Frustrated with current pump options

I hear ya. You’re new to Tandem, use Basal-IQ before you update to control-iq. You’ll be pleasantly surprised how wonderful Basal-IQ is. I’d personally give control-iq a try if I could go back to Basal-IQ if I found I didn’t like it. There are too many things I don’t like about control-iq that would not make me give up Basal-IQ

Tandem’s Sales team did answer this for me today and the answer makes a lot of sense to me. The reason for the lower threshold in Control IQ is because prior to even getting to 80 mg/dl Control IQ has been reducing basal rates once it first predicted a bg < 112.5 mg/dl.

The way I think about it, Control IQ is trying to engineer a soft landing before it has to resort to suspending insulin delivery which sounds reasonable to me.

On the other hand, since Basal IQ cannot reduce basal rates all it can do is cut the throttle to zero if glucose is predicted to drop be low 80 mg/dl or a CGM reading below 70 mg/dl is seen.

Would love to hear any counterpoints to the above explanation.

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This makes sense. I’m very comfortable having the pump suspend delivery at the predicted 80 and waiting to resume when it predicts the BG will stabilize and start to rise without any rebound highs or having to eat anything.

More clarity on Control IQ:

I was told by my local rep that the 100 unit per day limit is really for Day 1 pumping on the algorithm and creates no real limitations as to Control IQ’s ability to respond to highs once the patient has infused 100 units in a day. That question along with the weight question has implications for pediatric patients who have to meet minimum weight and minimum daily insulin dosing allow Control IQ to activate.

What happens if you don’t use 100 units a day? I average 55 units in a 24 hour period, with 24 basal units and 31 for bolus.

T:Slim X2 with Control IQ has been prescribed. Pump and supplies will be shipping out to me later today. Looking forward to seeing what it can do. So relieved to know that this got done.

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Awesome. You’re going to love the pump. My prescription for control-iq is still in limbo, hopefully Tandem will process it soon.

I’m thinking about going live with it asap upon arrival (scheduled for tomorrow if it’s delivered in time) without waiting for training which would be several weeks.

I have a week long business trip on Monday and would like the Control IQ hypo protection while I’m away. Sound doable or am I being over eager? After multiple pumps from both Disetronic and Medtronic, how hard could it possibly be?

I highly doubt it will be running control-iq out of the box. It will have Basal-IQ. The pump is very intuitive and the UI is fantastic. The only step in the cartridge filling process that you should take great care to do, is removing the air from cartridge before you fill it with insulin. Other than that, you should be good to go right after you get it.

I know the Rx was written for Control IQ. Would they really permit shipment of a pump that includes an algorithm that the doctor didnt technically “approve” ( i know this is semantics).

Lets say you are correct, and I have to download the update, is that the worst case scenario or does a pump trainer have to “sign off” in their systems before it will let me proceed?

Tandem has said pumps with control-iq will start to ship in the next few months. If this is true, you’ll have to go through the update process to control-iq, which will be no big deal since you have a prescription on file for control-iq. No, there’s no sign-off by anyone. All you need is a RX on file for control-iq.

Hi there. I’ve just happened upon this thread. I can totally relate to your sentiments regarding changing from Medtronic to Tandem. I had been using a the various versions of the Paradigm pump, starting in 1996. I also used the Enlite sensors when they became FDA approved, with variable results. Fast forward to 2016: retired and on Medicare, who will not pay for the sensors. BTW, A1C 5.7-6.3 consistently. It took me almost 2 years of paying out of pocket to make the switch to DexCom G5. Love it!! In the spring of this year, Paradigm pump out of warranty. I went through the same self torture you went through, and made the switch to the tSlimx2. It only took me about three cartridge changes to get the hang of getting the air and filling it with insulin. The large syringes annoy me, but I can live with them. The disposable inserter gave me more trouble: the introducer needle appears to fit tightly into the cannula, so I managed to pull a couple of sets out after insertion, trying to get the needle out. I use skintac to help the sets adhere better, and I think the inserter stuck to this as well. I have mastered it in the intervening and Tandem tech support sent me several infusion sets to replace the ones I destroyed. My A1C is now in the low to mid 6 range, making my Endo doc much happier, and I have significantly more time in range (though I set a tight range), and less hypoglycemia. I don’t think the pump is quite as intuitive as the Paradigm, but maybe that was my familiarity with that system. Overall, I am glad I made the switch. I will continue to follow developments, and knowing that I am only locked for 4 years is helpful. Also just approval for the G6 sensor. Another new chapter. Sorry for the length of this, but hope it is helpful.

@dagster1, it’s helpful. Welcome to Type One Nation and the forum!

Thanks Joe. I’ve been on the forum many times, but have decided to more actively participate. I’m now into my 45th year with T1D. I look forward to your words of wisdom.

Dagmar

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Thank you for sharing your experience. As I keep reading the various forums on the web and Reddit, there appears to be a recurring theme of T1s who have been very happy with the Paradigm series of pumps but were unwilling to continue onto the 670G or alternatively once they went with the 670G were not happy with the pump and/or the Guardian sensors.

These are very personal decisions, and after 13 years using (3) Paradigm pumps I’ve found it difficult to transition away from that platform. I’m not going to lie that I still have some trepidation, but I also have the butterflies of excitement as I look forward to what I see as a new era of treatment.

Once you start using the X2 you’ll forget all about the MiniMed. I still have a soft spot for my blue transparent Medtronic pumps. I’ve been running control-iq since this morning. I don’t have any opinions on it yet

@trifona I’m impressed with how control-iq handles lower BGs. Once you drop below 110 it reduces the basal rate. My normal rate for this time of day is 0.975, it reduced the rate to 0.216

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2 hours after delivery, I had the pump setup, cartridge loaded, and infusing insulin with Control IQ turned on.

Early Control IQ observations:

CGM reading was 195

  1. Bolus 16 units for chinese takeout (yummy steamed pork dumplings! - I did it in the name of science! ), 50% now, 50% extended 2 hours. I did not pre-bolus…long story.

  2. Control IQ canceled the extended portion of the bolus once my CGM started reading in the 170s citing hypo concern. I probably should have bolused all upfront anyway but I was testing the system out, so let’s see what happens.

  3. 90 minutes later my G6 is reading 297…I definitely should not have tried to extend the bolus.
    Control IQ has ramped up my basal from its normal 1.4 units per hour to 5.079 units per hour to compensate for the high reading. Wow now that’s interesting…a 350% temp basal

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