Opinion for anyone considering Tandem Control IQ Tech

8/22/20. I have changed my opinion re: usefulness of CIQ Tech for me. Obviously it is very good tech for others based on opinions shared & replies to this post. I have had CIQ Tech turned off for several days now. In the future I will attempt not to post opinions based on first impressions… What follows were my 1st thoughts after a week of use.

installed Control-IQ Tech on Monday, 8/3. I have been using the Tandem t:slim x2 for a year coupled with Dexcom G6. I previously used 3 diff insulin pumps over 15 years before the x2. I have also used Dexcom CGM’s for 6 yrs & currently the G6 CGM for a year.

An old friend thinks I was a skeptic from birth. I was not born in Missouri but do say, “show me.”

I’m very IMPRESSED with the vast improvement in bg control afforded me by use of IQ Tech. I am not experiencing the many wild swings in bg which were routine for me. I still have to be involved in managing bg but it is many times easier with IQ Tech. As the PA Dutch say, “It wonders me that I waited so long to install IQ.”

If you have been considering Control-IQ Tech consult with your diabetes care provider. It has given a real boost to my bg control.


Did you lose your Basal IQ technology with Control IQ?

Yeah Henry @Hen51, why did ja wait so long. CIQ is awesome technology, best diabetes assistant I’ve used in 64 years.

Actually it is so impressive, I’ve spoken with endocrinologist who will prescribe the CIQ only for patients who previously have demonstrated a sound understanding of effective diabetes management, and only for those who have studied the system.


Dennis, It sure does wonder me! I got too soon old und too late schmart.


@happyquilter, Sleep mode on CIQ is similar to BIQ.

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Reread your last reply. Yes it makes total sense that individual intending to use CIQ have “a sound understanding of effective diabetes management”. You helped me reflect on my own journey of training & experience in managing bg levels. I have taken both of those for granted. Your reply made me reflect on all I have learned re: bg control since advent of at-home bg testing, intro of humalin, glargine insulin & time being on pumps & CGM’S. I have had especially benefited from expert guidance since receiving diabetes care at PSU Hershey for the last 20 yrs.

Education & training is definitely a key for use of any new tech. In your opinion what is the state of the distribution of knowledgable medical caregivers & educators re: treatment of T1 in our country?

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@Hen51, if you use Facebook, check out the group, Tandem Diabetes Control-IQ User’s Group. There is a lot of CIQ experience available there. I used a “DIY artificial pancreas” system for over a year before moving to Tandem, and my A1C and time in range is even better with CIQ. Tandem is “THE” system for technology today.


Thanks. I will check out that group.

Henry @Hen51, I apologize for not getting back to you sooner with a response to your question.

Before I answer your direct question, I need to expand on necessary “Training & Education” as related to some of the wonderful new tools. The “EDUCATION” begins with the individual - most importantly to avoid beginning use of a new pump, CGM, etc., without knowing what the thing is intended to do, and what it is not expected to do. In other words, read, understand, and comprehend - at minimum, open the User Manual.

As far as “awareness” of medical providers throughout the Country, I cant answer. I know the Medical Awareness in the Boston area and the Southwest Florida areas, and that is all. In these two areas, I have observed a WIDE VARIANCE in diabetes knowledge. I’ve had a doctor “cure” me of my TypeOne and make me a Two Type just by looking at my date of birth; another “certified endocrinologist” when I was interviewing him as a possible provider responded to my query about experience helping manage persons with TypeOne, responded by saying, "diabetes is diabetes, all are done the same way.

Those two examples aside, in SW Florida, I have found, and regularly visit, some very knowledgable and helpful physicians. And that includes an anesthesiologist who when I said the day before surgery that I would keep my pump running during surgery requested that I help educate her, and staff, about diabetes management especially during surgery. Up to that point, the hospital printed pricedures stated that “ALL diabetes medication” had to be stopped the day before surgery; the hospital surgery rules have now been changed.


I can not wait for my warranty on my Medtronic 670G insulin pump and CGM sensor to be up. I hate the way it doesn’t control me and so many beeps and so much blood sugar testing, and still not correct. Just another 2 years and 3 months.

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Same here re: caregivers. While hospitalized for non-diab health issues & during stay in physical rehab home my experience the same. Nursing staff had not been educated on use of insulin pumps. I tried to give primer to those who were interested. Glad doctors were willing to allow me to manage with pump.

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@Hen51. I am glad I am not the only one with “hospital teaching” experience. I was able to ‘educate’ the nurses and cajoled the hospital’s CDE to help me get my CIQ on in the ICU after open heart surgery. G6 on first, then pump. Biggest issue was I could not flex my neck to see what I was doing. After convincing nurses, it was shooting fish in a barrel.

BTW, the G6 needs no calibration. That was a learning curve for most of the nurses caring for me. It was teach, teach, teach once I got it set up.

Just for grins & giggles, one of my docs wanted a Chemistry panel every morning. I would note the G6 when my blood was drawn. Every day, glucose by lab was 16mg/dL lower than the CGM reading during phlebotomy. Reason = the red cells keep eating the sugar while the blood is being carried to the lab. By my last day, my pump and CGM were entertainment for all the nurses. The hospital CDE checked by every other day. Things went great after strong education applied to all.


J @987jaj, I like the Chemistry and Science “course” you experienced hile in the hospital. Beyond that, I hope you are making a successful recovery and soon back to a place better than your previous normal.

I wish [only for validating my G6] that I could be in your position for having daily total plasma BG test results to compare with my real-time monitor readings. My question, when making your notes, did you include arrow-direction for reference? I know that now with the availability of BG data history on t-Connect, Tidepool, Clarity, you will be able to see if or when your CGM reading matched your lab-test result - did your CGM match your Lab before or after?

Continue with your recovery regimen, and continue posting; I learn from you.

Greetins @Dennis. Thank you for your kind words. Being I was under the influence of hospitalization & the associated drugs, I did not note the exact times of those slumber interrupting, blood sucking, vampires performing their exsanguinations. GRIN The only thing I am certain of is one of the night shift nurses making simultaneous rounds and I were discussing my CGM, the laboratory glucose measurement, and my freedom of hospital required diabetic patient protocol mandated finger sticks. The nurse and I started noting my G6 & lab glucose. The point was everyday, the lab came back 16 mg/dL lower than the CGM reading displayed at the time of the phlebotomy.

Since I don’t have the exact time and because it was before breakfast, conjecture is the CGM was level.

I have a few other things to share and will private message you later.


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Dennis, I have recently changed my mind about CIQ Tech. Currently not a fan & I have turned it off at times. I’m not ready to post my current change of opinion. I may be knocked down but the ref has only counted to two & I am trying to get up. I won’t post a new opinion & may never do that until I see how everything shakes out.

This AM I sent a text to my provider who prescribed Tandem t:slim x2 as well as CIQ Tech at PSU Med Center in Hershey. I know you often advise doing so. Also I’m not sure what adjustments may need to be made due to the eating regimen for gastroparesis. It has helped relieve some symptoms.

Anyway I think I need more than the required Tandem course on CIQ. I will read the manual through today. So far I have used it for troubleshooting. Just wanted to update you. Henry

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Henry, if CIQ isn’t working for you, you should discontinue using this tool.

You have most likely read some of my many posts saying diabetes management isn’t a one size fits all. There are many reasons why this may not be your tool.

Certainly discuss this with your provider. The endo with whom I work, has told me she refuses to write the CIQ prescription for some patients who have requested one.


Hey @Dennis. Confession time. I started on CIQ a month ago, after a few weeks on BIQ. WHILE BIQ wasn’t stopping the lows as well as I had hoped they were better, and I was hoping to see good results on the high end of the scale as well as the low one. Unfortunately that has not been the case so I reached out to my endo with the message below, yesterday. I have an online visit with her on 9/1 and we will discuss then - in the meantime I’ve contacted my pump rep as the DNE is away for a few days.
I would appreciate any thoughts you have about things I may have missed. I’m sure basal is a party of it, but what’s got me confused is how I go high after eating, only to see that In projected to go low later. I’m thinking IOB and/or custom factor. I know you’re not a physician but a person with tons of diabetes experience😊 - if there’s anything in missing that I should discuss with my rep/doctor/DNE I would welcome suggestions. I’ve been pumping for a couple of decades, on TSLIM for around half of that, and using Dexcom G4/5 for most of my time on TSLIM. I’ve been using Humalog and it’s worked fine until now, and I use an app to track my carbs. There are occasional “mystery meals” where all I can do is approximate the carbs, but I have issues even with “for sure” foods. Sorry to drone on but I know you’re a data guy.
My letter to my endo

I started on CIQ a few weeks ago. Things are okay but my range still is not where I want it to be. I did a basal rate test a few days prior, and I thought I could lower them/some of them a touch, but my doctor said to leave things as they were. On a side note, although I am a long-term diabetic and experienced pump user, I have tried some settings that didn’t work as I had hoped so my doctor told me to check them with her first. That’s just to explain why I left them and not the topic I’m writing in about, which is:

I’m finding my after meal readings can be in the low 200s - sometimes quite a bit higher but I may have eaten something questonable whose carb counts I could only guesstimate. I’ll press the bolus button - largely out of habit from the good old days - and I’ll see a message along the lines of “Due to insulin on board you may go low later…”

So here’s my dilemma:

  1. my basal still seems a little high - although I’m often in the low 100s or so there are times I get a warning that I’m projected to drop below 70. I prefer to be a bit over 100, and even with CIQ, at 80 I’m wary of driving, and let’s face it - you have to be able to function. At 80 and especially 70 I may not feel up to doing some of the things I need to do and I don’t have much of a cushion to work with. Sorry for rambling…
  2. I could increase my carb ratio, but again I would get that anticipated low alert.

Dori @wadawabbit, I can see two different “issues” that you want to talk about - 1) popping up to 200 after a meal, and 2) fear that your BGL will drop too low when/if CIQ makes a correction.

The #2, automatic corrections causing drop - plagued me a little. What is helping me there, I only made this change recently, and then bit-by-bit, was to change my Correction Factor [ISF]. currently, depending on time of day, my ISF range from 1 unit will drop me 65 mg/dl, to 1 unit will drop me 85 mg/dl. Avoid “hitting the bolus button” and giving yourself insulin without FIRST checking to see if and when CIQ might have provided a bolus. Insulin Stacking.

For seeing what CIQ is doing, I strongly recommend the t-connect app on your phone - I see you are now using a “smart” phone - I got one a couple of months ago. The App upon opening shows the most recent three hours, but by swiping from left-to-right, 24 hours come into view. Bolus are in three different colors depending why they were initiated; tap on any “bolus” and a screen opens giving details.

The #1 - going as high as 200 mg/dl.
There are several remedies here, but before doing something that will admit that diabetes controls you rather than your living your life and insist that diabetes fit in, ask yourself a few questions. Can I tolerate my BGL popping to 200 for a couple of minutes? If mine goes that high, it is OK as long as it doesn’t stay there. What I do to try keeping my BGL within a 50 mg/dl range all day long [at night, I am within 15 mg/dl]:

  • Try to pre-bolus. This should be a little easier these days when we are eating at home. For both breakfast and lunch, I know what I’m going to make for myself, and know the carb count exactly - except for the size of the apple. Just don’t make the mistake I’ve made a few times - take my insulin and then get involved in a project that pops-up, like writing a long reply to a new email.

  • Once your basal rates are set, go to work on your carb ratios. More on basal in next bullet. I have slowly increased my bolus ratios over time, once my basal was set, and wait at least two days between changes. Keep in mind, that your “history” plays a big part, what you have done [including basal] in the previous 2, 3, 4 hours.

  • Basal, Basal, Basal: For me, the basal rate I have used between 9:30 and lunch can affect my IOB at lunch time as much as my 4 mile morning walk. You have to study your body. To observe how CIQ is playing on your basal rates, I very strongly urge you to look closely at the Daily graph in t-Connect or in Tidepool. (In some ways, I find this study easier with Tidepool.) It is very easy to see on these graphs if CIQ makes a basal increase, a basal decrease, or a basal suspend - including the exact rate set.

Other stuff: I don’t ask any doctor if I can change pump settings; this is something that both you and I understand better than an “outside” person. Even a top-notch Endocrinologist I was seeing who was profess or of endocrinology at the university medical school and himself T1D would only make suggestions to stear me in the right direction, but never set limits on “how much” a change. When he prescribed my first pump, he told me to figure out basal rates and carb ratios; the only caution was to have my total daily insulin about 30% lower than the total I was injecting. Now when I visit with a very good endo, she first gives me her eagle eye, observing my whole being and listening to what has gone on with me for three months. After that, she will then review any lab tests look any of my data reports I think important to discuss, and last of all, ask for my pump settings [I have six profiles on my pump] so they can be added to her data base.

I hope Dori, that this may be helpful, and not too much so as to confuse you. The other bit I should add, is don’t be afraid to make mistakes - but be careful and be conservative and avoid any hypoglycemic event. It has taken me a while, but with my wife’s encouragement, I can now easily accept that effective diabetes management is fraught with errors - my wife [54 years and she hasn’t left me] will just say"tomorrow will be different".

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Thanks Dennis. Yes, I’ve corrected my basals on my own before and it generally goes alright - I do it in small measures and tweak as necessary - but a while back I miscalculated - nothing bad happened but my ratio of daily basal to bolus ended up way off. I thought about overriding that instruction this time but decided to go with the program and see if I proved myself right, which I believe is the case this time around.
I don’t mind going a little over 200 for a short time but I can get to the mid-200s and it seemed to me that if my settings were correct my rise shouldn’t be that drastic. It makes sense if I eat something questionable, but it’s happened with foods with known counts and measures. Sometimes I hit the books button to see if a warning will pop up although I may not actually take a bolus. That’s how I discovered I was projected to drop low later. I think it may be a combination of carb ratio and correction factor. Like I said, I’m usually comfortable making changes on my own but I’m going to take into consideration your wise advice and that of my rep since it may involve at least a couple of things. I did decrease my overnight basal a tad - I’ve been getting alerts that I’m projected to go to below 70 - that will start tonight, and I plan to test more basals this week. Do you have any advice on checking correction factor? Thanks!
Re using the smartphone app: although many of not most people love to see their data on their phone, I personally prefer to use my pump as my receiver and use my phone for “other stuff” - call me a purist, I plead guilty. Having said that, if I understand and recall correctly you have to decide whether to use your receiver or your smart phone (one or the other) to see you patterns. Since I would rather use my pump as my receiver, could I share my data with myself on my own smart phone? I think there may be a slight lag of a few minutes but I could live with that if it’s the case. I know it’s redundant but it sounds like I could see my graphs better when I needed to do dome quick analysis.

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Dorie @wadawabbit , really happy to hear that you are comfortable setting and tweaking your own pump settings. In my experience, it is the only practical path to follow. I’ve been doing my own dose adjustments since at least 1960; it became very practical when I began working as a field auditor, traveling, living in hotels, all meals in restaurants - and long-distance phone calls to speak with a doctor.

A way to estimate Correction Factor [ISF], is to give myself 1 unit [one unit] of insulin when I’m more or less inactive, haven’t eaten or taken a bolus for a few hours, my BG is at least 150 mg/dl, and then watch how my BGL drops during the next four or five hours. This process should be repeated at different times of day; the ISF I currently have in my pump Profiles range from 65 to 85.

Naturally, with CIQ, my pump has to be my principal Receiver for real-time glucose readings. If the Tandem pump is used as Receiver, the DexCom Receiver becomes inoperative. I use my new ‘smart’ phone as a secondary receiver for both my pump activity and my CGM. The phone automatically and continuously [a couple of seconds delay] uploads wirelessly all glucose readings and insulin dosing data to both Tandem t-Connect and to DexCom Clarity; no longer a need to plug into a computer. Every Sunday morning, DexCom sends me an email providing detailed graph of my previous week; I was surprised this morning with a 95% TIR despite having a faulty DexCom sensor on Friday - which was giving readings in the 50’s when my feelings and blood said otherwise. Yeah, after six to eight hours of crazy readings, I pulled the thing off and started a new sensor; I had a hard time finding the sensor wire because it was crunched up.

Has your doctor suggested that you maintain a certain ratio between basal and bolus insulin?