOT change your infusion set before bedtime or if you will not be able to test your BG 1-2 hours after the new infusion set is placed. It is important to confirm that the infusion set is inserted correctly and delivering insulin. It is also important to respond quickly to any problems with the insertion to ensure continued insulin delivery.

ALWAYS check that your cartridge has enough insulin to last through the night before going to bed. If you are sleeping, you could fail to hear the Empty Cartridge Alarm and miss part of your basal insulin delivery.

CHECK your insulin pump’s personal settings regularly to ensure they are correct. Incorrect settings can result in over delivery or under delivery of insulin. Consult with your healthcare provider as needed.

ALWAYS make sure that the correct time and date are set on your insulin pump. When editing time, always check that the AM/PM setting is accurate. AM is to be used from midnight until 11:59 AM. PM is to be used from noon until 11:59 PM. Not having the correct time and date setting may affect safe insulin delivery.

CONFIRM that the screen display turns on, you can hear audible beeps, feel the pump vibrate, and see the green LED light blinking around the edge of the Screen On Button when you connect a power source to the USB port. These features are used to notify you about alerts, alarms, and other conditions that require your attention. If these features are not working, discontinue use of the pump and contact Customer Technical Support at (877) 801-6901.

CHECK your pump regularly for potential alarm conditions that may display. It is important to be aware of conditions that may affect insulin delivery and require your attention so you can respond as soon as possible.

DO NOT use the vibrate feature for alerts and alarms during sleep unless otherwise directed by your healthcare provider. Having the volume for alerts and alarms set to high will help ensure that you don’t miss an alert or alarm.

ALWAYS look at the screen to confirm correct programming of the bolus amount when you first use the Quick Bolus feature. Looking at the screen will ensure that you are correctly using the beep/vibration commands to program the intended bolus amount.

DO NOT use your pump if you think it might be damaged due to dropping it or hitting it against a hard surface. Check that the pump is working properly by plugging a power source into the USB port and confirming that the display turns on, you hear audible beeps, feel the pump vibrate, and see the green LED light blinking around the edge of the Screen On Button. If you are unsure about potential damage, discontinue use of the System and contact Customer Technical Support at (877) 801-6901.

AVOID exposure of your pump to temperatures below 40°F or above 99°F. Insulin can freeze at low temperatures or degrade at high temperatures. Insulin that has been exposed to conditions outside of the manufacturer’s recommended ranges can affect the safety and performance of the pump.

AVOID submerging your pump in fluid beyond a depth of 3 feet or for more than 30 minutes (IPX7 rating). If your pump has been exposed to fluid beyond these limits, check for any signs of fluid ingress. If there are signs of fluid entry, discontinue use of the pump and contact Customer Technical Support at (877) 801-6901.

AVOID areas where there may be flammable anesthetics or explosive gases. The pump is not suitable for use in these areas and there is a risk of explosion. Remove your pump if you need to enter these areas.

MAKE SURE to not move further than the length of the USB cable when you are connected to the pump and to a charging source. Moving further than the length of the USB cable may cause the cannula to be pulled out of the infusion site. For this reason, it is recommended not to charge the pump while sleeping.

DISCONNECT your infusion set from your body while on high-speed/high gravity amusement park thrill rides. Rapid changes in altitude or gravity can affect insulin delivery and cause injury.

DISCONNECT your infusion set from your body before flying in an aircraft without cabin pressurization or in planes used for aerobatics or combat simulation (pressurized or not). Rapid changes in altitude or gravity can affect insulin delivery and cause injury.

CONSULT your healthcare provider about lifestyle changes such as weight gain or loss and starting or stopping exercise. Your insulin needs may change in response to lifestyle changes. Your basal rate(s) and other settings may need adjustment.

CHECK your BG using a BG meter following a gradual elevation change of up to 1,000 feet, such as when snow skiing or driving on a mountain road. Delivery accuracy can vary up to 15% until 3 units of total insulin have been delivered or elevation has changed by more than 1,000 feet. Changes in delivery accuracy can affect insulin delivery and cause injury.

ALWAYS check with your healthcare provider for specific guidelines if you want or need to disconnect from the pump for any reason. Depending on the length of time and reason you are disconnecting, you may need to replace missed basal and/or bolus insulin. Check your BG before disconnecting from the pump and again when you reconnect and treat high BG levels as recommended by your healthcare provider.

ENSURE that your personal insulin delivery settings are programmed into the pump before you use the System if you receive a warranty replacement. Failure to enter your insulin delivery settings could result in over delivery or under delivery of insulin. This can cause very low or very high BG which could result in serious injury or death. Consult your healthcare provider as needed.

Interference with your pump’s electronics by cell phones can occur if worn in close proximity. It is recommended that your pump and cell phone be worn at least 6.4 inches apart.

ALWAYS dispose of used System components such as cartridges, syringes, needles, infusion sets, and CGM sensors following the instructions from your healthcare provider. Wash your hands thoroughly after handling used System components.

/!\PRECAUTIONS: Using Dexcom G6 CGM with Your t:slim X2 Insulin Pump

DO NOT open the sensor package until you have washed your hands with soap and water and let them dry. You may contaminate the insertion site and suffer an infection if you have dirty hands while inserting the sensor.

DO NOT insert the sensor until you have cleaned the skin with a topical antimicrobial solution, such as isopropyl alcohol, and allowed the skin to dry. Inserting into unclean skin might lead to infection. Do not insert the sensor until the cleaned area is dry so the sensor adhesive will stick better.

AVOID using the same spot repeatedly for sensor insertion. Rotate your sensor placement sites, and do not use the same site for two sensor sessions in a row. Using the same site might cause scarring or skin irritation.

AVOID inserting the sensor in areas that are likely to be bumped, pushed or compressed, or areas of skin with scarring, tattoos, or irritation as these are not ideal sites to measure glucose. Insertion in those areas might affect accuracy and could result in you missing severe hypoglycemia (low BG) or hyperglycemia (high BG) events.

AVOID injecting insulin or placing an infusion set within 3 inches of the sensor. The insulin might affect sensor accuracy and could result in you missing severe hypoglycemia (low BG) or hyperglycemia (high BG) events.

DO NOT use the sensor if its sterile package has been damaged or opened. Using an unsterile sensor might cause infection. To calibrate the Dexcom G6 CGM system, DO enter the exact BG value that your BG meter displays within 5 minutes of a carefully performed BG measurement. Do not enter sensor glucose readings for calibration. Entering incorrect BG values, BG values obtained more than 5 minutes before entry, or sensor glucose readings might affect sensor accuracy and could result in you missing severe hypoglycemia (low BG) or hyperglycemia (high BG) events.

DO NOT calibrate if your BG is changing at a significant rate, typically more than 2 mg/dL per minute. Do not calibrate when your receiver screen is showing the rising or falling single arrow or double arrow, which indicates that your BG is rapidly rising or falling. Calibrating during significant rise or fall of BG may affect sensor accuracy and could result in you missing severe hypoglycemia (low BG) or hyperglycemia (high BG) events. Dexcom G6 CGM accuracy may be affected when your glucose is changing at a significant rate (i.e., 2-3 mg/dL/min or more than 3 mg/dL each minute), such as during exercise or after a meal.

AVOID separating the transmitter and pump by more than 20 feet. The transmission range from the transmitter to the pump is up to 20 feet without obstruction. Wireless communication does not work well through water, so the range is much less if you are in a pool, bathtub, or on a water bed, etc. Types of obstruction differ and have not been tested. If your transmitter and pump are farther than 20 feet apart or are separated by an obstruction, they might not communicate, or the communication distance may be shorter and result in you missing severe hypoglycemia (low BG) or hyperglycemia (high BG) events.

DO NOT use alternative BG site testing (blood from your palm or forearm, etc.) for calibration. Alternative site BG values may be different than those taken from a fingerstick BG value and may not represent the timeliest BG value. Use a BG value taken only from a fingerstick for calibration. Alternative site BG values might affect sensor accuracy and result in you missing severe hypoglycemia (low BG) or hyperglycemia (high BG) events.

ENSURE that your transmitter ID is programmed into the pump before you use the System if you receive a warranty replacement pump. The pump cannot communicate with the transmitter unless the transmitter ID is entered. If the pump and transmitter are not communicating, you will not receive sensor glucose readings and you might miss severe hypoglycemia (low BG) or hyperglycemia (high BG) events.

DO NOT discard your transmitter. It is reusable. The same transmitter is used for each session until you have reached the end of the transmitter battery life. The Dexcom G6 sensor is not compatible with older versions of transmitters and receivers. Do not mix transmitters, receivers, and sensors from different generations.

Back to Top >>