# One week on Control IQ (tSlim)



## everydayupsanddowns (Sep 6, 2020)

So this is the end of my first week on ‘Control IQ’ with my new Tandem tSlim pump and Dexcom G6.

It’s a little like Medtronic‘s MM670G or MM780G in that it os a ‘hybrid closed loop‘ insulin pump that uses CGM values for predictive low glucose suspension of basal insulin, alongside increased basal and/or mini boluses if sensor glucose is predicted to go high. 

It is aiming for a target value of 6.1mmol/L which suits me well.

So far I’ve been pleasantly impressed by it’s interventions, and having tried (as far as I could manage!) to let it ‘do its thing’ for a week I think I have ide tified the things it does well, and the places where it struggles.

It has certainly brought my BG back into line smoothly on a number of occasions, and for the most part is just pottering away without much alarm nag.

So far so good!

I’ll be making a few tweaks to my reactions to things over the coming weeks, and trying to let it take over as much diabetes head space as it can going forward!


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## Vonny (Sep 6, 2020)

Treating T1 sounds terribly complicated compared to T2, where I just pop 3 pills a day! Glad that the new tech is suiting you and working well x


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## SB2015 (Sep 6, 2020)

This is really useful Mike.
I know it is a different pump but the general idea is the same.

At present having had walks interrupted by hypos as my insulin has a mind of its own at present I am very much looking forward to getting my 780.  I still have loads of questions to address such as 

How does it/you manage exercise?)
What steps do you need to take for illness (but I hope that you don’t get answer this one
I shall watch this thread with interest, and look forward to being able to ‘do less’ for my D.


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## trophywench (Sep 6, 2020)

Vonny said:


> Treating T1 sounds terribly complicated compared to T2, where I just pop 3 pills a day! Glad that the new tech is suiting you and working well x



LOL! - T1 is a far simpler condition to understand than T2 though, plus should we fancy that cream dougnut - we can allow for it (I just seriously dislike doughnuts in the main) so each has it's own pros and cons!


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## everydayupsanddowns (Sep 6, 2020)

SB2015 said:


> How does it/you manage exercise?)



Well I am still fine tuning that. The tSlim (like the MM670 etc) has an exercise mode which resets the algorithm parameters. But because I am currently slightly over sensitive to IOB during any activity I am also switching to an ‘exercise‘ basal profile I have made (unlike MM the tslim bases its adjustments on your profile settings). And then adding in a jelly baby or two if I need one.

One thing I like about the tslim versus MM’s smartguard os that the intervention doesn’t seem to have a minimum term (if activsted it always works for at least 30 mins on a Medtronic. So I *think* i am getting fewer ‘bounce backs‘ where a little dip with carbs on board ends up costing you a chunk of basal and you drift above target. I could always tweak settings (often basal) on my 640 and get Smartguard to work well, but there seem fewer ’ugh’ moments in these first few weeks.



> What steps do you need to take for illness (but I hope that you don’t get answer this one



Not had any reason to see yet, but again, because the algorithm uses your profile settings as part of its adjustment calculations I could create a ‘sickness’ profile so that the automated resoonses were more aggressive.


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## martindt1606 (Sep 6, 2020)

everydayupsanddowns said:


> So this is the end of my first week on ‘Control IQ’ with my new Tandem tSlim pump and Dexcom G6.
> 
> It’s a little like Medtronic‘s MM670G or MM780G in that it os a ‘hybrid closed loop‘ insulin pump that uses CGM values for predictive low glucose suspension of basal insulin, alongside increased basal and/or mini boluses if sensor glucose is predicted to go high.
> 
> ...


Currently on day 11 and have hit 75% in Target every day which is a good improvement on the previous 10 days where i missed the 65% target twice.  I have been slightly more proactive with changing settings for exercise and sleep (specific profiles) but this is due to the ongoing challenges I have from monthly somatuline injections.  Also think the basal interventions are working quite well although initially was concerned at the size of the basal until it dawned that it was the hourly rate and not a single (ie bolus type) dose....


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## SB2015 (Sep 6, 2020)

Thanks both of you, for your experiences so far.
I shall continue to watch with interest.


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## everydayupsanddowns (Sep 6, 2020)

Will be interested to see how you get on when you go all cyborg @SB2015


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## Sally71 (Sep 7, 2020)

That sounds really exciting!  We are just coming to the end of our first sensor on Basal IQ and I’m amazed at what that alone has done.  It has stepped in so many times during the last 10 days, I think without it we'd have been in hypo city and I'd have been frantically making adjustments trying to sort it out.  As it is it now feels as if I hardly need to bother as the pump will look after her.  Back to school today for the first time in almost 6 months and she's had pretty much perfect numbers all day, that never happens!  I suspect she might have forgotten to change her basal pattern back to the school one, but if so it hasn’t done her any harm with the pump assistance!



Only snag is, the sensor will end just before the end of the school day, and she’s determined she wants to walk home from the bus stop instead of me picking her up like I used to, so she'll have to do so without Basal IQ assistance  She has still got a Libre on though, we put the last one on 4 days before we got the Dexcom (wouldn’t have wanted to have no sensor at all, even for a few days) so decided to leave it there and do some interesting comparisons.  And the Libre will actually outlive the Dexcom by a few hours!  It dies tonight though and obviously won’t be replaced, end of another era.
Libre has been great and I would always recommend it to anyone thinking of getting one, it can’t compete with alarms and Basal IQ though!


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## everydayupsanddowns (Sep 7, 2020)

Glad to hear it’s working so well for you both 

I remember feeling very similar about my first experienced of sensor augmented pump therapy about 5 years ago






						64 Days with the Medtronic 640G: Ep 2 The first 28 days' results
					

Because no two days with type 1 diabetes are the same. Except when they are. The ups and downs of life with T1D.




					www.everydayupsanddowns.co.uk


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## SB2015 (Sep 8, 2020)

I look forward to the next instalment from any of you.


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## Thebearcametoo (Sep 9, 2020)

Can you move from basal iq to control iq and vice versa or do you need to choose one and stick with it?


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## Sally71 (Sep 9, 2020)

Pump comes with Basal IQ, to upgrade to Control IQ you have to do extra training, not aware that you can change back again


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## Lis Warren (Sep 9, 2020)

Thebearcametoo said:


> Can you move from basal iq to control iq and vice versa or do you need to choose one and stick with it?


You can move form Basal IQ to Control IQ but NOT the other way around.  If you switch off Control IQ you're left with a basic pump that won't suspend insulin for lows - you might as well stay with one of the older models of pump.


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## Thebearcametoo (Sep 9, 2020)

Lis Warren said:


> You can move form Basal IQ to Control IQ but NOT the other way around.  If you switch off Control IQ you're left with a basic pump that won't suspend insulin for lows - you might as well stay with one of the older models of pump.


Thanks. Our team are only just learning about control iq so weren’t sure what the possibilities were.


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## everydayupsanddowns (Sep 10, 2020)

Yes I was frustrated that you couldn’t go back, especially if you’d already had a few weeks on Basal IQ and found things you liked about it.

Having said that Control IQ is currently ‘winning’ for me... but there are things about Basal IQ that I really miss, and a combination of the two would be the ultimate pump for me.

Lovely to see you posting again @Lis Warren - how are you finding the tSlim?


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## Sally71 (Sep 10, 2020)

I thought Control IQ was just Basal IQ with some added programming to help it manage highs as well?  What's different about it?

Basal IQ is struggling a bit since daughter went back to school, not too bad on Monday although I think the pump had basal switched off more than on!  On Tuesday she had a thumping great low that came out of nowhere and the pump had no chance with, and ended up in the school medical room for an hour (we were hoping to avoid that now). Then she remembered that she hadn’t switched over to school basal so did that on Tuesday evening then spent half the night going low even though the basal is less (weather was unexpectedly warm though so we are going to blame that!)
Yesterday went high in the morning, corrected, then dropped again in the afternoon although not quite as bad that time and came up again quicker.  School basal has not been used since March on her old pump so I was fully expecting to have to do some changes; was going to wait and see what happened today first, but don’t really want her in the medical room again if we can help it, so did a couple of tweaks.  So far this morning she's sitting nice and steady around 6.8 so fingers crossed for this afternoon!


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## martindt1606 (Sep 10, 2020)

Sally71 said:


> I thought Control IQ was just Basal IQ with some added programming to help it manage highs as well?  What's different about it?
> 
> Basal IQ is struggling a bit since daughter went back to school, not too bad on Monday although I think the pump had basal switched off more than on!  On Tuesday she had a thumping great low that came out of nowhere and the pump had no chance with, and ended up in the school medical room for an hour (we were hoping to avoid that now). Then she remembered that she hadn’t switched over to school basal so did that on Tuesday evening then spent half the night going low even though the basal is less (weather was unexpectedly warm though so we are going to blame that!)
> Yesterday went high in the morning, corrected, then dropped again in the afternoon although not quite as bad that time and came up again quicker.  School basal has not been used since March on her old pump so I was fully expecting to have to do some changes; was going to wait and see what happened today first, but don’t really want her in the medical room again if we can help it, so did a couple of tweaks.  So far this morning she's sitting nice and steady around 6.8 so fingers crossed for this afternoon!


Hi my understanding was that Basal IQ is a pretty basic average calculation which is replaced by a more complex algorithm in Control IQ.  Control IQ enhances the low BS functionality of BIQ as well as adding High BS management.


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## everydayupsanddowns (Sep 10, 2020)

There are a few settings that change (and are not user-tweakable). Not sure I can remember them all, but here are a few...

The target BG is fixed at 6.1 (unless you have ‘exercise mode’ enabled).

Duration of insulin action is set as 5 hours, and can’t be changed.

Control IQ removes the option of TBR (because these are supposed to be done automatically by the algorithm) so you can no longer predefine temporary rates for a set duration - you have to let the algorigthm do its thing.


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## everydayupsanddowns (Sep 10, 2020)

Sally71 said:


> Basal IQ is struggling a bit since daughter went back to school, not too bad on Monday although I think the pump had basal switched off more than on!



One of the modifiable things about the tslim vs Medtronic is that it does base its adjustments in part on settings in your basal profile. Which gives you a degree of ‘steer’ if basal IQ / control IQ aren’t quite keeping up. Of course... it does mean you have to keep your basal profile properly tweaked!


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## Sally71 (Sep 10, 2020)

Well she didn’t go low today so the adjustment I made obviously worked!  That was easy!  In fact pretty good numbers all day and no alerts so I’m quite happy.  Let's see how long it lasts!
I don’t know how this pump calculates things, other than it's obviously different from the Combo, but it does seem much more responsive to changes.  I used to be almost constantly fiddling with her old pump and never quite got things right.  This one, especially with Basal IQ, seems to need very few tweaks and the ones you do make all the difference.  We like! (Unless I’ve just been lucky this time lol)

We have target set at 5.5 and insulin duration 4 hours so don’t know how Control IQ will affect things for us (why can’t you change the target, that seems daft!).  Not having TBRs makes sense though if it's meant to do them for you!


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