These days, I'm living the trifecta of new diabetes devices.

A new insulin pump, CGM (continuous glucose monitor) and glucose meter have made their way into my hands, allowing me to change up my entire D-gadget roster for the first time in more than a decade.

Two of them have already beThree DDevicesen bought and processed through insurance. And I'm still deciding on the third, weighing the pros and cons that play into whether I will go ahead and make the buy. Whether or not that happens, this has been an interesting ride.

New gadgets always get me back on my management wagon a bit, just because they're cool and fun to play with. But when the novelty and excitement wears off, it comes down to the universal question of whether the quality of life improvements they offer are really enough to warrant the investment. Not everything new is good, so here's my rundown of what I've found to be good, bad and ugly on the three new devices I've been using: the Dexcom G4, t:slim insulin pump, and Bayer Contour NEXT fingerstick meter.

First Puzzle Piece: Dexcom G4


Like everyone else, I desire my devices to have the ability to talk to each other, so there's less hassle on my end. That's one big reason I've enjoyed using Medtronic devices for so long, because they play well with each other; my meter was linked wirelessly to my pump, and my pump had a built-in CGM sensor. If it weren't for the continued hold-ups on Medtronic's long-awaited next-gen integrated pump/CGM, I might not be moving on now. But I just can't hold out any longer for the Medtronic 530G (U.S. version of the European Veo) that was submitted for FDA regulatory review back in June 2012. Plus, I've seen data showing the accuracy of the new CGM sensor isn't as good as what the Dexcom G4 currently has on the market. So, decision made: Dexcom it is.

I bought the Dexcom G4 Platinum in August, with insurance doing its thing and the deductible being paid. It is all mine now, less than a year after it was FDA approved and made available. A month into using it, I'm so in love with this device.

We've reviewed the Dexcom G4 here at the 'Mine a few times. Like my colleagues, I find the color screen is so much brighter and easier to read than the egg-shaped Seven Plus, and I like the smaller iPod-look. The G4 Dexcom Caught a Lowhas caught so many low blood sugars once I hit the 70 mg/dL mark, and then it continues vibrating or beeping once it gets to the 55 mg/dL level. At night a couple of times, I've dipped down to the point where it just displays LOW flashing in red, telling me that we're at that point of no more ignoring the alarms!

It comes with a flippy leather case that has a button to keep it closed, and I can wear that on my belt for easy viewing. A nice feature is that it has a variety of different alert profiles. I generally set it to the "medium" beep at night so I know the alarm will rattle me out of sleep, while during the day I usually keep it on "vibrate" and can totally feel that when wearing it on my belt.

I've yet to really dig into the Dexcom Studio software, but I have briefly looked it over and like the  look of the interface and all the data analysis options it provides. One thing I do wish the G4 had: the ability to scroll backward on the CGM graphs, to see what my blood sugar was at a particular time during the period of time it's displaying. The Medtronic CGM offers that, and I miss it -- but it's not a deal-breaker in terms of using the G4.

One cool thing about the Dexcom is future product plans: hopefully in the next several months we'll see FDA approval of the unprecedented Dexcom Share, a sort of docking station that would allow you to set your Dex G4 receiver inside a cradle overnight and have it send your diabetes data by Bluetooth to as many as five smartphones — even in places far away! The company submitted that for regulatory approval in late July, and we can only assume that the holdup was due to FDA struggles with the whole issue of mobile health apps and devices. The good news there is that FDA just yesterday issued its long-awaited final mHealth guidance. Expect to hear much buzz about that!

And that leads me to the next D-device...

Real t:slim, Please Stand Up

My summary, in a word: "It's pretty, but annoying. And I really don't trust it."

Unfortunately, that's my overall train of thought on the sexy touchscreen Tandem t:slim, which I've been trying out since mid-August.

This is my first truly new pump in about five years, after a brief year or so affair with the Deltec Cozmo that haTslim and MedT pumpss since been discontinued. I've been pumping for 12 years, mostly using various Medtronic Minimed pump iterations. That pump really hasn't changed in style much through the years and has only gradually moved forward, so switching to the 2013-esque t:slim has been quite the change.

Without a doubt, it's very good-looking.

Others in the Diabetes Online Community have already offered their impressions and adventures with this stylish pump, so some of my observations may not be surprising. Our own Wil Dubois complained about the so-very-many buttons you have to push just to authorize simple tasks like giving a bolus. For "security reasons," you have to hit the t:slim screen 10 times to give a simple food bolus, or 14 times if you want that to be an extended bolus. There are 11 screen-taps if it's a BG correction bolus -- compared to just a few button pushes with the Medtronic.

The FDA apparently required all these multiple confirmations because they were nervous that with a touch-screen medical device, there would be a lot of user error causing people to give insulin inadvertently. I suppose the company can't help that, but what a world of difference (the annoying kind of difference) those many more screen taps can make for the user!

Speaking of annoyance, the t:slim really likes to remind you of everything -- whether it's time to change your site, that you are low on insulin, if you've stopped insulin briefly, or if you're cartridge change is taking too long. That last one's kind of ironic, because a t:slim cartridge change takes about 15 minutes total, compared to about 5 minutes that I was used to before. Like any other pump, it vibrates at first every couple minutes before eventually wailing at you. Unlike any other pump, though, you can't shut off the alerts without actually taking care of the particular issue.

Every other pump out there allows you to quiet it by taking out the battery. Why make it so difficult to shut off an alarm if the user wants to remove the pump for a period of time? Apparently the t:slim has a Shelf/Sleep mode, but nowhere on the screen or manual can you find out how to use this. Nope, I had to call customer support.

They say this is because people might inadvertently put the pump to sleep. How about you trust us a little, and include these instructions in the user guide so we at least can research how to use that option?

Here's what else I would suggest changing on future t:slim models:

  • Cartridge Design: A simple improvement would be to make it see-through. Right now, Tandem has the "trust us" mentality in talking about how the t:slim is designed to have fewer air bubbles in the cartridge bag, but that doesn't jibe with some reports by users saying they've experienced more bubbles with this pump than with others they've used. I am one of those. Actually, I've heard from a couple CDEs inside and outside of clinical settings that Tandem is now teaching people to withdraw air from the cartridge with the syringe before filling to avoid bubbles, and they're stating that after the prime and load process, the system realistically holds just 220 units rather than the 240+ advertised capacity. Aymeric Lecanu-Fayet, Tandem's marketing director for commercial products, told us the company considered creating a clear cartridge, but found that "looking through the plastic casing and the pouch didn't make seeing the insulin inside easier and the dark plastic provides additional protection from light." If I had the ability to see inside the cartridge, and see for myself that there are no air bubbles interfering with my dosage, I would find this a better product that I'd be more willing to trust.
  • Wasted Insulin: For me, with the 23-inch tubing, it takes me 25 units of insulin before it's ready to use. In a month, that translates to a third of a bottle that I waste -- assuming I am changing out the tubing each and every time, which I don't necessarily do. Comparatively, I only had to waste about 16 units when prepping my other pump.
  • Reverse Correction: This feature is designed to trigger only once you go below 70 mg/dL. We shouldn't have to get down to 69 in order for the pump to realize we need less insulin! To clarify, if your set BG target is 100, the t:slim will suggest an insulin correction even when you're at exactly 110. The same should be true for reverse corrections. The pump should be able to calculate lopping off some suggested meal bolus insulin based on an undesirably low starting BG. On this issue, Tandem tells me:

"You are not the first person to request the reverse correction change and it is high on our list. We have heard mixed reviews on all bolus calculation algorithms, including ours. We came up with our existing method based on feedback from our Clinical Advisory Board, and we are working with them and other advisers to figure out the best way to address this so that we meet the needs of as many customers as possible."

  •  Standing Up: We are supposed to stand up the t:slim when going through the priming process, but did anyotslim Resume Insulin Alertne designing this pump think about the fact that it's quite top-heavy and doesn't like to free-stand very easily? Yes, I can lean it up against something. But if I'm trying to do a quick change while out-and-about, this is, well... less than convenient with the pump balanced in my lap. It's just another impracticality that seems like it would have been very easy to work around.
  • Hellooo?: I've attended a few high-volume sporting events and outside activities since starting on this pump, and one thing that bothers me is that I often don't realize when the t:slim is alerting me. Normally, I keep it on vibrate so that I can feel the vibration and don't mistakenly miss an audible alert. But with the holster provided, worn on my belt, the vibration of this product isn't too noticeable. And if I can't hear the eventual audible alert that comes within 5 minutes or so... the t:slim automatically suspends my insulin basals. Not good!

Despite all those annoyances, the most appealing aspect of the t:slim for me is their future integration plans:


As Tandem's Lecanu-Fayet tells us: "Tandem Diabetes Care is working closely with Dexcom on integration of the Dexcom G4 Platinum so the t:slim Insulin Pump.  We expect to submit... to the FDA by the end of 2013. We cannot predict the length of time of the regulatory review or when the product will be available.  Devices on WaistHowever we are integrating to existing products that were recently approved by the FDA.  The Dexcom G4 Platinum's transmitter uses a different radio frequency than the low-energy Bluetooth that is currently in every t:slim pump.  Therefore we will offer an upgrade program to t:slim pump users when the integrated product becomes available. We have no details at this time on the cost of such upgrade as it would be considered to be promoting the product by the FDA.  It will be competitively priced. Regarding the linking with BG meter, we are looking at options for future iterations."


That integration is huge for me, and almost seals the decision on its own!

There's also the fact that Tandem has bought multiple patents formerly owned by Smith's Medical and used in the Deltec Cozmo pump, and we can only hope some of those features we loved so much (like a calculation of how much insulin was missed while disconnected) might be weaved into future t:slim pumps.  

I'm also a fan of the t:connect software that's very simple to access and download online, and it allows you to upload BG data from a number of popular glucose meter models. I like the look of the screens and data analysis options, and would be very happy indeed if the Dexcom data could be uploaded into it as well.

Name It: Bayer Contour NEXT


Lastly, I'm using a new fingerstick meter, the Contour NEXT Link, a thumb-drive sized device that plugs into a USB port.

I've switched from the OneTouch UltraLink meter, which was a little larger than newer models. The main reason I started using that meter many years ago was that it wirelessly linked to my Medtronic pump, eliminating the need for me to manually share data. Well, since I'm switching pumps, there's no need to stay loyal there. I have tried a number of different meters Contour Next Link Replaces OneTouch UltraLinkin the past year or so, and have determined that really the one I like the best is the Contour NEXT Link.

Ironically, Medtronic just switched to pairing with this meter from OneTouch, so the Next Link actually now says "Medtronic" when you turn it on. I find it accurate and I really like the fact that it has a backlight! So, I can use it at night without turning a light on or using my other D-devices as a flashlight to see the screen. The meter does everything you'd hope and expect a meter does, and it's much more portable and easy to tote around.

However, there is a downside: this meter uses its own line of very specific test strips named Bayer Contour NEXT strips -- not to be confused with the traditional Bayer Contour strips that work on all their other meters, but not this one. WHY?? It's annoying enough that we need special strips in the first place, but couldn't the company at least come up with a different name for these improved strips to avoid confusion?

Remember that most PWDs (people with diabetes) must: 1) get a doctor's prescription for new strips, 2) get insurance to OK covering the new strips, and then 3) obtain the strips from either a local pharmacy or a mail-order supply company -- all of which probably aren't hip to the specific differences between the well-known Contour-brand strips and the new hardly-known Contour NEXT strips.

It may seem like clever marketing to have strips with a closely related name, but this creates a whole new line of headaches for every PWD faced with confirmation after confirmation with every party in the chain just to be sure we're getting the right product... on top of all the other insurance coverage and "preferred vs. non-preferred" hassles involved in this process. {insert frustrated grunt}

OK, rant over. The device itself is good, and I'm looking forward to using it more frequently once I deplete my supply of OneTouch strips on hand.

Just Grateful


In the end, the one thing I'm the most thankful for is that I have these choices to experiment with various D-devices and products. It may be a hassle jumping through all the hoops to get our hands on these things, and sometimes it's tough finding just the right one -- because you really have to live with it for a bit to know if it fits your life -- but I am grateful to have what I do. Like everything in life, there's always room for improvement and I can't wait to see what the future brings as far as these devices, and so many others.

As mentioned, I've not made a decision on purchasing the t:slim yet, but despite my gripes above, I am leaning toward this device. I may trial test the Animas Ping system so that I have a point of comparison, and then wait until the first of the year to make a decision based on what's available then.

Anybody else out there currently trying out new D-devices? Or using these three in particular? We always love to swap critiques...

Disclaimer: Content created by the Diabetes Mine team. For more details click here.


This content is created for Diabetes Mine, a consumer health blog focused on the diabetes community. The content is not medically reviewed and doesn't adhere to Healthline's editorial guidelines. For more information about Healthline's partnership with Diabetes Mine, please click here.