T:slim control IQ

Hi All.

I’m finally making the jump to a pump! Having never used one - in my own research and my doctors recommendation for achieving goals - i’ve chosen the new t:slim control IQ. I’m waiting for approval from insurance.

I realize the variable data input is most important and i’ve worked hard to figure out what my ratios are and times for meals plus foods both fats/carbs and cycles that take me on these visible and different trends in highs and lows - exhausting tracking all these moving parts right?

OK - my question is, for anyone currently on this control IQ pump - is, about every three months, I go through some weird hormone cycle that totally throws my BG high and act totally stubborn in coming down. On this pump what if any experiences has anyone had in how this pump handles stubborn (to budge downward) high BG numbers?

hope all are safe and well.

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Hi Mary @Disco2, welcome to the Tandem pump with CIQ. I’VE been using using CIQ since January and find it extremely helpful, keeping me in range, above 90% of the time for six months straight.

You are right on with having your basal rates accurate, and your carb ratios perfect for all times of day. Another important requirement is to have accurate insulin sensitivity factors, ISF, for various periods of the day…

I too have periods of hormonal swings, but mine require me to rrquire much less insulin . For these days, usually lasting 7 to 10 days, i have a separate Profile set in my pump. Actually, I have several Profiles set to accommodate my varied activities.

Enjoy the pump.

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@Disco2. Mary, you are on the best possible path. Having your numbers is going to make CIQ wonderful. I have been on CIQ since January 2020. Unlike, @Dennis, my biggest problems are the times I eat too much.

CIQ will auto administer fractional correction boluses when the CGM reports high BG. You may also respond to elevated sugars with your own correction boluses.

After you get started, you may notice the need to make corrections to settings like your basal rate during specific times of the day. I would share initially to work with the doc who prescribed the pump, to adjust the rates. You may expect to see significant changes in your CGM display with basal changes of 0.05 or 0.1 units per hour. Little changes sometimes show more change than expected.

Please share how you fair with CIQ. Your sharing is an opportunity for all of us to learn.

Mary @Disco2, I agree with the added bits J @987jaj supplied, but I will add a word of caution to manually forcing in a correction bolus. Before making any manual adjustments ALWAYS look at your pump “history”. I learned the hard way by manually adding a 1/2 unit correction when my BGL was very high without looking at history - CIQ had already put in a correction of an almost equal amount of insulin.

The “correction bolus” administered by CIQ is 60% of the calculated difference between BGL & Target divided by ISF [insulin sensitivity factor].

“History” is found very easily on the t-Slim: Options —>> [one arrow down] —>> History. There are separate Bolus and Basal histories, plus Complete History for each day. Also a few other helpful histories for reference. If you haven’t done so already, I recommend that you down the simulator app [android or apple] to a phone or tablet and practice making entries.

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@Dennis, you are CORRECT. Layering insulin is a real no-no. However, what I was trying to share was the insertion of a full correction instead of the CIQ bolus.

Keep me straight, thanks.

I’m very excited thanks Dennis!

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That’s a great tip…I’ll do that and now just in the process que probably hear from the medical supply rep next week.

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Maybe I can’t understand the answers but I have a similar question as Mary’s. Does the pump give incrementally high boluses for higher BS readings. For instance, If i want to be at 100 and I’m 175, I would give x amount of insulin. BUT, if I’m at 250, I required not just 2x, more like 2.5-3x to get back toward 100. So, does CIQ automatically adjust the basal and bolus to achieve that without moving to a different profile? and if so, is it within a time range you expect.

Kevin @987jaj, what CIQ will do, when in standard mode, is to bring you to 120 mg/dl. The formula is:

BGL minus 120, the difference divided by your ISF for that time of day, and that dividend multiplied by 60%.

60% to help prevent a hypo.

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Thank you for that…it doesn’t sound like an aggressive response if you’re having a bad time of it for some reason.

To amend what I wrote, @Grumpy, the CIQ will NOT deliver a bolus if you are only as high as 175. The threshold for CIQ bolus is 180 mg/dl.

Exercise Mode target is 140, and Sleep Mode target is 110. CIQ will NOT initiate a bolus in Sleep Mode, all corrections are achieved by basal adjustment.

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@moderators I apologize for putting this here since it’s off topic but - I started to type a comment then changed my mind. I tried to delete as I was typing but the comment delete button doesn’t work unless you’ve saved - then the system says “Post withdrawn by author…”
It may be possible to delete without saving using my computer but I’m usually using my phone. I’m wondering if I’m missing something? Thanks.

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Dorie @wadawabbit, the only way I’ve found, and this works both on my PC and my phone, to abandon a comment I’ve begun writing and not post, is to use my “backspace” and remove all comment in the “Reply Box”.
I then can use the “Cancel” button on the PC, but on my phone I’ve just closed that “window” and then reopened. Everything gone!!!

Kevin, it may NOT appear to be aggressive, but it works - and works well for my body, at least. I strongly believe that this approach was included by the University of Virginia team [the developers of what Tandem calls its CIQ] was so that FDA would approve. As you must have seen from the many postings on this site, is that many users have been trained to over-dose with insulin to blast themselves from going too high.

If the first bolus calculated and delivered by CIQ does not bring my BGL to an acceptable, CIQ will calculate and deliver repeat bolus does at two hour intervals. What I didn’t mention in my first posting with the CIQ Bolus Formula, is that the initial CIQ bolus might be reduced by IOB, making the approach even less agressive.

Thanks @Dennis. Sometimes I come back even days later and my draft is still there. No biggie. Thanks again.

To quote you, “ As you must have seen from the many postings on this site, is that many users have been trained to over-dose with insulin to blast themselves from going too high.”

GEEZE IM SO GLAD IM NOT THE ONLY ONE THAT DOES THIS…my diabetes RN educator said, oh that’s what we call “rage dosing”. I’d call it something else but not appropriate for this site…

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I’m glad it works for you and thanks for replying.

Congratulations, Mary! I really like Control IQ. I have found that the Tconnect reports (Tandem reports) and Tidepool reports, help me understand what is happening so that I can make adjustments. You might try this when setting up your second profile for the hormone cycle. I use Tconnect Logbooks to view the details about my basal settings and what Control IQ actually delivered and the Tidepool Daily report graphs to scroll through the days to analyze why my blood sugar increased and decreased. They both show when and how Control IQ is making adjustments but in different ways. The basal optimization Tidepool webinar on May 28th taught me how to better analyze the data. The July 30th webinar was also helpful. You can watch them here: Tidepool. Enjoy your new pump!