30 hours with Tandem Control IQ

I have to admit that I am skeptical when it comes to automatic systems of any type. I suppose I am a bit of a control freak when it comes to technology. Yesterday I received training on the T:Slim X2. The person from Tandem was outstanding. I had been wearing the pump since I received it, with it paired to Dexcom without insulin. I wanted to see how it was wearing the pump. I even made a mockup of an infusion set and tubing.

I had set up a profile, just for fun. She was amazed at how close my numbers were to the endos. I said, that just what I’ve been doing with Lantus and Humalog pens.

We set 2 sleep profiles and of course when through a lot of stuff like the various infusing sets. The ones I was sent are 9mm straight soft. I told her that I used an 8mm needle and was concerned that I might be hitting muscle as it is not possible to pinch the skin before inserting. She had some 6mm and we used one of those.

Also she gave me some TruSteel. I think if those aren’t uncomfortable that the way I will go. She said they are less likely to get occlusions. Plus much simpler. She doesn’t care for the tubing unwinding.

I mentioned that some use sleep mode all the time. She smiled, saying, “We call them sleepwalkers.”

Today I did a 32 mile bicycle ride in the cold and wind. She told me to start exercise mode 30 minutes before start. I did. My BG was rock steady 100 to 105 for 20 miles, and then dropped in the 90s
When it hit 89, I ate a 9g carb nut bar and finished the ride at 96.

Last night was flat throughout the night. I had a slight rise of FOTF as I fasted for the thyroid med. I appreciated getting the option to do a correction when I bolused for breakfast.

I realize, that I don’t have enough experience to really make a judgement, but I am impressed at this early stage.

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Great to hear you had a successful start.

Mine was a bit rocky 2 years ago, done remotely due to covid. I also had pumped with Medtronic for over 25 years, and missed the equivalent of quick sets were not available, and filling cartridge much easier on Minimed. But used to Tandem now, and CIQ, so wouldn’t go back to Medtronic without dexcom cgm integration.

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Looks like you did great on your start. It took me a good 3 months to get my settings right.

When I first started pumping they had me fill it with saline and pump that to see how it felt.

The day before I switched to pumping insulin, I had to go off my long acting insulin, but going on multiple injections of regular to be sure I had no long acting in me before I started pumping.

I don’t imagine they bother with that anymore. I have gone off my pump and back on again many times. I just set my basal a bit lower for a day.

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Yeah, that’s still a thing. It worked out OK, I have been splitting the Lantus into 3 doses. I just did it in two, with the last one at 10:30AM. My appointment was at 11:45AM so it should’ve been out of my system by then. It was around 1:00PM before the pump was delivering insulin.

@Timothy & @Luis3

Luis, you are on target, if i am reading correctly. If you are on a long acting, most endos will allow the trainer to start the pump because as the CIQ sees the CGM data, CIQ will throttle back the basal and it will continue with the long until the long fades and then CIQ will jump in.

Thoughts?

That may be so, but the trainer wanted me to stop the long insulin 24 hours before our session. It caused not problems for me, as the Lantus was still working just before our appointment.

I need more data, at least a week, probably a month to understand, but it seems like my TDD is quite reduced from MDI. The ratio is close, with MDI it was 78%:22% Basal:Bolus. Now it is 72%: 28%, but the TDD is less.

I can’t help it, both my parents were data analysts and I guess some of that rubbed off on me. It’s how I made my living for 44 years.Being retired or diabetic doesn’t change who you are.

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Congrats on your successful pump start, @Luis3. Your early success bodes well for continuing on that path. Pumps take a certain amount of fuss but they deliver a convenience and memory that MDI can not.

Automated insulin dosing is the wave of the future. It may not be for everyone but for those it does work, the benefit and potential are tremendous. Their value of taking you safely and dependably through the night are reason enough to justify using. When you start the day in-range with low glucose variability it sets the stage for a better BG day.

Keep up your attentive and mindful adoption of this new routine. You will be rewarded!

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Yes just to add on, as your sugars stay lower you will need less insulin. My daily dose dropped a bit when I started my tandem but since I gained a little weight on it , I’m back to the same TDD that I have been historically.
I plan to lose a little weight then next few months.
I use my total daily dose to know when I should stop eating. I essentially use 25 units basal so I don’t want to bolus more than 25 , usually it’s 18 but then I’ll do a few corrections.

Are you also taking any type 2 meds now that you are on a pump?

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I am on 500mg Metformin twice a day. That dropped from 1000mg twice a day when I started MDI a year ago. The odd thing is that I lost 8 to 10 pounds after I started MDI.

luis3 you are such an encouragement to me as I look at beginning with T:Slim X2 when I move to Medicare later this year! I met remotely with the local Virginia rep who walked me through the setup to introduce me. Sounds like all agree that Tandem is the way to go over Medtronic.
I previously used Lantus and Humalog MDI, but have been on the OmniPod for almost 2 years now but will not be able to afford the Part D expenses for OmniPod. Hopefully it will be a blessing to move to Tandem Control IQ!

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@RLS1 glad to be helpful. I’m on Medicare as well.

I think it’s an easy choice but only because the tslim works with dexcom. Medtronic has a newer sensor which I haven’t tried, but it still requires calibrating twice a day.

I actually loved my Medtronic pump, it was just the sensors that were horrible.

If Medtronic could be paired with dexcom, they would be a real contender in my opinion.

Now That tandem is coming out with a new even smaller pump it makes even more attractive to me.
I am happy with the tandem algorithm but I’ve never tried the Medtronic algorithm.

I will be getting the Tandem Mobi as soon as it comes out. I’m pretty certain about that unless Medtronic comes out with something spectacular.

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On the 13th day with the T:Slim, I am quite pleased. In another post I mentioned buying a couple of SpiBelts. I have nothing against them, but I wanted to wear them under my clothes and with the pump in the provided case w/clip. My main reason for the case is so I could attach a Garmin lanyard to prevent dropping the pump.

My problem with the SpiBelt is it would flip putting the display against my body. This seemed to cause more loss of signal problems from the Dexcom. I had a lightweight elastic military style belt that I used for a while. Then I found something on Amazon that works for me. This picture is over my shirt to prevent the picture being flashed out my my fish white belly. LOL.

These only expand to 39 plus a bit which works OK for me. They are very comfortable, staying in place and not restricting breathing.


The black loop is the stretchy Garmin lanyard.

I like to use that tiny pocket in my jeans for my tandem. It works really well. In most of my slacks I have a small pocket inside my regular pockets so my pump will sit higher and not drop all the way down.

I use my Apple Watch to see my sugar, so I don’t really need to look at my pump unless I’m bolusing.
I prefer to keep it out of the way so I don’t catch it on things.
I think having it under your shirt would make it difficult, because you will need to lift your shirt to see. It.

I very much dislike any kind of belt or strap for my pump.

Also I use the 23 inch tubing so that it won’t hit the ground if I drop it.

I think it would be fun to post pics of us holding our tech, pens or pumps etc. maybe I’ll start a thread. It would be nice to put faces to the posts. The tiny thumbnails are not useful

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That’s what I do as well. I was trying to come up with a way to secure the pump while wearing cycling kit. I really didn’t want to put the pump in one of the back jersey pockets. I too, use the 23 tubing. I would hate to have the pump jump out and crash into the chain rings.

I use both the Apple Watch and my Garmin bicycle computer to display BG, the latter while riding, of course.

So, I shouldn’t have decapitated myself on purpose?

Some of our women members put their pump in their bras. I don’t think they would post a pic.

Here’s a thread from a while back: