About five weeks ago, I started using Control-IQ Technology by Tandem. I am a veteran in both time living with diabetes (44+ years) and using an insulin pump (10+ years). And this technology (in conjunction with Dexcom’s CGM G6) is a game changer.
In general, the pump and CGM technologies provide greater flexibility with managing one’s diabetes. Life happens. And if you are like me, your life is not the same from day to day, or even hour to hour.
So, what do I think…?
The algorithm used appears to react quite well to dropping blood glucose levels. It reduces or suspends basal insulin delivery. But, in my opinion, too slow to rising ones. I often wait and wait, not too patiently mind you, for either the basal rate to increase or for the correction bolus to kick in. However, when I keep seeing my glucose levels continue to rise with no response from my pump, I find myself manually administering a correction bolus or two.
I was so frustrated with the pump’s slow response time, I contacted Tandem thinking that there was a problem with the pump. Technical Support confirmed that the basal rate and automatic correction bolus were working as designed and to be patient. Nevertheless, I continue to work with my endocrinologist to tweak my factors (basal rates, correction factors, carb ratios, etc.) to take full advantage of the pump’s capabilities.
Other items I’ve noticed:
- Less time managing lows (< 70mg/dl) and highs (> 180mg/dl). Improved ‘Time In Range.’
- Taking 5-8 units of insulin less per day. I was a bit surprised at this, but it is likely the result of not chasing so many ‘highs.’
- Learned that using the Sleep & Exercise Modes work well for me. I currently use the Sleep Activity from 8:00pm to 8:00am but am considering leaving it on all the time. I like the tighter control. However, the trade-off is that correction boluses are not automatically administered.
- Thrilled with no, or reduced number of, finger sticks.
- Question sensor readings that do not match how you feel.
- Double check your factors (basal rates, correction factors, carb ratios, etc.).
- Still need to actively manage your diabetes.
What I would like to see: user flexibility in settings.
- Increase basal insulin delivery when sensor glucose is predicted to be > 130mg/dl rather than at > 160.
- Deliver automatic correction bolus if sensor glucose is predicted to be > 150mg/dl rather than at > 180.
- Change duration of insulin action. Fixed at 5 hours. Most people’s rapid insulin lasts less than that, which impacts the insulin on board (IOB) calculation.
Overall, I am quite pleased with Control-IQ. As with anything new, patience is key. For instance, remember the introduction of different types of insulin, multiple daily injections, CGM’s? Or the amount of time you and your medical team worked together to adapt these changes to your lifestyle?
Proficiency doesn’t happen overnight. But it’ll come.
I welcome hearing about your journey with Control-IQ.
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