Is there a way to export the pump data? I would think that I could run sleep mode for a week and then export the data to get a good idea of what my basal rate needs to be during certain times of the day, especially if I do some fasting to really get it dialed in.
Fiasp was problematic for me.
Lyumjev works great!
While I agree with Basal settings being a huge factor, I disagree with your statement of not going aggressive.
Basals are a MUST for any pump (well, except the new Omnipod5 which ignores them pretty much.)
But, perfect basals alone will not always bring numbers down where you want them. These pumps, being commercially liable, are not nearly as aggressive as they could be, they have to play it safe.
That being said, if you are sensitive to insulin, you MUST get your basals as good as you can first. Then the sleep mode 24/7 will probably do a really good job.
If you are pretty resistant, then there is no way these pumps will do what you want without going aggressive. They are just made to be too safe.
As a point, I had great basal rates set, then Basal-IQ came out. My numbers dropped because I could make them more aggressive and have the pump accomodate for the lows.
When Control-IQ came out, I used the same basals, but the new programming still needed tweaks to make it work really good on it’s own.
That being said, this is also HIGHLY dependent on the insulin you are using.
With the speed of Fiasp or Lyumjev, it worked great.
When I had to switch back to Novolog for a while, YUCK! It was a rollercoaster ride from hell! I needed to dial it back a ways to keep this from happening because of how long it takes to act, and how long it stays active.
Aggressive, if you mean more aggressive CF or larger I:C ratio settings are not the way that will give you the result that the CIQ algorithm. Insulin sensitivity specific, high or low, to meet your needs. In sleep mode when aggressive setting are used to compensate for to little basal is a a disaster and a quite common error when setting up CIQ.
Your description of of the CIQ setting up process is true, because basal iq had no ability to change basals, up or down. The settings will not match. Lyumjev is what I’ve been using since it was released and the settings for novolog and Lyumjev will always be different, the action profiles are different.
Getting the correct basal is the first step for a pump no matter what.
And all other settings should be based off of the ‘best’ basals you can manage. Cause we all know they like to change…
But, even with PERFECT basals, “FOR ME” Control-IQ will NOT act quickly enough or aggressive enough.
Let’s say I forget to bolus for a small meal.
CIQ will start adjusting my basals once I exceed 120, but with very limited amounts. By the time CIQ has given me any real amount, I am going to skyrocket.
With a more aggressive correction factor, it reacts much better for rises above 120 all on it’s own. Not perfect, but enough to slow the spike down to become manageable. I remember to bolus, do the math in my head for what I really should be adding to what CIQ gave me, and I am pretty good.
It works good enough that I can eat a low/zero carb meal and not bother to bolus. My BG will have a slow rise, and will come back down very nicely! This is where those smaller basal adjustments are a true thing of beauty!
Btw, when on Basal-IQ, I also created a profile with super aggressive basals that were constantly being adjusted for (cutting the basal off, not true adjustments.) But it worked great. Up until the point the pump lost contact with the CGM, or hte CGM had issues, etc. Then the basals were too much and I would go low.
So, for me, AFTER getting my basals good. Yes, aggressive CF was the biggest change that made control IQ make my life so much easier.
And no, I don’t have, or rarely have (read, MY fault for eating, or not paying attention to my BG) rollercoasters with these aggressive settings.
My goal was quality of life with what I consider a fair amount of BG control. With much more carbs now, and a LOT less time spent messing with my T1, my aggressive control IQ settings keep me in the 5.2 to 5.6 range consistently.
Btw, Omnipod 5 is not nearly as good for this, as it’s idea of a good basal routine is far from what works good for me. It does good about not letting me go low, but I stay higher with it then I would like.
Does anyone prefill some cartridges and leave them in the fridge? It seems like an ok idea but is there any reason to believe that the insulin will degrade over time because of whatever the cartridge is made of? I’m just annoyed how long the swap out procedure takes but if I had prefilled cartridges it would go faster. Thanks.
I switched to Ctrl-IQ & sleep mode 24:7 after your 2/14 post. Thank you!
Good to know not to put Fiasp in my pump. … Yet perhaps I’ll want to try Lyumjev sooner rather than later. When I tried it with injections it seemed to have a long tail. (I see that it can last out to 7 hr) But perhaps in a pump it won’t be so obvious.I’m pretty sensitive to insulin … unless BGs get too high. 
Maybe part of my roller coaster was/is the NovoLog. What a thought!
Thank you!! I’ll see how it goes 
I’ll check back … in a week if not sooner.
CR
I would NOT do this with Fiasp. EVER.
The other ones, I imagine it wouldn’t be too big of a deal. But the cartridge design isn’t the greatest when it comes to longer term storage of prefilled cartridges.
I definitely rollercoaster with Novolog unless I am being very conservative, and running higher BGs.
Try it!
If you are sensitive to insulin, I would be VERY careful and not be overly aggressive.
Try Lyumjev if you can. It can sting/hurt some people (it does me once in a while, but I find it worth it!) The faster acting really makes a huge difference with any of the loop/hybrid loop setups. The act faster and last less. Which is getting closer to how real insulin is supposed to be (still a long ways off, but closer none the less.)
I would really concentrate on getting your basals set. Also remember, basals with faster insulins are different that with Novolog/Humolog, etc.
Response to Hammer,
Yes, I have one vial of Lyumjev & am using it. First impression it keeps bg from continuing to rise after bolus is given. Wonderful!! And it has not been stinging - seems good to me!
I think my basals are pretty close…
But what do you mean re
“Also remember, basals with faster insulins are different that with Novolog” ??
In what manner do they differ?? So far I’m just using my NovoLog basal rates. Granted my bgs are not great yet, but neither has been my eating.
Thank you!
CR
You basal rates ‘can’ be different, I should say.
First, they can start quicker. So if you have a change in basal rates during the day, and it is a bigger jump, you will most likely notice a trend where your BG drops a little sooner than it used to before.
Second part is that even though your basal is a small amount, it is technically ‘stacking’ all day long. And with longer acting insulins, this stacking could be what keeps your BG down better than when using a shorter acting insulin.
I noticed this when I changed from Novolog to Fiasp.
I had to increase my basal rates to adjust for this.
I also had to delay the timing in my profile to account for the faster insulin, especially after I had to increase the basal rate.
These were not big changes btw, but something to keep in mind.
Btw, what are you using to look at your 2 week trends?
I love xdrip for this, but dexcom/tandem do a pretty good job of showing you a simple graph that shows how your average BG has been doing for the past two weeks. THIS is how I make changes to my basals. One or two days isn’t enough data. Two weeks seems to be perfect for me to judge how my basals have been working, and if any changes are needed.
Careful on terminology, concepts are good but you descriptions are confusing in writhing. A steady flow of fast acting insulin cannot stack , but too much basal insulin is too much basal whenever it occurs. Technically the basal is only use to cove the normal release of glycogen your body releases to function not for meals or to lower bg. Any insulin yo take has a half life, an action time and a duration, long, short or rapid. If you use continual dosing of insulin using a pump the impact of the insulin action becomes irrelevant. So the stacking is not happening at all. However, if a bolus is delivered from the same pump the level of insulin and the action time become a part of the equation and need to be considered if bg needs to be managed with additional insulin to avoid over doing the insulin amount while insulin is on board.
Pushing aggressive CF can create a multitude of issues with CIQ that impact how it works. If basal rates are low all too often users get in the habit of increasing the carp ratio or CF to compensate. The CF is the guiding measure for how the algorithm responds to bg rising or dropping, if e what you have set is not battling against the basal rate settings then things are good. It’s not about aggressiveness, it is what it is. The CF will be different throughout the day as dose the basal need. It does sound like you are mixing up aggressiveness with tight control management.
As do I, you are aiming for tight control which can only be done using sleep mode with involved management. That’s the only way to get the 5.x A1c and the +90% in range along with a lower deviation, we are doing the same to get there.
I give others the following resources to help understand and manage basal rates.
Integrated Diabetes Services
Juicebox Podcast
Defining Diabetes
https://www.juiceboxpodcast.com/search?q=defining%20diabetes
Juicebox Podcast 411
Juicebox Podcast #820 Math behind the settings
Juicebox Podcast #826, basal settings
Dr. Adi interview
Dr. Adi CGM Data
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The t:connect mobile app will upload your data to the Tandem t:connect portal and you can create multiple reports there. You can also use Tidepool (uploader and website) to do the same thing.
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I might do this if I was traveling but at home, I don’t think it would save much time.
My procedure includes sucking out the last bit of insulin from the old cartridge and tubing, using that amount of insulin to buffer (see the bubbles) while sucking the air out of the new cartridge, and then finish filling the syringe with the correct amount of insulin to inject into the new cartridge.
I do keep the old cartridge and the syringe until the next time so if I have a problem with the new ones, I don’t have to open (half of) another new set.
bsmorgan, how do you get the insulin out of the old tubing? It’s easy to draw it out of the cartridge, but I’ve never found a way to reliably connect to the tubing, to pull the old insulin out.
Dave
Just an old syringe needle and an old cartridge!
Thank you, bsmorgan.
I had tried to get a needle in the tubing before, but I didn’t have a magnifying headset, so I couldn’t see what I was doing. This will save about 17 more units at each infusion set change.
Dave
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Yes, I do like that the BG starts dropping sooner than with NovoLog.
I have the Clarity app on my phone re 2 wk (2d-90d) info.
So I think I’ve come to understand your suggestions.
My numbers when eating low carb are pretty good …
A few days ago I finally understood (I think) what you meant about figuring my own corrections.
I had been figuring them & then counting them with the pump. (ie give an injection & then run that amount through the pump while disconnected.)
But I came to realize that that made the pump cut back on its efforts.
So a few days ago I started just giving Fiasp injections for corrections. I keep track of them on an app. Works much better.
But I’ll keep on observing.
Next I need to determine how best to afford Lyumjev & Fiasp. Looks like they have programs for people w insurance.
But one of them only allows 12 uses? Are you familiar with these programs? How best to use them?
Thank you,
CR
You can check this link for Fiasp (and others). I have been getting Novolog and Tresiba. Up to 3 vials for $99. My insurance does not cover. I signed up 3 years ago.
Thank you! How is your prescription written? (How many … how often? ) Do you get pens or vials?
I have 2 RX from endo, for Novolog and Tresiba. Each time I fill, I can specify quantity of each. I use more Novolog in pump, with occasional purchase of Tresiba as backup.
Thank you!!
CR