So for long digesting meals do you just trust CIQ is good enough? Thinking things where you might normally do a 6 hour bolus.
I have problems with the correction factor when using Novolog, but not as much with Fiasp.
That being said, I still do a quick mental check if it is a larger bolus/correction.
I do not feel safe with too high of a basal rate. If/when your X2 looses connection with your G6, it will default to the high basal rate. No options or lowering the rate.
A high correction factor does come at a risk of it giving too much when you are entering in a meal or doing a manual correction.
Thing is, you have the opportunity to override it and enter whatever bolus you want it to give.
It will make more aggressive corrections for when it is doing it all the time though, which makes a big difference for ME.
In the end, you need to do what works best and SAFE for YOU!
Don’t let us make the choice, just use our advise and possible solutions that can help you out.
Again, Fiasp makes all the difference for me. I couldn’t get Novolog to work as well for me.
We all need to do what’s best for us is everyone is different when it comes to diabetes. Most people give themselves insulin at meals based on the food they eat but they must count carbs. I do the opposite I give myself x units of insulin and then I eat for what I’m going to see over the next 4 hours. A lot of people count carbs but a lot of people give themselves equivalent carbs for protein and a smaller amount of equivalent carbs for fat. I don’t have to do any of that. Works for me. My average glucose used to be
My average blood sugar used to be 164 and now it is 105. This works for me . I haven’t figured it out in terms of using the control IQ. I put an insulin in terms of what I’m going to eat over the next 4 hours including snacks. but I think the control IQ will look at the bolus I just put in and assume I will be going low and start decreasing my basil. So I will need a workaround. But control IQ is great for me except for mealtime.
This sounds like a good reason for a higher basal.
It will cut back some of it, but still give enough to keep you where you want to be.
I hadn’t thought of that. That may work. If you put a bolus in for the whole meal control IQ knows immediately that the bolus has gone in. If you pre-bolus don’t you run the risk that control IQ will decrease your basal assuming you will go low?
It will if it thinks you will go low.
But it doesn’t stop it unless you are going fairly low. Until then, it will just reduce it.
And if your basal is set fairly high, it will only cut out some of it. It should work pretty good for you.
I would try and set a time frame for when you plan to eat, or that 3 to 6 hour time frame where it would affect it.
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So let’s assume my usual prebolus is 45 minutes sometimes it’s 15 to 30 sometimes it’s more than an hour. And assume my blood glucose is 95 when I put the bolus in 45 minutes before I eat. What would you do?Preformatted text
You could also superbolus where you account for the amount of basal over that same time frame.
But when you start with a BG of 95, I would be hesistant on whether or not you would drop too low before the carbs kicked in. You would know yourself better than I.
Do you eat at the same time each day? I know you eat to what you bolus, and not the other way around.
If you eat at the same time, I would add a basal rate for that time and add 10% to your basal until it feels right.
If you eat at different times, I would superbolus.
As of today, it has been 4 days in a row that SLEEP mode has kept my BG almost perfect. IF I can figure out meals (somewhat unique to me) I will absolutely keep myself on SLEEP mode all day.
Yes, I generally eat at the same time for lunch and dinner. And I generally put in the same amount of units for each meal.
What is a Superbolus? Instead of a 4 unit meal bolus you increase you basal rate by 4 units for the timeframe you would give the bolus?
I know CIQ considers a meal/corrective bolus when arriving at their 30 minute predictive BG values because as soon as you take a bolus it is delivered and increases IOB. That seems to be my problem. So does CIQ not consider basals when making its 30 minute predictions? If so that could have some merit.
It does not figure normal basals into a bolus. It only figures in if you have increased basals because it is trying to bring down an elevated BG.
Superbolus is where you give the normal bolus plus the amount of basal that would also be given during the next few hours that you are planning for. So if you give a 4 unit bolus, and if your basal was 1 unit per hour, you would give and additional 3 or 4 units for those hours you plan on the meal affecting your BG. So a total of 7 or 8 units.
Of course this is only rough set theoretical numbers. But you get the idea.
Oh, and if you eat at the same time, you can have a basal set for that time frame, plus or minus some depending on how fast you react to you insulin. And start adding 10% at a time to that basal over your normal.
This is nice with CIQ because even if you don’t eat, it will limit the actual basal at that time to what is needed.
I tried an extended bolus as a possible meal solution for me.
I put in bolus equal to my dinner meal plus snack tonight. So I put in 30 carbs for both.
Then I said to deliver 65% now and it calculates the remaining 35% bolus and delivers it over two hours I assume like a basal. That will work if it doesn’t automatically decrease my basal as I waited close to an hour to eat.
In general I think Control IQ takes care of the last hours of digestion although maybe all bets are off for things like pizza. I stay in Sleep Mode 24/7 and have an alarm on my pump for when I hit 150. If there is not enough IOB to cover that, I will bolus. During the day I look at my numbers enough that I may bolus before I get to 150 if I think it will be needed. Control IQ is not completely hands off for me but in general I think I am better with it than without it.
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I am waiting for my new tslim. I currently have an older minimed. Can you explain what sleep mode is. And why you would be on it all day. How is it different from regular day mode. I think I get exercise mode. I think it will be good to have. Right now I just cut my basal in half when I exercise.
I would like to use Sleep Mode 24/7 but I seem to have a problem because I have a long pre-bolus for meals. If I pre-bolus for 45-60 minutes then Sleep Mode will decrease my basal as it think I have too much insulin and predicts a low. Can’t figure out how much time it waits for BG to go up from eating but when it triggers, it decreases or suspend my basals because it predicts I will go low.
I agree with about everything you mentioned.
I have an alarm set at 140. I try not to look at my pump but if I do I know a bolus is better than a basal to take down a high blood sugar so I generally give myself a bolus rather than wait for Sleep Mode to take me down with a basal.
I think one of the benefits of Control IQ is you only have to be in the general vicinity with your profile basal. If you are, then Control IQ can take over and get things pretty good for you. No longer need the precision in many of your metrics.
It is doing what it promised. It improves my sleep immensely and I am spending much less time managing by BG. Once I am over the learning curve (almost there) switching from Medtronic I will be much better off.
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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.