Frustration with CIQ and inaccuracies in CGM

Now that I know what to expect from sensors, I try to schedule changes to minimize changes when on a trip. I also NEVER trust a new sensor or infusion site. My go bag has MDI supplies, and a special CGM sensor tool*. (On my first new pump user “vacation trip” I took a backup loaner pump.)

With the G6 it is possible to extend the life of a sensor by carefully removing the transmitter*, waiting for a half hour and treating it as if it were a new install. It’s also possible to “soak” a new sensor by installing it for 12-24 hours before stopping the old sensor.

There are patterns in T1D, it’s just hard sometimes to discern them, harder to apply them. If you expect to get great results 24x7 you will be disappointed. I have had days where my TIR was worse than 85%, ran as high as 250 and as low as 68. I;ve also had weeks of 100% TIR.

What you do is to look for average responses within cycles. Lunar months, biologic cycles, weeks, days. Forget “low and flat” as a standard. It applies perfectly - to dead people.

If your activity will change radically for more than a day, stress is as much an issue to maintaining BG control as anything else. Instead of becoming stressed out during a vacation, lower your expectations, be prepared to take a CGM/pump vacation and always to handle lows.

So frustrating and so true

I’ve been using the Tandem X2 with BIQ for several years now. For me, the CIQ target (110 bg) is too high, and I don’t like waiting until the bg reaches 180 for the CIQ to react. One thing I have learned over my 40 years with T1D, is that my body has different insulin needs throughout the day. My settings have abut 9 different “time zones”: specific basal rates, carb: insulin ratios and correction factors. It took some time to dial it in, but I basically stay within my chosen range (60-120). Yeah, I do get rogue numbers, but don’t we all.

I’d start off with a basal test. I can recommend 3 books to help with that: Sugar Surfing by Steven Ponder, Think Like a Pancreas by Gary Scheider, and Pumping Insulin by John Walsh. These books will walk you through setting approriate settings.


Since you’re so insulin sensitive you might want to try diluting your Humalog so you can realistically do occasional corrections. Ask your Dr. for the dilutant. Eli Lily will send it directly to you and I believe it’s free. It’s normally used on small children but is helpful for those who still have some endogenous insulin production.

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Thanks for the tip! I think I’ve heard of that, but have never really considered it, so thank you.

According to my c-peptide test I’m not producing any (or hardly any) insulin. I think it’s a problem of matching carb curves to insulin curves–often I think I didn’t take enough insulin, when it’s really the carb curve just got a bit ahead of the insulin curve, for a time. But it’s also true that even when I do need a correction post-meal, it’s much less than what I need for any morning highs (before I have any Humalog on board). Anyway, just putting the info out there–sharing experiences may help others (as others sharing has helped me!).

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Can you turn off the CIQ and hyper monitor CGM accuracy for a month in order to get things back on track?

I can’t think of an easier way out or another way to make you feel better.

If your meal combines carbs AND proteins/fats, it may slow down the carb digestion to match insulin curve.

Eating just carbs may work if you wait 15-20 minutes after insulin bolus, depending on which insulin.

I recommend getting a book on life with an insulin pump. Then you can learn how to manage all the settings on your own. They will have you periodically skip a meal and if your settings are correct, you will stay in range.

Agree — as long as you do everything else the same (no exercising that could send you low — or, in some instances, high) or stressful event which usually drives me high, or illness, or previous meal was especially high in protein and/or fat which may increase your sugar hours later!!

Or just the occasional random inexplicable wackiness of diabetes