Tandem t:slim X2 One Week In

First off, thank you to all those who answered mine and many others in here’s questions about this pump and Control IQ.

I switched from the Omnipod Classic. Love the Omnipod, but was just told a month ago that our insuarnce changed pharmacy benefits, and the new one won’t cover the Dash or 5. I’ve had my heart set on a loop system, but really didn’t want to delve into the DIY looping (I’m not in the apple ecosystem, and even though I am good with tech, just didn’t want to mess with everything). I just decided that I looping systems were just too good to not try, and my insurance assured me that if I wanted to go back, it’s as simple as ordering pods and not t:slim supplies on my next 90 day order.

My obvious concerns were the tube, and what to do with it and the pump when I am active and sleeping. I ended up purchasing some garments from revelwear.com, and they are amazing, but have found it’s just easier to put the dang thing in my pocket if I am dressed for work with a tuck in shirt, or clip it to my workout/lounge clothes. Crazy how the simplest solutions are usually the best.

The algorithm is really a game changer. I am a one-meal-a-day eater, so I have a huge fasting window. I have played around in the past with my basal rates, but could never consistently lock in something. Felt like I was either slowly rising, or slowly falling, no matter what I was doing. And I hate slowly rising, so I have been slowly falling, then on most days needing to eat a date to pump me up from mid 80s to the low 100s. Haven’t needed to do that all week. It’s awesome watching the algorithm work as it lessens the basal to “stick the landing” of my falls and bring them back up to target.

I have been playing with the settings. I do see the appeal of using sleep mode all the time, as it keeps it in a lower range. I may continue to use this throughout the day, as I am fasting all day until 5pm, so in theory sleep mode will work good because there shouldn’t be any sharp rises or falls, but I find I don’t like sleep mode as much when I actually am sleeping. This likely due to the fact that my one meals are huge 2500 to 3000 calories (I’m a 200 lbs male who is a former college athlete, now is a has been that just tries to continue doing athletic things but often just show how old I am getting). And those huge meals, which have lots of protein and fat, leave me vulnerable to unattended spikes middle of the night. I really wish I could use a 4 or 5 hour extended bolus, but CiQ only allows 2 hour. I may end up splitting my bolus into 2 2 hour extended, just have to set a reminder to give the second one. Anyway, I think I want the pump to have the ability to give me an autocorrection bolus in the middle of the night. I’ll keep playing with that in the future.

Also, like many that I have read, I’m not so excited about the Exercise Activity function. Yes I do like that it raises my target to 140, but if I do what it says, and that is to turn it on well in advance, and then in the beginning of my exercise, the pump senses my sugars rising, it will give an auto-correction bolus, which then, combined with my workout, will inevitably cause me to come crashing down. I may try to combine these methods, turning exercise mode on 30 minutes before workout, then right before workout switching it to sleep mode to keep it from auto-bolusing.

All in all, I’ve had an amazing experience. Not so humble brag alert, I have been 89% in range this past week! Please continue to post any advice or remarks based on my experience. Anyone looking to get into this pump, feel free to ask me any questions based on my initial experience. Thanks again for everyone here!



Keep in mind ciq will NOT do a bolus correction for highs in sleep mode.

I know, and i get it. Since i deal with big meals, i think I’m going to keep sleep mode off until i wake up in the morning. Since I am fasting until 5pm, sleep mode should work well during my fasting hours.

For exercise I do two things: first I put on exercise mode, and second, I have an alternate profile (which I call “weekend” with a much lower basal rate and with much higher correction factor. Any correction bolus automatically given is quite a bit less.
Seems to work better for me.

So funny you said this! Yesterday I literally created an “Exercise” profile. I was thinking about it as either/or, but you may be right, might be using the alternate profile AND Exercise mode. I’m definitely going to play with it.

Also, just in general, had a small frustration last night. I had a great day, did 2 extended boluses to cover my one big meal, and went to bed with a perfect blood sugar. Only issue is, the Dexcom had one of its “issues” where everything was steady but it had about 3 or 4 bad readings where it trended down hard (may have been laying on sensor). Of course this means control IQ shut off basal for about 15 minutes, but that was enough to take me from a nice flat 120 to 150 by 4am. Those random issues just something we have to deal with I guess when everything relies on those readings.

Argh nighttime compression lows! I only use the backs of my arms (over triceps) for Dexcom which seems to have stopped the artificial compression lows. I don’t really lie on that part of my body.
Exercise activity and alternate profiles. Although not certain, I believe / understand that “Exercise” activity only raises your target blood glucose. Basal is unchanged and correction boluses likewise. So that’s why I also use a different profile when I’m skiing, hiking, biking, etc. Too bad this isn’t more easily customizable!
I have learned that exercising with ANY insulin on board puts me at risk of dropping glucose like a rock. So I pre-carbo load if I have eaten within a couple of hours pre-exercise; in addition, always bring extras: juice, granola bars, gels, etc. I don’t head out with less than 100 g of additional carbs! I’ve used it all a couple times.

My diet otherwise is as “normal” as possible. I have thee meals a day, I rarely snack, minimize sweets, and dose for 40g at breakfast, 40 grams lunch, 70 grams evening meal. (If heavy protein or fat, I will add 20 g (about 2 units more) as an extended bolus.) I don’t overdrink but I do like beer and wine and the occasional Manhattan. - - sorry got off topic a bit there. Carry on. :grinning:
(Edit for spelling)

I’m definitely going to do some trial and error. I just had a conversation with the Tandem nurse (called me after a week to check in) and she said a lot of people experience a blood sugar spike at the beginning of the exercise, which is why they want the autobolus feature enabled in exercise mode. I am not doing any high intense, competitive, stressful activities. Usually a few mile run, or an hour to 2 hour gravel bike, which is an easy build up first 15 minutes then a sustained output for a while. So I think possibly an exercise profile that cuts all my basal in half and weakens my correction factor, added with a sleep profile (just to make sure it doesn’t give me an autocorrection bolus) may be the ticket.

I’m not a drinker, but I think I’m worse. I am addicted to PM bowls of cereal.