Control IQ with Tandem: Adjusting Settings for Your BEST Control

Describes exactly what each setting does and how to adjust them to fine-tune your settings for improved glycemic control with the use of Control IQ on the Tandem pump.

[Panman-fishing-Venture]

Thank you I been on dialysis for 6 years it is a hard battle diabetes is a evil enemy

[craigmelissa]

Thanks so much. Have had the same correction factor for so long that I just thought I didn't have to change it. For some reason I had to change it now and this video helped.
Went from 1-1 to 1-1.2 (ML) Cheers!!!1

[TiddlesParadiddles]

it took me so long to realize that i needed more insulin around different times of my cycle. if only this was discussed and fine tuned more often with female patients! and still knowing this, every month it frustrates me to see how much more insulin i need.

[robertlinek]

I thought the video was great. You cleared up some obscure points about the pump regarding the correction factor. I always wondered why the pump always seem to make puny corrections compared to what I would do. Finding that happy medium between aggressive and conservative changes is always a struggle but having more information allows you to make better decisions. Thanks for providing some clarity on this.

[jameshallahan]

My pump and cgm have been game changers but equal to those is these weekly wt loss injections - my A1c’s have dropped dramatially

[mertonhirsch]

A few points.

1) Harvard found that the best controlled T1Ds using a PUMP only had 30% of TDD in basal. People with higher % basal had high post meal spikes and tended to drift low several hours after eating. The range of good control was about 26%-33% basal. This is somewhat different from MDI where you have to have enough basal to get through the night, even if it's a little too high in the daytime. There may be exceptions. Very low carb dieters may have up to 70% basal, but with over 20% carbs it averages around 30%.

2) Control IQ in sleep mode wont do the 60% bolus, but it will raise basal by up to 300% and it will put enough on board at any one time to get you to 110. It also starts doing this when it thinks you will go over 120 and don't have enough IOB to cover it, while in standard mode, it won't start to do anything until you are going to hit 160, but will try to get your basal up enough to get you down to 110, and will give a 60% bolus if you are going to hit 180.

3) In activity mode, if raises basal only at most enough to target you to 140 (which may push you lower with activity). It only corrects to get you to a 60% correction with a bolus so it should never put enough on board to get you below 140 except that activity might raise sensitivity. In other words, if you ran activity mode but weren't exercising, and you were rising, it would raise basal only enough to cover to 140, and if it was going to get to 180 it would only bolus enough that when combined with the basal increase it would get you to 140, or 60% of the way down to 140 from wherever you are. Activity mode could be used at night if you tend to run low and want to play it safe since it will never target you below 140 (with a 60% bolus max to 110).

4) The pump assumes that the following amount of insulin comes off board each hour: 1) 25%; 2) 40%; 3) 25%) 4) 7%; 5) 3%

5) IF your correction factor is too low, you may get high enough automatic basal or bolus to make you low. For example. if your correction factor is set at 30 and it should be 45, and you drift up to 200 at night over a few hours, it will put enough basal on board to drop you 135 points, about 50% more than you really need, and enough to drop to 65. If you drift low at night after being somewhat high, your correction factor is probably too low. As a fairly good estimate, it has been found that good correction factors are around 30-35 divided by your hourly basal rate at that time. So if your basal is 1, typical correction factors are 30-35. If it is .5, you might be 60-70. People vary of course but that's based on how the liver works.

6) At any one time, you have about 2.2 hours of your basal rate in your system, so if your basal is 1, you have about 2.2 units in, and if it's .5 you have about 1.1 on board. If you trend low at night, it is usually your basal in the 2 hours before that point, and even more likely having your correction factor too low and getting an overcorrection after being somewhat higher for a while.

[TiddlesParadiddles]

I've had great control too with Tandem X2, but wonder if Omnipod is more liberating....sometimes I get tired of having the Tandem and tubing hanging on me. Curious to see how it's been for you!

[JasodaAustin]

Thanks for the video. I have a control IQ t-slim pump. My blood sugar at night (sleeping time) is frequently very low and it wakes me up every 1.5 to 2 hours. I have only one correction factor and one profile, and a sleep activity that is turned on from 9:00pm to 6:00 am. How can I fine tune it so that I can have a good night's sleep?

[mertonhirsch]

One last point. The pump will only auto bolus to get you down 60% of the way to 110 accounting for IOB, but the BASAL increase, over a long enough period will put enough IOB to get you down ALL the way to 110, not just 60%. So if you are at 180, and running night shift, you may have 100% IOB from basal increases to get you to 110. Basal increases can only add 1x your hourly basal rate every 20 minutes, so they may take 2 hours to get a full correction on board but WILL eventually put enough on board to go 100% down to 110 except in activity mode.

[revelationawake]

I want to change the target range on my Tslim x2 from 70-110 instead of 70-180. How do I do this???

[johnjillrobertson]

Ariel, thanks for all your help, o live in an area we’re there are no CDE, and all your videos have help me with my control .
I have had diabetes for 43 yrs and am doing very good with it.
Thanks you, John

[jeanph]

got my tandem x2 yesterday and it makes a big... well almost huge difference... i feel great... but it tend to overshoot when I eat a lot of carbs and it get me in low blood sugar afterwards... from what i read i should give my bolus at least 30 minutes before eating instead of right away of afterward... which is not a easy thing to do... I did not have the chance to test the activiy part but from what I read i should activate it at least an hour before my exercise
anyway thank you for your inputs it is helpfull

[kthomas]

We are new to all of this our 9 year old daughter was recently diagnosed we are on her third dexcom and it has proven to be very inaccurate even after calibration if you are using the pump with the G6 how trustworthy is it I fear of overdosing if we where to ever consider going to the pump

[corinnehowland]

I am struggling with control IQ raising basals too high to correct a high in sleep mode.

[dianariad]

My husband just did the update 7.4 and afterwards his readings are so high and control IQ doesn’t seem to be working properly .. has you heard any issues with that update ?

[jameshallahan]

There are 2 things I don’t like about tandem pumps # 1 battery using usb chord - medtronic is much better, convenient with AA battery
#2 medtronic you fill insulin with syringe, tandem uses silly cartridge

[mariagerard]

Has anyone had better control if you turn control IQ off ?

[BeautiFuFu]

Lol my doctor doesn’t even bother analyzing my numbers. I struggle for 3 months trying to make micro changes, and then during the appointment she just writes down my current settings even when I tell her all the trouble I have..

[dknyisles]

Hi. I am on year 64 with type 1. My only complication is starting to listen to country music. HELP…