TSlim issues

[Herbie1972]

I absolutely HATED my T-Slim after the ease of kit-change with the Accu-chek Insight but am used to it now (after 18 months)
I have bigger issues with the Control IQ over-compensating, sending me into huge swings.

 

[ElenaP]

I absolutely HATED my T-Slim after the ease of kit-change with the Accu-chek Insight but am used to it now (after 18 months)
I have bigger issues with the Control IQ over-compensating, sending me into huge swings.

I'm not technical, so I hope someone will pick this up if I'm wrong. But I'm just wondering if over-compensating has to do with the correction-factor within personal profiles perhaps having been set too high. Perhaps you could ask the diabetes clinic or T:Slim support line.

 

[eventhorizon]

I absolutely HATED my T-Slim after the ease of kit-change with the Accu-chek Insight but am used to it now (after 18 months)
I have bigger issues with the Control IQ over-compensating, sending me into huge swings.

I LOVE my Tslim! Strange how we're all different. I find my Tslim under compensates for high BGs. When running in Control IQ I use a different profile with higher correction factors and a slightly higher basal rates. I get beautifully smooth CGM lines about 85% TIR

 

[Herbie1972]

My big problem with the t:slim and Control IQ is the way it struggles with my slow insulin absorption / fast metabolism, and also the way it over compensates for post-hypo highs.

For example, I'll deliver a bolus 15 mins before a meal and my sugars will rocket pretty much as soon as I've started eating, sometimes into the 20s. So Control IQ kicks in and delivers a bolus correction to bring it down. Then the original meal-time bolus catches up and I end up going hypo.

Also, after treating a hypo, I've noticed Control IQ delivering a bolus correction to bring my sugars back down, even when they're only about 9, so I end up crashing into another hypo. Happened a few times before Christmas, where I went from about 2 up to 9, then down to 2 again. I complained to the Air Liquide rep and they said they'd help but we've not managed to catch up since I reported it. But I know of other t:slim users who've had similar issues with an over-exuberant Control IQ bolus correction.

 

[username3]

For example, I'll deliver a bolus 15 mins before a meal and my sugars will rocket pretty much as soon as I've started eating, sometimes into the 20s. So Control IQ kicks in and delivers a bolus correction to bring it down. Then the original meal-time bolus catches up and I end up going hypo.

That's a strange issue. It's certainly not going to be great for your health to rocket into the 20s. Do you think it would be possible to bolus perhaps half an hour to an hour earlier before your meals?

You should be able to stop Control IQ from kicking in by not inputting carbs when you deliver a bolus and just delivering the insulin dose plain - then Control IQ should only correct if your active insulin is lower than the correction would be for your blood sugar. This will only be effective if you have set the correct insulin duration (mine is currently set to 5hrs after bringing it up from 3 due to issues with insulin stacking)

Your hypo issue could be addressed by slightly raising your Target BG (mine is 6.1) and maybe increasing your correction factor.

Lastly, make sure that your weight and average daily dose is correct in your Control-IQ. The system is supposed to calculate insulin dosages more accurately taking into account factors such as metabolism and body composition - although, obviously there are individual differences.

Or...
try going on Basal-IQ technology if Control IQ is just not working out for you. Basal-IQ will not interfere with high blood sugars or insulin corrections at all and only deal with the lows.

 

[eventhorizon]

My big problem with the t:slim and Control IQ is the way it struggles with my slow insulin absorption / fast metabolism, and also the way it over compensates for post-hypo highs.

For example, I'll deliver a bolus 15 mins before a meal and my sugars will rocket pretty much as soon as I've started eating, sometimes into the 20s. So Control IQ kicks in and delivers a bolus correction to bring it down. Then the original meal-time bolus catches up and I end up going hypo.

Also, after treating a hypo, I've noticed Control IQ delivering a bolus correction to bring my sugars back down, even when they're only about 9, so I end up crashing into another hypo. Happened a few times before Christmas, where I went from about 2 up to 9, then down to 2 again. I complained to the Air Liquide rep and they said they'd help but we've not managed to catch up since I reported it. But I know of other t:slim users who've had similar issues with an over-exuberant Control IQ bolus correction.

It sounds like it would be worth adjusting your correction factor/s to deliver less insulin when correcting a high blood sugar.

Also, if you know it's going to deliver a badly timed or mis calculated bolus you can do a manual phantom bolus of 0.05 and that will prevent an auto correction for the next hour.

 

[Herbie1972]

It sounds like it would be worth adjusting your correction factor/s to deliver less insulin when correcting a high blood sugar.

Also, if you know it's going to deliver a badly timed or mis calculated bolus you can do a manual phantom bolus of 0.05 and that will prevent an auto correction for the next hour.

By 'manual phantom bolus' do you mean disconnecting the pump and delivering the bolus into the sink or whatever? Thanks for the tips.

 

[Herbie1972]

That's a strange issue. It's certainly not going to be great for your health to rocket into the 20s. Do you think it would be possible to bolus perhaps half an hour to an hour earlier before your meals?

You should be able to stop Control IQ from kicking in by not inputting carbs when you deliver a bolus and just delivering the insulin dose plain - then Control IQ should only correct if your active insulin is lower than the correction would be for your blood sugar. This will only be effective if you have set the correct insulin duration (mine is currently set to 5hrs after bringing it up from 3 due to issues with insulin stacking)

Your hypo issue could be addressed by slightly raising your Target BG (mine is 6.1) and maybe increasing your correction factor.

Lastly, make sure that your weight and average daily dose is correct in your Control-IQ. The system is supposed to calculate insulin dosages more accurately taking into account factors such as metabolism and body composition - although, obviously there are individual differences.

Or...
try going on Basal-IQ technology if Control IQ is just not working out for you. Basal-IQ will not interfere with high blood sugars or insulin corrections at all and only deal with the lows.

Thank you. Will look into all this.

 

[eventhorizon]

By 'manual phantom bolus' do you mean disconnecting the pump and delivering the bolus into the sink or whatever? Thanks for the tips.

No, leave it connected. But by giving a tiny manual bolus it will prevent Control IQ doing any corrections in the next hour.

 

[Herbie1972]

No, leave it connected. But by giving a tiny manual bolus it will prevent Control IQ doing any corrections in the next hour.

Fascinating, I had no idea. Thanks!

 

[Juicyj]

Also keep your weight up to date on your T Slim as this will impact insulin delivered too.

 

[Chas C]

I was having issues with what I thought was insulin a year or two ago only functioning for it seemed two days when using my stomach but my arms seemed fine.

I then noticed that the cannula's are supplied as 6mm standard but they are also available as 9mm. I moved over to 9mm for my stomach and still use 6mm for my arms, since moving my insulin functions for 4-5 days if needed.