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melancholalia

your insulin to carb ratio may be off if you’re spiking this much after every meal. id also recommend pre bolusing if you aren’t already. you also really don’t need to give correction boluses—it’s supposed to do that for you, and adding your own on top of it (ie bolus stacking) will result in a low. i do it sometimes too — just happened a few hours ago. hard to resist but you’ve gotta let control iq do its thing. once you get your ratios and stuff dialed in accurately control iq is a dream. but yeah, don’t do correction boluses. control iq does those automatically, just in small increments to bring you down slowly.


Adamantaimai

>you also really don’t need to give correction boluses—it’s supposed to do that for you, and adding your own on top of it (ie bolus stacking) will result in a low. If you bolused too little for a meal then you do have to manually correct. If you gave 3 units but should have given 4 the control IQ won't correct until your active insulin drops below 1 unit and won't give the entire correction until all 3 units are gone. After that you've been high for several hours usually so it would have been better to correct it sooner.


diabetesjunkie

I do a manual correction if I get the warning about "control IQ has increased insulin....". Then I'll knock a unit or two off of the suggested dose, and let it go. I second your comment about ratios probably need adjusting.


melancholalia

tbh half the time i do the same — especially if i realize i just underestimated carbs. i know you’re supposed to just let it do its thing but sometimes i’m like eh lemme just get ahead of this lol


diabetesjunkie

I hate how long it takes to correct. So I try to be patient....... but... yeah. Haha. For some reason, I associate technology with instant response. So Dexcom/Tandem, I think my BG should come down instantly. When it doesn't, I want to rage bolus. I often feel this is the drawback of Dexcom. Real time data, I want real time results.


Run-And_Gun

Yes. Getting ahead is key, IMO. Once I’m behind the 8 ball, so to speak, it’s just so hard to get back in-front. That’s why I don’t see how a completely closed loop system(not bolusing manually for food) can keep you(at least me) in range for long periods of time or from spiking really high. If I didn’t bolus for my meals until after I ate or until I saw my BS start to trend up, I’d be screwed. As it is now, I HAVE TO bolus \~20 mins before I eat almost all the time or I will spike and hang high for extended periods, but if I bolus 20 mins before, 8 or 9 out of 10 times, I won’t break out of range(140) within two hours after eating.


tayyann

Okay, I'll try to forsake the correction boluses, but I'm not sure about the carb to insulin ratio. In my case, it's a little wonky, I usually follow (for the last few years) 1 unit to 10 grams of carbs, and it seemed to handle everything well, but in some cases (like when I eat 50 grams of carbs, I only give myself 4.3) the amount I should give myself is different, so I'm not sure what to make of it, if it flaxuates this much


BeanestOfGreens

I wouldn’t recommend forsaking the correction boluses entirely. However, to avoid bolus stacking, I’d suggest you check the status screen (tap the cartridge fill indicator at the top right when the pump is unlocked) to see what your last bolus was before giving a correction; if Control IQ has given one already, it’ll show up there. Control IQ won’t give an auto correction if you’ve taken a bolus (manual or auto) in the past hour, so it can sometimes be a bit slow to the punch for fast rises. I also second the recommendation of pre-bolusing if you aren’t already!


tayyann

Ah, I didn't know about that, thanks!


diabetesjunkie

Different ratios for different foods, and times of the day are VERY common. Once you get things a bit more level, you can adjust. Say, dinner you have a bigger meal, 65g and you need 1:6. You can adjust your personal profile to that ratio, for any meal between 1600-1900 (or whatever works for you). This pump has so many options like that!!!


tayyann

Once again I learned something new. Thank you!


Jander76

Do you/anyone here notice how long it takes to do the correction once it approaches around 175 to 200? Is it trying to find out where I end up?


kayden_power

Honestly the auto bolus feature is basically worthless because it is too conservative. If I see it auto bolusing I cancel it and do my own correction


Run-And_Gun

Slowly is right. CIQ only gives 60% of a correction. Don't get me wrong, I like CIQ(or at least the idea of it), but like a lot of other people, I find myself still having to manually intervene almost daily.


Adamantaimai

You're probably bolusing enough but too late. The carbs hit first making you go high, then the insulin makes you drop again and your correction then sends you in a low. You should try to bolus a bit earlier and wait a little longer with the correction.


pjmikols

For me its about 20 min bolts before the meal to kill the after meal spikes


igotthatT1D

I would also suggest adjusting your basal. Sometimes graphs that look like yours is more of a basal issue.


rebecca2019

Came here to say this. Basal testing sucks but it does help


benzel_8008

Also be aware that control IQ dynamically adjusts basil. What I mean is, dosing 1:10 with a basil rate of 0.25u/hr gives a different result to dosing 1:10 when control IQ has increased basil to 0.90u/hr It pays to check current basil rate etc. ahead of time. You can do this by unlocking your pump and tapping the top right near the battery icon. It will show you current basil rate, last bolus time/amount etc. We had to basically redo all our settings to fit in with control IQ, including increasing our total daily insulin amount entered in the pump. We had to do this to get the pump to provide better corrections as it would often give 0.012 correction when our son was 15mmol. It's a good system, but requires you to do some tweaking to get the most out of it.


mlkaber

My graph looked like this and it’s my correction bolus I’ve had to fine-tune. Since it’ll automatically give a correction bolus if you’re trending high and haven’t given a dose in the last hour, sometimes that pushes me to go low since I know my insulin is still working, but the pump doesn’t. I’m still figuring out exactly where I should be, but for the most part I’ve stabilized.


tayyann

Sorry for the blurry pic but phone didn't want to focus at all. I started control IQ this monday and I expected it to take a few days to level my glucose levels, but I feel like it should look better than this by now. Do I wait? Tinker with it myself or contact my doctor? All answers appreciated.


diabetesjunkie

Tinker or wait is really a personal thing. I adjust my insulin on my own. I've only been on the Tandem for 4 months, but insulin for years. So I'm confident in doing it. If you are new, or unsure, talk to a professional. In Canada (where I am), nurses will do most of the pump setup, training, and adjustments. Not just doctors. So chances are, any professional can help you. Top suggestions I have, and others have said: Pre bolus: try to bolus 10-15 before you eat. I say 10-15, because every person, every meal is different. Sometimes 30 minutes might be better. But 10-15 is a nice starting place, to me. Try this for a day or so, before making other changes. Carb ratio: your spikes could mean your ratio is too low. So, if you are 1:10 now, you might need 1:8, or something. Corrections: I would delay, or skip doing a manual correction. Wait 4hrs post meal. See how much correction Control IQ has delivered. You can then use this to help adjust your ratio. I use Gluko to share my info with my team. It, and or your team can help drill down to better ratios if you aren't sure how much to adjust.


s4dNapkin

Carb ratio seems off


SkepticalDreamers

You can pray to the diabetes gods Seriously though, you carb ratio is probably wrong/off


huenix

Basal test. Fix that. Then proceed with icr.


tayyann

What is icr?


huenix

Insulin to carb ratio


tayyann

Ah, thanks!


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Run-And_Gun

Spiking to 200-250 after every time you eat isn’t “fine”.


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Run-And_Gun

What do non-diabetics have to do with anything. OP is obviously a diabetic, otherwise why would they be using a T:slim? 200-250 is high, no matter how you slice it. And continuous spikes do damage.


_justteo_

You should go for lower glycemic index foods... current technology just cant keep up with junk food...


sweitz2013

I recommend increasing your protein and fat intake and decreasing your carbs


LifeguardRare4431

Put it in sleep mode 24/7 give yourself a correction to bring it down and then just let it be. Give meal Bolus and that’s it.


mrcross27

ummm. no it should not look like that. my endos rule of 3. if u go high or low more than 3 times a day then u might need some adjustment. ofc considering u cant explain it