Any reason NOT to update to Control-iq?

Hi all,

So my daughter is 14 and since we’re in Canada and behind the times, we just received notification that we can upgrade my daughter’s t-slim X2 to use Control-Iq. We are currently using the Basal-Iq which has been great, but I know that once we update to Control-Iq we can’t go back.

So some things about my daughter - her A1C runs pretty high, around 8.2 (which actually is the pediatric national average in Canada) and she doesn’t have the best control, she forgets to bolus at least once a day. She is also active which makes her go low. So she is up and down like a yo-yo,

So I should be super excited to add this feature, but then I worry that since she can’t remember to bolus, will she remember to tell her pump she is active? And if she forgets and the pump corrects her too much, she could end up with some bad lows.

At least she feels her lows and maybe once or twice of forgetting she would manage to remember, but still.

Any thoughts?

As with all things pumps, you need to think long and hard on what you like and what you hate about her current system. Make a list and compare to the new system and see if it might be better.
Her forgetting to bolus is a tough one for any system but maybe with Control IQ, it could help by upping the basal. I do like that it does the increases, but for some (myself included) it is not as aggressive as I would like, but maybe for you it would be better than where she is at.
And if she is into sports, having the exercise mode might be helpful with the lows, but it requires you to remember to turn it off. There is not way to tell it to turn off in 2 hours.
Pumps are trying to decide what is a deal breaker for you.
I personally love the system! My overnights are perfect. I sleep through the night! And I think much less about my diabetes which is what I wanted most of all after 50 years! Less diabetes, not more is what I desperately wanted.
Good luck in your research! And keep asking questions.

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I recommend it 100% I do not even think about nighttime lows or highs anymore. It is a complete gamechanger.

I work out every day. Spin, weights, high intensity intervals, tennis, juggling swords(kidding) and I frequently forget to switch to exercise mode. Control IQ is my best friend!

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I am new to both Tandem and Control IQ. So far, I think it’s not perfect but it’s very good. I still need a few adjustments on my settings but I think I’m close and once I get there, I will love CIQ. Actually, just yesterday my husband was laughing at me because I couldn’t stop myself from repeatedly opening the dexcom clarity app to admire the 2 day 98% in range!

Of course, you need to be sure that the sensor is accurate. I just put a new one in today. When it came online after the warmup, it said 42, but my meter said 84. Obviously I don’t want ciq working off of that number so I turned it off for now in the hopes that I can get the sensor readings to be more accurate.

The only real reason NOT to upgrade is if you have specific goals outside Control-IQ’s parameters, or are otherwise contra-indicated. This mostly applies to those targeting really low and tight control, high 4s-low 5s. (A1c is wildly inaccurate, so these numbers are POSSIBLE on Control-IQ, but it’s not the goal range.)

High-risk OBGYNs that want pregnant women to maintain those really low, tight parameters often prefer Basal-IQ. Personally I think that’s crazy, though. I know Control-IQ is the best control of my 31 years, and couldn’t imagine doing better with Badal-IQ… But that’s me.

There are also restrictions to the software that make it inappropriate for anyone with exceptionally small or exceptionally high insulin needs.

From what you’ve mentioned, though, your daughter doesn’t seem to fall into any of the above categories. In fact, she’s the target audience Control-IQ was designed for. The “average” diabetic that can’t quite reach 70% TIR or a sub-7 A1c on their own, but still has a basic grasp of management techniques.

Control-IQ is BETTER at low prevention than Basal-IQ, because it will start reducing basal as soon as she’s predicted to go below 112 in the next 30 minutes, and suspend it completely if she’s predicted to go under 70… And it doesn’t resume insulin until she’s predicted to be back in range. Whereas Basal-IQ can only do hard stops, and resumes the moment her BG changes direction… Even if it was just a slight waiver in the data. On top of better hypo-management, it comes with the added benefit of taming the highs and catching her missed boluses (it’s not perfect at that, but it’s better than nothing). Why wouldn’t you want that?

I was diagnosed May of 1991. My blood sugars have never been very good throughout my teenage years and even into college, they were all over the place. My A1c s have ranged from 7 to above 11 back when I was a teenager. I was on a Medtronic pump from 2011 until November of last year. Having the pump helped me tremendously but not as much as having a Dexcom along with it. Since November of last year, I have been on the T slim X2 pump with control IQ. I have never had a better A1c then I had today. It was 6.5! For me, it’s fantastic. Control IQ is definitely the way to go.

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Thanks everyone, super appreciate all your replies. And reading them has actually made me super excited to move forward with this! This might be the game changer that finally helps her to get her numbers under control.

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I’m like a broken record on this, but the overnight control of ControlIQ is awesome. If that was the only benefit, I would still upgrade. I can probably count on one hand the number of times I have woke up very low or to a raging high BS since upgrading to ControlIQ.

Below is a good example fro last night. At 12:30am, I was moving high, basil was increased. 3:00 am trending low, basil reduced/cut. 4:00 am trending back to normal range. Me…:sleeping::sleeping::sleeping:.

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I know someone who was rather frustrated with control IQ because he said it doesn’t alert you before giving a bolus. So if you decide to go out for a brisk walk and didn’t check your screen to see that a bolus had been delivered, it’s very possible you could walk right into a low blood sugar without realizing it.

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Good point. One of the reasons I run in sleep mode all day. Exercise mode is the same way, it will bolus without notification.

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Your friend would be the first person I’ve ever heard ask for MORE alarms! I hope they’ve since learned to use the exercise function appropriately to avoid the lows.

You just turn off the CIQ? I have been wanting to switch over from Basal IQ to CIQ for a year now, but just scared of the unknown. I haven’t had a good night’s rest in forever. What settings need to be adjusted?? I turn my basal up and down constantly.

You can only have either basal or control iq. If you upgrade, you can’t go back to basal iq.
You could turn the entire logarithm off but that won’t bring back basal iq.
Some people prefer it. I’ve only ever used control iq. I like it, it works well most of the time.

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As Timothy said, you can turn off ciq but that does not bring back biq- you can only have one or the other on your pump. If you turn off ciq, the pump uses you programmed basals.

I loved BIQ for the great night control. But, frankly, CIQ does it even better. I like the nighttime control so much with its reduced range that I run 24/7 on Sleep Mode. My only problems are the post prandial spikes which are not addressed in Sleep Mode and are addressed too late in Regular CIQ mode anyway.

I agree. I hope they update it soon. I always correct high sugars before ciq gets around to it. But sleeping is super flat all the time.

And I’m in Canada too @Leelaa - and just managed to get my hands on a used t:slim a few weeks ago (the person who gave it to me, hated it, and has gone onto Omnipod). Am loving it compared to the other pumps I’ve used over the 12 years I’ve been a cyborg BUT because I’m self funded, I’m still on the G4 / G5 system with handouts from Americans / Canadian T1D’s on welfare who have great coverage. I’m hoping to try out the basal portion once I get the courage to change out the battery in the used G5 transmitters that folks give to me along with expired sensors (they still work well past their death date believe it or not). I’m telling you, the things some of us folks without help from private/work insurance or government programs can be daunting at first, but I’ve been doing my own “self help” since leaving the nest at 16 back in the 70’s. The Tandem though is night/day over all the pumps I’ve had the privilege to trial out.

Like you, I’m being told by other t:slim users to upgrade, but until I can afford the G6 I’m just sticking with the program that’s in it now.

Please note, I don’t recommend if you don’t have to, using other folks discards like I do, but when you have no other choice, that’s all we can do. The sad thing, here in Canada, the bill for Pharmacare coverage, which I’ve been involved in for some time to help others like myself with costs out of pocket to stay alive … got turned down this week. Sigh. Thank goodness I’m still able to work as I enter into my 60’s (but psst Leelaa - I’m still a kid at heart after 55 years as a T1D :wink: ).

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This is something I didn’t know, I always assumed you can turn either off independently. I wonder why they don’t allow turning off control iq and allowing basal iq to be on? Anyone know?

We don’t have control iq yet here but it’s coming.
What’s sleep mode? How is this different to normal mode?

Sleep mode gives tighter control that is targeted at 112 mg/d

However it will not give bolus corrections when you are high, so sleep mode is pretty close to how BIq works.

I run sleep mode all the time on days I don’t work.
When I’m working I can’t take my pump out of my pocket so I need to let ciq do the job. Otherwise I would probably run in sleep mode all the time.