Discussion of Tandem's recently released Basal-IQ function

[sahmcolorado]

Yes, I look forward to using it at night too!!

[sahmcolorado]

BTW - I just received this announcement about Tandem presenting data on Basal-IQ.

[Chris]

If the G6 is like the G5 (I think it is) you can connect to two outside devices. Hopefully we can do the pump and his phone. Otherwise we will be stuck doing the pump and the receiver, and then figuring out how to gin something up to get the share working.

[sahmcolorado]

Why not the pump and his phone and follow the data from the phone? Would that work?

[Chris]

That would work, however, there are some restrictions that are in the back recesses of my brain that I can’t recall now, on whether the pump works from the receiver slot or the phone slot on the device. There are some restrictions on the G5. The pump and the phone would be ideal. I hope it works that way.

[sahmcolorado]

Right after we got the G6, I noticed that when I connected to my phone, the receiver disconnected. Not sure if that jives with what you have buried in your brain. LOL

[Thomas]

@Chris

If the G6 is like the G5 (I think it is) you can connect to two outside devices.

True. Tandem is changing slightly the terminology they use which I think makes it easier to understand what can be connected.

Transmitter can only be paired with one medical device (either a Dexcom receiver or t:slim X2 Pump) and one consumer device (phone or tablet) at the same time.

A typical scenario is the G6 connected to both the pump and the phone. The phone then feeds the watch. The phone also feeds a remote tablet.

[Thomas]

@sahmcolorado

Right after we got the G6, I noticed that when I connected to my phone, the receiver disconnected.

That does not make sense. Something is wrong. There is no reason this should not be working to send to both the phone and the receiver.

[sahmcolorado]

Hmmmm… Well, maybe it was a very odd coincidence? Now I’m curious to try it again.

[Jattzl]

@Chris

my son can go from 50-200 on 15 carbs. So when he treats a low, he watches his CGM, and if it double arrows up, he hits it with insulin.

@Chris I am the same as your son. And do the same process for low. I spent six months on the 670 and for many reasons I’ve talked about before it was nothing short of a disaster. The key to this system for me will be the accuracy of the G6 sensors, less dropped connections and having an accurate user-friendly system. I basically do this manually now. It will be nice if it works and takes a little of the load off. But I won’t be heartbroken if it doesn’t as I like a lot of control and use my phone as a receiver regularly.

[Jattzl]

@Thomas

Additionally, if you update your pump software, you will no longer have the ability to see Dexcom G5 Mobile CGM values on your pump screen.

I’m waiting to be sure I’m ready to move from the G5. But I can’t wait too long as my 3 month supply has already switched to G6 and as I understand I will need to do the download to follow the G6 on my X2 which is important to me. It’s nice to know I can just turn the basil IQ off if it doesn’t work for me and I preferred to do it manually. Also I’m so grateful to have this forum to follow during this process. Thank you for such great information and summation @Thomas!

[sahmcolorado]

@Chris

In the second example, when my son treats a low, he needs to be able to deliver a bolus pretty quickly after, because he is so carb sensitive. For example, my son can go from 50-200 on 15 carbs. So when he treats a low, he watches his CGM, and if it double arrows up, he hits it with insulin.

So he would still be able to do this with Basal IQ, since insulin delivery will resume on the first CGM reading that shows a rise, right? We typially don’t bolus for carbs until my daughter’s BG stops falling anyway.

[Chris]

That is what they say it will do. Whether or not it actually does that, is another story. Until enough people have experience with it, we won’t know what it takes to trigger insulin delivery.

[bkh]

I just went through the process of updating the t:slim X2 to the B6/Basal-IQ firmware. I’m not planning to use it, because I run LOOP, but the t:slim is my backup pump if the old Medtronic 722 conks out, and in that case I will be happy to have the low-suspend feature available.

The update process has a few steps. First you sign up for the update at https://portal.tandemdiabetes.com/ and provide your in-warranty X2’s serial number and verify your doctor information and so on. Second, Tandem contacts your doctor for a new prescription for this feature. Third they send you an email stating that you can go back to the portal to take the mandatory training (45 minutes of excruciating video tedium that explains at a beginner’s level what CGM is, how to use a CGM, how to access the CGM settings in the t:slim menus, and so on. There are a couple simple quizzes along the way: you need to get 80% right but if you don’t pass you can immediately go back and retake the quiz, or you can retake the course first. After completing the video training and passing the final quiz, they send you an email containing an Update ID number. Then go back to the portal to download the current t:slim updater. (Available for PC or mac.) When you launch the updater, it checks that the pump’s serial number goes with the Update ID number you type in, and after about 10 minutes of updating, the pump is ready to use. Except for the training course, which could have been shortened to 1 printed page of facts for an experienced CGM and t:slim user (followed by the quizzes, of course), the process was easy.

The t:slim user guide that contains the Basal-IQ material is at https://www.tandemdiabetes.com/docs/default-source/product-documents/t-slim-x2-insulin-pump/user-guide_tslimx2_basal_iq.pdf Page 250 of that pdf is the start of the Basal-IQ section.

[Chris]

Thanks bkh for the in-depth explanation of the upgrade process. Really appreciate that. We will be heading down this path shortly.

[Thomas]

@Chris

We will be heading down this path shortly.

Our prescription finally went through. So tonight we just received the email stating that the training module is unlocked for us. Probably tomorrow we will watch the training and then upgrade.

We still don’t have the G6 (running the G5 now) so won’t be able to use the new functionality yet.

In about 3 or 4 weeks, I am going to try and get the G6.

We have not been running the G5 integrated with the X2 so for us there is no downside to applying the upgrade prior to getting onto the G6.

[Chris]

Please let us know how it goes. Due to an unfortunate transmitter issue, we will be getting the G6 sooner than we thought. But we are really excited to hear if the approach discussed above will be viable (fingers crossed)

[Jattzl]

Hi! I’ve been on Basal IQ for 6 days now. Absolutely amazing. I have not calibrated once. Only test BG once to see if it is working because my line is so straight! lol! The accuracy has been exceptional.

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[Jattzl]

This is what Medtronic wishes it could be when it grows up. Can’t wait for the Control IQ next year. I have every confidence it will be as incredible!

[Jattzl]

@sahmcolorado

So he would still be able to do this with Basal IQ, since insulin delivery will resume on the first CGM reading that shows a rise, right? We typially don’t bolus for carbs until my daughter’s BG stops falling anyway.

@sahmcolorado @Chris Yes, this is correct. I also bolus after treating low with carbs. So far, I have not had to treat lows at all but when I did it was very easy to bolus at the right time after suspension ends. The timing of the suspension is right on. With 670 it would suspend way too soon and I would have a big after spike. This has not been an issue especially because I have not needed to use carbs to treat the low.