TSlim-Control IQ Users Help Please

Sleep Mode suspends your basal if it predicts you will be under 70 within a half hour, decreases your profile basal rate if it predicts you will be under 100 within 30 minutes and increase you basal if it thinks you will go over 130 in 30 minutes. It never gives you a bolus. They key is 130. I look at it as attempting to keep you in a tighter range and that is what I am shooting for. It has worked for me. I have not given myself insulin or eaten carbs and I used to do both when I should have been sleeping. I think it is almost miraculous. I would like to do do that all day and hence 24/7.

Once you introduce eating, tension, almost any daily activity it knows it cannot keep you in such as tight range and thus Control IQ is more during the day is more like 100-160 or 180.

I have been type one for more than 40 years. I was doing well on a G6 and Animas pump with a A1c about 6 and time in range about 87%. I have hypoglycemic unawareness but the CGM virtually eliminated hypoglycemia as a problem. So why did I want the Tandem ControlIQ which I started one month ago? I was being driven crazy by alarms during the night. I would correct a high glucose only to have the low alarm ring two hours later. I was averaging two or three alarms each night and eating glucose or taking an insulin Bolus almost every night. I adjusted my basal rates but the variability was inexplicable. I have had the control IQ now for a month and have been awakened only one time and that was an “out of range” alarm. The pump does it’s job silently all night but I am free to bolus as I need to. The automated system actually beats me to make adjustments and I’ve learned that often I just have to let it do it’s thing. You can see on the CGM graph when the pump shuts off due to a projected low sugar but it’s never intrusive. I leave my pump on sleep mode all the time which allows for tighter control. I read on blogs about people fearful of closed loop pumps. For me it is like a car with crash avoidance. I still have to drive but am much less likely to “hit a wall”.

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Hi, I am fairly new with being on a pump and got my first pump June 2020. T:slim with BIQ after injecting for about 35 years. CIQ finally came to Canada and I did the online training so expect to get the update within 72 hours. Currently I weigh about 160 and TDD is about 60 units. Would I bump right up to 308 lbs and 100 units off the start? What did others do? Just looking for suggestions.

I hope a future release will add option to define a default “no cgm” profile to switch to when no cgm.

When I do lose cgm, sometimes it comes back immediately if I go into the menu functions. Usually to profiles to flip to my lower setting, then back out without change. Main screen usually shows cgm number again.
I know cgm working continuously since I don’t lose reading on phone/xDrip.

I don’t really understand your question. Really your settings shouldn’t change because your weight is already in there. I assume your carb ratio is also in there.

The only difference is that it will bolus when you are high.
But I never let it get that far because I correct before the software does.

I run in sleep mode most of the time.
I reduced my insulin sensitivity and carb ratio just so I could get a little tighter control.

I use a little more insulin than on my last pump. I was 45 per day now I’m more like 50, but it varies more some days it’s 42 some days it’s 60. And thats because it changes my basal as needed

I read that to maintain tight control I should put my weight and TDD settings to max. When I enter my settings to start off, should I start off with my real weight and TDD and slowly raise them or start off right away with weight and TDD maxed out.

Weight is one of the many factors that puts limitations on the Control-IQ algorithm. It’s a choice only you can make for yourself, but using the max weight removes that one factor, giving Control-IQ a little more freedom to dose for you.

TDD is another one of those limiting factors, but that setting is moot after the first day or so. The pump will use your actual data, rather than the setting you enter, once it has accumulated enough.

These are small safety measures, though. They just determine the maximum amount of extra insulin the system can deliver. They don’t in any way define how much is given at a particular moment. They’re not the basis of operation. The key to tight control will come with tweaking your basal rate(s) and correction factor(s) (which determines how aggressive Control-IQ works).

Control-IQ works fine for me at my correct weight. I would start with normal settings and adjust gradually from there to fine tune. For me this technology allows me to sleep without giving insulin or eating carbs two or three time a night. A true gift! I have always been a fan of trying things out on myself so you can be bold as long as you are watching your BG. Experiment but be safe.

Richard J. Carli

Thanks for the comments, that is what I was looking for. When starting with BIQ, I thought a good strategy was to be aggressive with basal settings to take advantage suspending delivery when going low, which is not what my diabetes specialist believes, who feels it is a sign that basal settings are wrong whenever there is a suspension.

This mindset irks the heck out of me. The whole medical field is terrified of hypos, and they use a random benchmark to determine this which isn’t even considered a hypo in non-diabetics. But it’s how they’re trained.

The suspension is an incredible tool for overcoming the shortcomings of our insulin. That darned tail that keeps you falling 3-5 hours after you bolus. That “suspension means your settings are wrong” mindset essentially equals “you HAVE to be high post-prandial if you eat carbs, to leave room to fall 3-5 hours later.”. That’s exactly why the 70% TIR goal is so low. There is zero reason to abide by that mentality if you can do better safely.

I think the ability to “super bolus” is the single greatest advantage of these automated systems. It let’s you give extra insulin up front where you need it, and redirect that annoying lingering tail to be basal insulin instead, by suspending the programmed basal.

Thank goodness my doctor knows better than to try and interfere with my management techniques!

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The only caveat with Fiasp is that it is not FDA approved for use in pumps and I find that the insulin crystalizes and occludes my entire set up during day 3

Agreed. Human intelligent is always better than the A.I. or any algorithm, such as. Control IQ.

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Does anyone know the reasons causing FIASP’s crystallization? low ambient temperatures?

The additive taht makes it absorb faster interacts with the plastic in the tubing and cartridge and crystallizes.
Happens more in tubing because there is less insulin in the tubing.
That’s why tandem will tell you to only use humalog or novolog.

I know that if you want to use it anyway. Use 80 percent and 20 percent humalog. So if you are loading 100 units. Just put in 80 of fiaspand 20 of humalog. It’s enough to prevent crystallizing. While giving almost the same action as fiasp alone.

Timothy, thanks. I am waiting for my first lot of FIASP and will try it out.

Have you tried Lyumjev? Do you know if it has the same crystallization issues?

I’m going to ask my doctor about getting a tandem pump with control iq. My insurance covers Lyumjev. I’m currently on MDI and like Lyumjev’s action profile a lot.

I know people who pump with it, I have never tried it. Officially only novolog ot humalog are officially approved

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Both fiasp and lyumjev in pump discussed here.

Yes, I actually commented on that thread.

I was just wondering if Timothy had ever used Lyumjev in a tandem pump.

Nope I’ve used fiasp and it clogged so I diluted it 80 percent to 20 percent humalog.
I’ve also used novolog and currently using humalog because my insurance pays for it. I would try lyumejev tho if I had some.
What’s the worst that can happen?

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