An Open [Breakup] Letter to My 670g

I’ve been tubed up for so long that I think it would feel like I was missing an arm or something :sweat_smile: I know the tubing is a turnoff for some diabetics but it’s weirdly comforting to me? It would be fun to run around naked (tubeless) for just one night and howl with the wolves though…

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@Thomas - 1st of all, thank you for the clear response. I’m always happy to read more on diabetes so don’t feel like you’re talking into the wind with me… I could seriously go on for hours, days maybe ¯_(ツ)_/¯ I didn’t know all this about control- and basal-IQ’s algorithms… Kind of have had my head down thinking “tslim, tslim, tslim”

I completely agree … I wouldn’t be an earlier adopter by any means if it means no basal-iq. UNLESS I see incredible results from many people I trust who are personally use it

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I suspect you could combine this with the naked bike ride that is well attended every year in Portland, and then bystanders could try and pick out who is the diabetic?

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This thread is too funny! :rofl:

I hope the Tandem works for you!! I’m not familiar with the algorithms but Basal-IQ sounds great per @Chris’ description, sort of like Loop for OmniPod.

Hmm, I wonder if Dexcom will be getting into insulin delivery???

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Here’s a good description…

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That’s odd. I never hear from my Omnipods except, every three days, a reminder to change to a new one. Maybe they’re scared of me?

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So glad to hear you like the 670g!!! But also give yourself some credit on the great control you’ve gotten to!

With the 670g and sensors, do you use the suspend features?? I could never get them to work for me without sending me high…

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Hi Larissa! I use the suspend before low feature. Early on I would over react and consume a bit to much sugar and end up going from 80 to well over 200. Like other aspects of the 670G it was a learning experience and after a month or so I got in tune with it. After the initial learning curve, the suspend before low feature has worked well for me…

Have you gotten into the way that the extended bolus interacts with the Basal-IQ on the X2?

There are two different aspects. One related to low BG while eating and the other related to high BG trying to bring it down.

We make extensive use of the extended bolus to bring down high BG in conjunction with Basal-IQ.

Ok, so this is something I’m still trying to figure out. So far, the issue pops up frequently of when I’m borderline low, say 65, and basal-iq wants me suspended, but I’m eating and want to do an extended bolus like I would have w a dumb pump. I’m playing around with +% temp basals but that involves more math than I’d like to do…

That being said, it seems to me like I can be way more aggressive as well as loose with my boluses and +% temp basals knowing the basal-iq will catch me if I start trending down. Which is cool to me because even without precision I’m able to get some nice flatish lines on the regular.

Now, for the second scenario of basal-iq with highs and using extended bolus: can you explain a little more what’s the issue? I generally turn to using a pen or injection if I’m on the higher end to send me down, even if it’s a drastic down rather than a general trend down just so I’m not sitting higher up

Yes. That is the one aspect I was referring to. Here (low BG with food), Basal-IQ works against you so we just bypass it. We turn Basal-IQ off and set a phone alarm for 1 hour to ensure we don’t forget to turn it back on.

@LarissaW

Second aspect re High BG is what I consider a huge benefit.
Would have to think better how to word it.

The gist is remaining extended bolus gets terminated when Basal-IQ activates.

I should try this but I somehow am always distracted when the phone alarm goes off meaning to remind me of pump things…

As in you guys will be more aggressive w highs up front and extending, knowing that basal-iq will cancel out the extra extended insulin once it’s no longer necessary? That’s a good idea and I’m sure helps bring the highs down smoothly

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My biggest objective is not speed of BG decrease but rather avoiding a subsequent roller coaster.

Coupled with the reality of not knowing how much insulin is required up front to bring the BG down from “high” to whatever the target at the moment might be.

So, an upfront bolus (whether pump or MDI) coupled with an extended pump bolus has shown to be incredibly effective for us at sticking level landings. We will often do an extended (in addition to up front bolus - pump or MDI) for 4 hours and change the extended rate up in terms of how much per hour anywhere in the range of 0.5 unit/hr ~ 2.0 unit/hr based on other factors in play.

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Only some quick taps on the pump. It literally is less than 5 seconds.

BTW - If you are low BG with Basal-IQ active and want to eat and bolus but NOT extended bolus then you do NOT need to cancel Basal-IQ.

Simply hit RESUME INSULIN then you can Bolus (no extend). A regular (non-extend) Bolus will always run to completion even if Basal-IQ activates 1 second after you start the Bolus even though the Tandem Bolus is relatively slow and may be continuing even after the Basal-IQ may have activated.

When you hit RESUME INSULIN the Basal-IQ algorithm will evaluate state upon the next cgm data point (depending on timing anywhere from 1 second to 5 minutes) and the Basal-IQ could immediately suspend upon the next cgm data point based on the Basal-IQ rules.

However regular (non-extended) bolus is NEVER cancelled due to Basal-IQ.

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[quote=“Thomas, post:35, topic:7969”] a subsequent roller coaster.
[/quote]

Wow, sounds oddly familiar :joy: when doing the extended bolus for bringing down highs, are you giving in total more tinsulin than you would expect is necessary for the high, but extending it? And knowing that basal-iq will catch the fall? Sorry, just trying to make sure I understand, because I definitely am a victim of riding too many roller coasters for my liking (prob my own fault too for being too reactive rather than waiting a lot of the time)

Ugh I know. I’ve tried the phone alarms when I would manually suspend on the 670g and you think I would take those few seconds to resume but a couple times I really failed on that front :woman_facepalming: Again a personal problem here lol. I really do love and prefer the extended boluses over temp basals for meals when starting low. Just a lot more exact for getting the amount of insulin I want. So maybe I just need to suck it up and pay more attention to diabetes alarms on my phone…

Yes! I definitely have noticed the distinction of the cancelling of extended vs no cancelling of the non-extended. Good clarification though since the basal-iq suspends happen so frequently and silently while most boluses do take a while imo

Welp, the first thing on my list of things to do is learn how to turn basal-iq off and try that for an extended bolus while starting lower