New Control-IQ is this normal?

Hi All,

As of 2:00pm today, I am up and running on the control IQ pump…hmmmm, already thinking there is a problem, i did a meal bolus 26 carbs for a LATE lunch - have been hanging high all afternoon, seen two auto corrections and still high - started thinking maybe i’m not getting the insulin? then about 15 minutes ago had to eat something…plugged in 5 carbs and gave a calculation at that time said i was 198 bg, then 10 minutes later it suddenly says 138 down arrow, (don’t think so) a manual test said i was 175 more like it…now i’m completely into no reading zone? is this a situation thats “when in doubt change it out”? already?? first 5 hours of the voyage?

Any recommendations at this point would help, i’m totally brained fried from 3.5 hours education then online mobile support call plus worrying if this is working correctly. thanks. Mary

Hi @Disco2. I started on CIQ a few weeks ago. Before starting I did a basal rate check and thought I could decrease a smidge but they said to keep things as they were, so I did. I ended up getting multiple corrections for lows - my thought was that CIQ could not adjust fat enough to correct my drops. That’s the opposite of what you’re describing but if basals are too low the system may not be able to compensate for the highs efficiently either.
All of which is to say - my doctor finally suggested I talk with my Tandem rep, and we’re working together to tweak my basal rates, sensitivity factor and duration - and are making some progress. Some of those things must be programmed manually - I don’t recall if they all carry over from your basic pump settings.
I have done a manual bolus - which I let the pump calculate - to bring down a high, but I’m finding the system does that on its own of I’m patient (in my case) - but of course we don’t want to stay up there for long so it can be hard to resist. It’s particularly frustrating when I press the Bolus button and get a message that my IOB may cause me to go low later?!?!?), which is why my rep adjusted some of the other settings.
Sorry to overload you but I wanted to share my story. I had 3 or 4 settings during the day and now we’re working with just one and things are coming together. So:
Doublecheck that your previous settings were keyed correctly.
Call your Tandem rep if you feel you need more training - I’ve seen a number of posts on the forum where even experienced pumpers and CGM users didn’t find the online training sufficient.
If you feel you can wait, ask them also if they think there’s a problem with the actual sensor, or
If you don’t feel safe waiting, call Tandem’s 24/7 tech support (again😫) and tell them you might have a faulty sensor that needs to be replaced. I’d call before changing it out. On a side note, on the rate occasions I’ve had issues with a sensor it’s because I “but a bleeder”. I covered it with a patch so I didn’t realize it until I went to remove it.
So sorry for your initial frustrations. Keep us posted.

Sharing helps thanks. i decided to phone tandem first, possibly a faulty insertion on the soft 90 whatever its called…my dexcom g6 sensor gets changed out tomorrow at 3:00pm, haven’t had a sensor error yet these 10 days so i’m thinking its the pump and where i placed the thing…i’ve already reached out to my rep so i’m glad you said he can help or the educator definitely…for now just trying to figure out how to proceed before I fall over exhausted. 3.5 hours education - plus ongoing adjustment and learning i’m fried.

@Disco2, Mary, the very wise Dorie has shared all I would share about CIQ. It is not perfect. Wait and watch are my operative words. I have been on CIQ since January 2020 managed to get it back on in hospital after open heart surgery with less than a week’s experience before surgery.


  1. Don’t expect everything.
  2. Accept CIQ but verify. If you do a finger stick, don’t calibrate unless you get two wonky sticks an hour apart unless Tandem or Dexcom tech support says to enter it.
  3. Download the mobile version of t:Connect. You can see what is going on for the past 24 hours on your enabled phone in 5 minute slices for the past 24 hours. This is helpful in teasing things out for understanding.

You have brain drain. In regard to your 3.5 hours of education, “the mind can only absorb what the tail can endure” was a classic of a retired teacher I know.

Please share what you figure out. Your sharing is how we all learn.

I want to add, I really appreciate having the TCONNECT app on my phone - my Tandem rep recommended it when I reached out to them. I didn’t expect to like it as much s I do, and expected to use it only now and then, but I find myself looking at it frequently. The graphs are much easier to read on the larger screen. This is not the same as using your phone as the Dexcom receiver, and the instructing do say not to use it to make treatment decisions so keep that in mind. But it’s great to have a “living screenshot” and you no longer have to plug in your pump to do periodic uploads.

@Disco2 Sad to say, Mary, what you are experiencing with Control IQ is NOT the ‘new normal’; or at least this should not be considered normal. Assuming that you had accurate basal rates, accurate Correction Factors set in your pump profile, what you experienced is abnormal.

without knowing all that id happening, my thought is to suspect your eight-day old G6 sensor; even if you have not received any “sensor error” message - or skipped readings. After experiencing an extremely positive six-months using CIQ, over the last month I experienced, and logged, frightening performance from a couple of G6 sensors in their final three-days of use. You could replace your sensor now, a couple of days early, and make a report to Tandem - tell the representative what you experienced. Keep notes.

Tandem listens, and wants to know what you are experiencing. Just a week ago I completed one of the periodic quality assurance surveys that Tandem sends to users; based on a couple of comments I placed on the survey, within two days I had a phone call from “Tandem Cares”; after a detailed conversation, “Cares” asked to connect me with Tandem Technology. I gave Technology permission to log on to my pump, and after data reviews, it arent that multi sensors mal-reported - the “problem” is being addressed. BTW - on Sunday, replacement sensors were delivered to my door.

Dorie, with all your experience adjusting insulin dosing, I’m surprised that you let an out-sider [I don’t care how many letters the person places after her/his name] over-rule your apparently correct decision to reduce basal rates - even by more than a “smidge”. That was mentioned to me yesterday during a tele-med endocrinology appointment, when she said I know best when adjustments are needed. My thought, because CIQ has “more room” to INcrease basal flow, than to DEcrease basal, when in doubt, I user a lower basal rate.

Another thought on manually correcting via Bolus Adjustment. [Almost] Never do a manual bolus if a meal bolus, or a CIQ bolus have been initiated within three hours. The exception is, if you realize that you seriously under-counted meal carbs, and as long as CIQ hasn’t given the correction.

When doing a manual correction, DO NOT use the pump “estimate” without careful consideration. Look at IOB, do quick arithmetic in your head and know to what point the “Est Bolus” will drop you in two hours; the “Est Bolus”, should usually be reduced by 40%.

Thanks @Dennis. Despite my experience I do appreciate input to consider. My reps recommendations have been working pretty well, and I have one setting going all day! Given the new features - which can be a bit complex - I personally found it helpful to get guidance from someone really familiar with the workings. I look at it like borrowing someone else’s car - I know how to drive and am comfortable with my own, but if someone lens me theirs is good to know about any quirks. Actually I’m glad I did it - I had 4(?) rates over the course of the day and while I would make individual adjustments as needed - that worked okay - it never occurred to me to stay over with one and modify from there.
Anyway, just another perspective. You’ve done so much personal analysis and study participation you’ve got me best in the analysis department!

ALL - good replies thanks so much, sincerely. I finally got some intuitive reasoning that the reading was calibrating but taking its time to even out. Late, at that point, I said i know myself well enough by now to wake up if need, i’m passing out and let it do its thing. I had an hour conversation with my educator this morning - things were good enough waking up and I switched out the sensor at 3:00 pm today. NO problems so far, even took a shower haha disconnecting myself.

I gather a few things happened - first of all my pump was NOT properly paired to the iPhone - it said it was but i’d try to get on T:connect mobile and it kept wanting me to go through a-z again signing up and that wasn’t right. i guess it was working but not on my doctors range that we input…does that sound right? possibly it was working on a default range setting which is why BG hung high for as long as it did. Last night, before writing to the group, I got the pump paired properly with tandem support and t:connect mobile going properly then all hell broke loose and I got the wonky readings then it tanked then later came back online again at the point as I mentioned above it seemed to be trying to level out…since this morning I have not had a problem - this new sensor is still warming up and I should be getting a new transmitter in a week or so.

Its hard to know with two devises moving - which one do I do what with? since i’ve been using my phone app for dexcom i used that app to switch out the sensor taking a photo of the code. i’m accepting this is another learning curve in all respects…how to eat how to exercise how to shower how to reload how to do everything…

I really appreciate this site for being able to troubleshoot and get some feedback from you guys who have been dealing with this much longer than I have. I had this image of my late maternal Aunt who was a juvenile diabetic and died in the early 60s not long after I was born, I didn’t know her, but to think of her challenges then without any technology or possibly a finger BGM the size of a type writer? I don’t know my heart breaks for all of us, but then I get on with it, and I actually cried on the way home yesterday thinking i was relieved and grateful to have this tech tool I call my Bionic P…happy pumping.

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Your comment about the settings makes sense when it comes to the highs you had. I’m glad you got that worked out - having those correct background settings is key. Keep learning and asking questions - it’s s process. I’m finding that with the adjustments I’ve made, I’m not getting my insulin so much - just my face (I was having to snack frequently due to lows - that’s pretty much over now🎉).
If you’re still concerned about whether you’re paired well with your phone and getting what you need, you could always go back to using your pump as the receiver instead of the Dexcom app, until you’ve gained confidence. Check the manual to see if there’s something you need to do (calibrate?) if you switch in the middle of a session - something is tickling my mind but I can’t think what it is. I use my pump as my receiver so can’t guide you on the Dexcom phone details.
Keep up the good work!

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Thanks Dorie, i read in the manual if IQ is not able to work then the default setting of every 3 hour insulin delivery will do its thing which makes sense why it didn’t auto correct me at such a high BG and hung there for only a small delivery over a longer period. I’ll check into the other stuff - good advise. thanks for your feedback. m

When I started Control IQ it took a couple months to get my settings to work. The hardest thing for me was correcting lows. Without C IQ and a BG of 50, I would need about 10 grams of carbs to get back to normal. But, since C IQ turns off the basal insulin delivery, there was less circulating insulin than without C IQ, so my sugars would end up at 150 instead of 100. The same sort of thing happens to correcting highs. If I have a BG of 180, the basal rate is turned up. If I try to correct that reading with a manual bolus, the pump knows I have, say, .5 units of IOB which it has already dispensed through a raised basal rate. So it calculates I need another .3 units to get back to 100. But after I take the .3 units dose, the basal rate remains high for another hour or more, and I end up with a low BG. So you either do it manually, or you let the pump do it, not both.

We found I changing my sensitivity factor and insulin duration helped tremendously. You might try tweaking one or both.

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Yes I was thinking about duration but I’ll be meeting with my team in October so for now taking notes. M

You got that correct. Especially entering a manual bolus, without doing “research”, while CIQ is active can create unwanted results. As for guessing how many carbs to eat to bring BGL up to a desired level, a glance back at trends, and basal automatic CIQ adjustments may help.

In effect, what you wrote IS the “New Normal”. When using CIQ it is necessary to modify how we make adjustments when our BGL is not where we think it is.

On Control IQ you get no choice about the insulin duration. I have always had it set for 2 or 2.5 hours. But C IQ chooses 5 hours for everyone.

As to insulin sensitivity, that has always been a high number for me. I once tried 110 instead of 100, but that did not help. Time and time again, when I am not stressed, a unit of insulin ends up, after 4-5 hours, reducing my blood sugar by 100. Today right after lunch, my BG was 157, and there was insulin on board, but I gave myself a bolus of .3 units. It then rose to 183 10 minutes later, so I gave another .5 units (a total of .8 to bring a BG from 183 to 103). Five minutes later it was 203, so I gave another .5 units. All this with insulin still on board from lunch. Now my BG is down to 114, where it should be. If I had not been stressed, the original .8 units would have been overkill.

Wow before the pump on InPen which records IOB I’d correct with .05u at 173 arrow at 2:00 o’clock position and usually get a change to begin lowering in 10 minutes. My doctor has my high range set for 200? I’m scratching my head and thinking why because it will rise to the setting. Even on MDI I was able to avoid in most cases a 200 bg level. I’m fighting off the urge to manual correct so she can see a trend on her setting start point for me being new on the pump. It’s funny how I’m resisting all the ways I’m already figuring out how to trick or override some settings. But I don’t want to fall in that habit for wanting the devise to “do it’s thing”. At 200 I get the message high check your infusion set which make me want to say your IG is dropping it’s just a glucose high it is what it is…any suggestions for a newbie thinking I’m smarter than IQs control?

Those who are adept at using their pump and managing their diabetes often make our own adjustments when the need arises. If you shared how long you’ve been pumping I don’t recall. I’m wondering why your doctor set your high there - they may have wanted to give you a cushion until you see how your respond - to make sure it doesn’t over correct for highs - just to be safe.
I think CIQ is new to doctors as well as patients so they want to err on the safe side, then lower the number after seeing how the system works. If that’s the case and you’re new to pumping I might try it for a little while, using CIQ and no manual adjustments to see what happens.

Dorie I figured as much - err on safe side. I’ve only had the pump since Monday lol…but driving me crazy to have a high set for 200, I’ll check in with her next week just to drop that bit of info and explain how I’m dealing with it (treadmill for 15 minutes then starting exercise mode for another 15 minutes) will avoid going over 203ish…

Keep in mind that exercise - like adding insulin to what CIQ has determined you need - will not show what CIQ is doing on its own. First let me say I truly appreciate your wanting to stay below 200 - especially since it’s what you were doing before. But CIQ needs to learn your body’s responses.
Let me share a story: many (many many) years ago I changed doctors. I had been pumping for a while but this doctor was younger and more in tune with technology than my previous endo (no offense to him), and he was off the opinion that I could cut my insulin needs a bit with a few changes: some tweaks to my basal rate, exercising and more, and losing weight. I forget which one he recommended I start with, but I said I would start exercising more, right away. He suggested I hold off and see how the first change worked - if I did two things at once it would be hard to determine which one made the difference.
I’m not a doctor and certainly don’t want to tell you what to do in terms of caring for yourself. But I would recommend seeing what it does on its own first, then incorporating changes gradually. I was having lows followed by highs from my (cough cough) overly enthusiastic corrections. My lows have nearly disappeared (the ones I get are probably due to bad carb counts) and I’m in range about 80% now and working on higher. Since you’re new to pumping by so means discuss with your doctor. Your Tandem rep may guide you as well as they know the system inside out. Eventually and with experience you’ll be making changes on your own.