Control IQ - First Day Thoughts

It’s definitely working for those that are doing it.

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We have been using Control IQ for a little over two weeks now and while we continue to have spectacular days (1 our of every 4 or 5) we also have normal days just like before Control IQ. On a two-week average our Time In Range has gone from 43% to 50%, and our Coefficient of Variation has gone down slightly. The real improvement has been in needing less low recoveries and in the dramatically less time it has required to maintain this control. For Cody, he is giving Control IQ a B+, for him the A1c range with Control IQ and not much additional effort will be 6.8-7.1. So not bad. This week since he has some time off school, we will probably play around with the 23.9 hour sleep mode and report how that works for us.

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@Chris Your experience sounds the same as mine. You’ll definitely see much better numbers once you start using sleep mode.

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Looking forward to the play by play on sleep mode

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Hi @Chris. Curious if you have any additional thoughts on Control IQ.

Yes, It is an interesting algorithm.

The good: Super easy to use, reduces the workload of being a diabetic, using sleep mode 23.9 hours per day is a definite improvement over non-sleep mode. It doesn’t alarm or require intervention very often, so it is easy and quiet and improves control over not using it.

The not-so good: it doesn’t really pound down highs very well if you eat loosely or miss your dose timing. So for us it isn’t going to result in a dramatically lower A1c, perhaps a couple of tenths, which I don’t really consider therapeutic improvement.

Overall, I would say it is better for us than just Basal-IQ, but the lack of paying attention that this algorithm allows, may also be counterproductive in the overall control my son is able to maintain. When his life is a bit more regimented and a second generation algorithm is available I think it is realistic that he could maintain an A1c in the 5’s with something similiar to this although a bit more aggressive when high excursions happen. My son is currently maintaining an A1c in the high 6’s low 7’s.

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Thanks @Chris. I bit the bullet and decided to go with the Control IQ upgrade. Waiting for the prescription to come through.

I’m hoping for a little less hands on mangement and better control overnight!! We’ll see.

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You need to raise his basal rates. My profile while on basal-iq had a total daily basal of 23 units. I’m now using 42 basal units per 24 hours. Most others that are using sleep mode all the time have found they needed to greatly increase their rates. The first two months using CIQ I had an a1c of 5.6 and didn’t like that it was so low. I’ve adjusted my rates so now I’m around 6-6.2 which is where I want to be.

I’m liking Control IQ now. Running in sleep mode all the time . Only part I still have trouble with is exercise. I have a personal profile with a very low basal rate that I can switch to for exercise which works okay unless I forget to switch back to my normal profile. I miss temp basals. But overall I’m happy with it. I like that you can adjust a lot of variables.

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Really glad it is working as well for you as it does for us.

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Can I ask how you are getting an A1C that low when others I read are 7-7.5 while on CIQ? I ask because I am at 7.5 now without doing much of anything right. I just started the process of getting the pump so now I’m worried, if I cant get my A1C a lot lower it wont be worth it to me to be tied to a pump again. I used to have 3 different pumps many years ago. I plan on doing Tresiba while on the pump though as I dont like being dependent on only Novolog as my basal.

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@drpepper68. If C-IQ isn’t working for you, you can always turn it off and old school it. My A1c is sub 7 prior to switching to C-IQ, and if it rises I plan to turn the algorithm off. The pump works great with just cgm integration if your numbers are dialed in.

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Honestly if all you do is use it for your night control, you won’t want to go back. It does great things for the night, and I expect the next generation of algorithm will be much more aggressive at dealing with the highs during the day. fingers crossed.

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The main issue I have now is Tresiba works perfect at night for me but is too low a dose for the day. If I take more then I go low at night. So I’m stuck with taking lots of Novolog shots during the day but I dont pre-bolus so I get spikes. Im kinda burnt out on MDI. When I get tired of the pump I’ll take it off for a few days and go back to shots.

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If you have active tresiba, rather than pump basal on tandem IQ, you won’t get the same benefits. C-IQ will suspend pump basal, which causes rise in BG. So if most/all your basal is injection, you would not see bg rise (from low).
If you split basal - some portion between pump and injection, there might be enough bg rise to recover from low without your interaction.

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My son injects 50% of his basal and uses Control IQ, it works fine. Agree that 100% basal and CIQ probably wouldn’t work out too well.

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Good to hear, was thinking of trying this. Which basal does he use? I have Levemir and lantus to try, but have only used them in past during pump outage.

We have only ever used Lantus. Works well for him.

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Yes that’s what I meant I was going to do also. I think it’s called the un-tethered approach from years ago.

The only drawback I always had with a pump was when I had site issues (absorption, which you can’t recognize right away, and it pulling out totally). So when I’d run high I’d just think it was due to food or something then it ended up being absorption issues. I hated it so I ditched the pump. The 50-75% basal approach at least keeps insulin in my system. Granted I still won’t know if I have absorption issues but at least I won’t go into DKA like before.

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Try continuing your Tresiba dose at the lower amount, and take a small amount of Levemir in the morning. This will increase your daytime basal and leave your nighttime alone, because a small amount of Levemir (0.20 units per kilogram or less) will not last very long, and be finished before the nighttime.

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