I think you missed the points I was trying to make. Control IQ is a tool. It’s reliable and not very complicated. When you have a chronic illness it’s not a matter of what a doctor expects from you it’s a matter of what you expect from yourself and what you are able to do.
You can’t find meaningful patterns in any complex system that is totally uncontrolled. Systems we build are created starting with very simple systems and carefully adding on to them. Unfamiliar complex systems are analyzed by controlling as many variables as possible and observing how a few control variables result in changes. This are the bases of engineering and, its child, science. ( If you believe the relationship is the opposite you haven’t studied history.)
Although it seems very complicated managing blood glucose effectively requires only two things; Understanding a person’s rate of metabolism and controlling their actions. Any person who does not control his actions in a way where they stay within their ability to keep themself safe, whether or not they have a chronic illness, is a person who will get in trouble.
A rational person with type 1 diabetes will recognize that they have a life-threatening condition and will make a commitment to keeping themselves safe by learning as much as they can about how their body responds to food, insulin, activity, stress and illness.
What this requires is periodically denying their impulses and living on a controlled regimen and keeping sufficiently detailed records so that they can assess how their body may have changed.
The latter used to be very difficult before CGMs. Today it can be done simply and automatically IF an insulin pump is not complicating things by working in automatic mode at the time.
imo In general Control IQ should not be enabled until it can be configured to match the individual’s metabolism. I believe that this is being done because those setting up the system mistakenly believe that it’s an artificial pancreas. It’s not marketed as such because it is not. No company would give their product an overly complicated name like hybrid closed loop insulin pump if they could call it an artificial pancreas.
Instead it’s a tool that can do what a person who understands what he’s doing would do, 280 times a day instead of four or eight. That can make it possible to get much finer control of BG at any time of the day. It’s not a comprehensive solution and it’s not a perfect solution. It’s better than trying to do that manually.
If a person knows enough about using insulin to make intelligent decisions about using sliding scale then Control IQ can make this job simpler. If they don’t then Control IQ is going to make things harder to understand.
The better you understand what ideally should be done, the more accurately you can provide information to CIQ, the better the job that you can do with it ,and the easier the job of managing BG becomes.
So starting with Control IQ is the most difficult part of using it, but objectively it is not difficult. What it requires is realistic expectations and a systematic study of how your body responds to food and insulin which can be done by anyone. All it requires is eliminating variables.
The book Think like a Pancreas describes the very simple process of systematically monitoring how your body behaves, one meal period at a time. If followed for a week for one meal you can determine your basal rate for that period. If done for all three meal periods and sleep, you will learn your 24 hour basal profile.
The nightime pattern observed during the dinner study from a week’s sleep data will also show if and when dawn phenomenon starts. (Good sleep and good fasting BG makes everything easier, so I advise that dinner response be studied first.)
After basal profile for the entire day has been determined over the course of a month, if you’re willing to eat the same thing every day for one meal for a week you can accurately determine your insulin to carb ratio for that meal. With those two factors determined a person who is committed to achieving control should be able to get fairly good control of their blood glucose using Control IQ for that meal and period.
This sounds more complicated than it actually is. Mostly it’s just boring. Breaking that boredom by studying one meal at a time provides a series of rewarding improvements instead of continual frustration. Reinforcing knowledge and behavior through rewards is the basis of successful education.
so we tweaked my basal instead.
