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    • 14 hours, 29 minutes ago
      Greg Felton likes your comment at
      If you have T1D, have you ever dated or married someone who also has T1D?
      I fell in love with an insulin-dependent Type 2 20 years ago. There’s something terribly romantic about taking Lantus together at the end of the day.
    • 15 hours, 1 minute ago
      ConnieT1D62 likes your comment at
      Do you feel that your T1D healthcare provider understands the daily challenges and work that goes into living with T1D?
      One time I was explaining that a new pump would be too expensive at the time because my deductible had just started over.. and she asked if I had insurance and I said yes….. then she said “then it should be free with insurance.” 🤦‍♀️ She may know a little about the challenges of living with diabetes, but she knows nothing about how insurance works or how costly T1D supplies are.
    • 15 hours, 19 minutes ago
      Steve Rumble likes your comment at
      If you have T1D, have you ever dated or married someone who also has T1D?
      I fell in love with an insulin-dependent Type 2 20 years ago. There’s something terribly romantic about taking Lantus together at the end of the day.
    • 15 hours, 50 minutes ago
      Lawrence S. likes your comment at
      Do you feel that your T1D healthcare provider understands the daily challenges and work that goes into living with T1D?
      I am an RN. Been going to same doctor for about ten years. Took me six years to train him. I am very well read when it comes to my LADA. He trusts my judgement and gives me excellent parameters to make decisions. Recently had a bad case of Covid. Insulin needs changed dramatically. Getting back to normal but he made sure I had scripts to cover my ups and downs with insulin needs.
    • 15 hours, 51 minutes ago
      Lawrence S. likes your comment at
      Do you feel that your T1D healthcare provider understands the daily challenges and work that goes into living with T1D?
      Mine acknowledges the struggles and challenges that go along with managing T1D in my daily life. She gives suggestions as to what may or may not help and has often asked me I how I handle situations so she can give suggestions to other T1D patient's.
    • 15 hours, 52 minutes ago
      Lawrence S. likes your comment at
      Do you feel that your T1D healthcare provider understands the daily challenges and work that goes into living with T1D?
      None of my endocrinologists or NPs have had T1D but I always discuss my challenges and they are incredibly helpful. What I always find astonishing is they are constantly amazed at how well I’m doing even when i don’t think I’m doing that well because most of their patients have nowhere near the A1c’s I’m able to achieve. And just hovers in the 6’s!
    • 16 hours, 17 minutes ago
      Jubin Veera likes your comment at
      Have you developed lipohypertrophy due to repeated injections/infusions of insulin? Lipohypertrophy is a term to describe hardened lumps of body fat just under the skin that resulted from repeated insulin injections/infusion sites. If so, share how you’ve handled lipohypertrophy in the comments!
      The hard spots are fairly frequent with the pump infusion sets. Especially if I go past 3 days which I try to avoid! I don’t think I ever got one from injections. I try heat and massaging to treat them and they normally go away after a day or so. Once I had a large area that I had to treat with antibiotics.
    • 16 hours, 19 minutes ago
      Magnus Hiis likes your comment at
      Have you experienced any symptoms of physical sexual dysfunction as a result of having diabetes, or having diabetes-related complications?
      I’m 79. My last orgasm was springtime about 3 or 4 years ago. When I complained of ED, my PCP Rxd 3 to 5 (60-100 mg) sildenafil tablets by mouth about one hour prior to sexual activity. This alone hasn’t worked to bring me up to former sexual capacity that I had 10 years years ago. I’m still considering consulting finding a doctor who’ll prescribe a safe but effective way of administering testosterone or an anabolic steroid in a dose low enough to avoid causing cardiovascular problems but high enough to restore normal ability that I had up to my sixties. My present doctors say it can’t be done, but there are doctors who advertise otherwise. Analogs of the hormone insulin can be delivered in small safe doses, why not testosterone?
    • 1 day, 8 hours ago
      Becky Hertz likes your comment at
      Do you feel that your T1D healthcare provider understands the daily challenges and work that goes into living with T1D?
      We are all so very different, and trying to say that all of us with T1 understand what it's like for another who has the same hill to climb is unproductive. Having a health care provider with T1 may often be helpful just because there's apt to be more knowledge about the specifics. How we respond to the disease is such a personal matter, that I really don't think there are any guaranteed benefits beyond the grasp of the factual. Finding a doc with the same general attitude about the disease does feel good, and sometimes that's all I hope for after working hard to make peace with the disease for 70 years. Asking my doc to "get it" used to be almost my mantra, but I've come to realize that the ones who don't just see us as unruly childrenchildren
    • 1 day, 8 hours ago
      Becky Hertz likes your comment at
      Do you feel that your T1D healthcare provider understands the daily challenges and work that goes into living with T1D?
      Both my endocrinologist and my nurse practitioner are great. They compliment me on the way I take care of my life and health and make aure I get all the supplies I need managing all the paperwork Medicare and insurance requires. My nurse practitioner who works with me on managing the pump has her own opinion about the pump settings based on her technical knowledge which is different than what I do with my settings based on living with them. She has thru the years learned to respect what I do and is surprised with how my settings work. So we are now at peace. Both very supportive.
    • 1 day, 11 hours ago
      pru barry likes your comment at
      Do you feel that your T1D healthcare provider understands the daily challenges and work that goes into living with T1D?
      Yes. However, for those of you who assert, "It takes one to know one," the same might be said of age. Geriatrics is a marvelous array of marvels.
    • 1 day, 11 hours ago
      mojoseje likes your comment at
      Do you feel that your T1D healthcare provider understands the daily challenges and work that goes into living with T1D?
      I said yes but that refers to my nurse practitioner who sees me every other visit, if not more often. The doctor may know how hard I try but perhaps takes my efforts for granted.
    • 1 day, 13 hours ago
      Anneyun likes your comment at
      Do you feel that your T1D healthcare provider understands the daily challenges and work that goes into living with T1D?
      How can someone without the disease really understand what it is to live with it? I have never had a doctor with T1D in 60 years.
    • 1 day, 14 hours ago
      Bruce Schnitzler likes your comment at
      Do you feel that your T1D healthcare provider understands the daily challenges and work that goes into living with T1D?
      Yes. However, for those of you who assert, "It takes one to know one," the same might be said of age. Geriatrics is a marvelous array of marvels.
    • 1 day, 14 hours ago
      Kristine Warmecke likes your comment at
      Do you feel that your T1D healthcare provider understands the daily challenges and work that goes into living with T1D?
      My endo is young, very empathetic, thorough, always asks for my input, and does research. I am blessed too. have him, and the one before for over 25 yrs.
    • 1 day, 14 hours ago
      Kristine Warmecke likes your comment at
      Do you feel that your T1D healthcare provider understands the daily challenges and work that goes into living with T1D?
      Yes. However, for those of you who assert, "It takes one to know one," the same might be said of age. Geriatrics is a marvelous array of marvels.
    • 1 day, 14 hours ago
      lis be likes your comment at
      Do you feel that your T1D healthcare provider understands the daily challenges and work that goes into living with T1D?
      None of my endocrinologists or NPs have had T1D but I always discuss my challenges and they are incredibly helpful. What I always find astonishing is they are constantly amazed at how well I’m doing even when i don’t think I’m doing that well because most of their patients have nowhere near the A1c’s I’m able to achieve. And just hovers in the 6’s!
    • 1 day, 15 hours ago
      Daniel Bestvater likes your comment at
      Do you feel that your T1D healthcare provider understands the daily challenges and work that goes into living with T1D?
      My provider does not have T1. Only someone with it can truly understand the various daily challenges and worth it takes to manage this.
    • 1 day, 15 hours ago
      TEH likes your comment at
      Do you feel that your T1D healthcare provider understands the daily challenges and work that goes into living with T1D?
      My provider does not have T1. Only someone with it can truly understand the various daily challenges and worth it takes to manage this.
    • 1 day, 15 hours ago
      Lawrence S. likes your comment at
      Do you feel that your T1D healthcare provider understands the daily challenges and work that goes into living with T1D?
      I have no clue what my T1D health care provider understands about my daily challenges and I don’t know about his daily challenges either. Not sure why I should care as long as I have access to information how to best take care of myself.
    • 1 day, 16 hours ago
      Jeff Marvel likes your comment at
      Do you feel that your T1D healthcare provider understands the daily challenges and work that goes into living with T1D?
      My provider does not have T1. Only someone with it can truly understand the various daily challenges and worth it takes to manage this.
    • 1 day, 16 hours ago
      Richard Wiener likes your comment at
      Do you feel that your T1D healthcare provider understands the daily challenges and work that goes into living with T1D?
      My provider does not have T1. Only someone with it can truly understand the various daily challenges and worth it takes to manage this.
    • 2 days, 7 hours ago
      sweetcharlie likes your comment at
      Have you developed lipohypertrophy due to repeated injections/infusions of insulin? Lipohypertrophy is a term to describe hardened lumps of body fat just under the skin that resulted from repeated insulin injections/infusion sites. If so, share how you’ve handled lipohypertrophy in the comments!
      Hi Connie, I still have my glass syringe and show it off occasionally. We boiled the needle and syringe every morning and sharpened the needle with a file. I was diagnosed at age 6 in 1963. Life is so different now! Then, my diet was extremely limited as was my exercise. Now, I am very active and eat pretty much as I please. I maintain an A1C in the low 6s (6.2 was my last).
    • 2 days, 7 hours ago
      sweetcharlie likes your comment at
      Have you developed lipohypertrophy due to repeated injections/infusions of insulin? Lipohypertrophy is a term to describe hardened lumps of body fat just under the skin that resulted from repeated insulin injections/infusion sites. If so, share how you’ve handled lipohypertrophy in the comments!
      Connie and Beth, I was diagnosed in Nov 1962, age 10. During the early years I developed lumps and indentations on my upper thighs from my injections. In fact, I was able t o spot other t1 kids in my junior high school based upon the lumps in their upper arms.. (I eventually met up with them and learned that I was correct.) By the time I reached my twenties, these indentations had more or less disappeared, but I still have remnants of the lumps. I wish I could say that the layers of tissue now deposited on my legs disguises them, but they don't. I think the changes in insulin have been responsible for this improvement: the isolation and purification of animal insulins were refined, and then the various human clones were game changers in many ways.
    • 2 days, 7 hours ago
      sweetcharlie likes your comment at
      Have you developed lipohypertrophy due to repeated injections/infusions of insulin? Lipohypertrophy is a term to describe hardened lumps of body fat just under the skin that resulted from repeated insulin injections/infusion sites. If so, share how you’ve handled lipohypertrophy in the comments!
      Yes in my upper arms when I was a petite and skinny child in the 1960s with T1D. In those days we used glass syringes with stainless steel 1/2 inch long heavy gauge needles. My mother would jab me in the upper arms, it hurt like the dickens, and I developed several hard nodules. I was diagnosed at age 8 in December 1962 and after the initial two months of her jabbing me in the upper arms, I took over giving my own "shots" and started self injecting via site rotation in my thighs for several years. Eventually the lipohypertrophy in my upper arms resolved and I never injected there again until many years later as an adult on MDI using disposable syringes with very short and fine gauge needle tips. Periodically I would give my tired pin cushion thighs a rest and take a break for a few months or a couple of years and rotate injections in my abdomen or upper arms. Have been using a pump for over 20 years now and rarely use MDI unless I am taking a pump break for a short period of time. Happily, I no longer have lumpy sites.
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    If you currently use both an insulin pump and CGM, do you use any of the following automated insulin delivery (also known as “closed-loop”) algorithms to help keep your glucose in-range?

    Home > LC Polls > If you currently use both an insulin pump and CGM, do you use any of the following automated insulin delivery (also known as “closed-loop”) algorithms to help keep your glucose in-range?
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    Have you ever used expired glucose strips? If so, share in the comments whether you noticed any differences from unexpired strips.

    Sarah Howard

    Sarah Howard (nee Tackett) has dedicated her career to supporting the T1D community ever since she was diagnosed with T1D while in college in May 2013. Since then, she has worked for various diabetes organizations, focusing on research, advocacy, and community-building efforts for people with T1D and their loved ones. Sarah is currently the Senior Marketing Manager at T1D Exchange. Sarah and her husband live in NYC with their cat Gracie. In her spare time, she enjoys doing comedy, taking dance classes, visiting art museums, and exploring different neighborhoods in NYC.

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    28 Comments

    1. Brenda Pronschinske

      Meftronic system (smart guard) raised my A1C!
      It’s set to keep your blood sugar at 150! Aargh! There is no changing that so therefore I no longer use SmartGuard, not until Medtronic lowers the base rate to 100 but I’m afraid they are too late, better sensors and pumps out there now !

      6
      2 years ago Log in to Reply
      1. William Bennett

        I had the same result and the same complaint. So I went back to my old pager-style paradigm and Dexcom G6, which I prefer hugely over the Guardian CGM. I’m due for a replacement pump since back in March, but I’m down on the whole algorithm concept. If it works for you, great, but for those of us who already achieve tight control they can end up feeling like a straightjacket.

        3
        2 years ago Log in to Reply
    2. Lawrence Stearns

      I’m using Tandem X2, with Dexcom G6, and the Control-IQ system. Works very well. Set my own blood sugar level at 115. I wake up every morning between about 97 to 110, mostly 104.

      3
      2 years ago Log in to Reply
      1. Jneticdiabetic

        Wow! Now that’s precise!

        2 years ago Log in to Reply
    3. Larry Martin

      Medtronic Smartguard does not work for highs so I only use the low suspend. This thing should have never been released because my time in range is worse in Auto Mode. Basal units stop after a mealtime bolus and you end up so high the dribbles of insulin can not correct for usually 6 hours. I achieve 90% in range on my own so I stopped using Auto Mode.

      5
      2 years ago Log in to Reply
    4. David Smith

      I tried Medtronic Guardian but wasn’t impressed with either the algorithm or the sensor. Switched to Medtronic pump + Dexcom, entering my own boluses, but plan to change pumps to automate the process once my Medtronic warranty is up.

      2
      2 years ago Log in to Reply
    5. Nevin Bowman

      I have a Medtronic pump and switched to a Dexcom cgm because Medtronic’s was worthless. So, I can’t do any automated deliveries, but I had stopped before then anyway as Medtronic’s algorithms are not accurate.

      2
      2 years ago Log in to Reply
    6. Joan McGinnis

      I use tandem control IQ and dexcom g6. Just switched from basal in and was hesitant to give up the control I had over this but have found out that the algorithm is good and an endo who really understands well and communicates well is the best combination

      3
      2 years ago Log in to Reply
    7. kristina blake

      I use the Tandem/Dexcom G6 BIQ. I am quite aggressive in my Y1D mgt, and the CIQ targets are too high for me. With BIQ I still have temp basal I can use, lots of micro-dosing and I can correct when I deem it appropriate. While I hear that CIQ does tale a lot of the drudgery away for many people, I guess my preference to have my foot on the accelerator/brake pedals suits my personality better.

      3
      2 years ago Log in to Reply
    8. Mig Vascos

      I agree with many of the responders that the Medtronic sensors are worthless. They drove me crazy and was still checking 8-10 times daily while I used them.
      I went back to Dexcom starting with the G4. I’ve been on Tandem Control IQ for about a year and a half.
      I keep it on the Sleep Mode all the time. The goal on this mode is lower than the regular mode. The system works perfectly during the night. It’s a real blessing.
      During the day it’s not as great. I find there is a problem when it stops the basal at 112 and then later it falls short when you eat and then the bolus doesn’t cover the BG spike. So I turn the Control IQ off during the day at times so that if my bg is between 90 and 112 I don’t want my insulin to be stopped and get a high later on.
      As I said before is great at night when you are not eating or exercising. I’m grateful for a good night sleep.

      1
      2 years ago Log in to Reply
    9. BOB FISK

      Since I turned 65 and retired several years ago, my health insurance has been a Medicare Plus situation. I use a Medtronic pump, but Medicare only approves the Dexcom CGM system, and the Medtronic sensors are much too expensive for me to purchase. So, I am the robotic link between the pump and the CGM.

      1
      2 years ago Log in to Reply
    10. Jneticdiabetic

      Previously used Medtronic pump with Dexcom 4 CGM. A few years ago switched to the Medtronic Smartguard (670G) because it was the first and only “closed loop” option on the market at the time. I find I have greater time in range while in auto mode. It especially helps me avoid lows. I went hiking this weekend without any lows, manual suspends, or frantic carb ingestion needed, which is rare for me. While the Medtronic’s CGM technology has improved in recent years, I’d agree that the Dexcom CGM is much more user friendly (simple application, no blasted tape, no charging of transmitters, and fewer nonsense alarms). Switching from injections to a Medtronic pump on 2000 probably saved my life (in terms of avoiding severe lows), so I’ll always be grateful. But when my warranty comes up I’ll be researching all my options.

      1
      2 years ago Log in to Reply
      1. RobbyLee

        I was a loyal to Medtronic for many years (1999 -2020), but found their technology was lacking compared to other companies. I finally took the leap, and switched to Dexcom CGM with the Tandem control IQ pump. There are some user differences (ie, you but don’t need to use batteries but do need to charge the pump every 2-3 days, and some other more minor differences), but overall, it’s been a very positive experience for me. My control has markedly improved, and those blasted calibration errors on the 670G system are becoming a mere memory!

        2
        2 years ago Log in to Reply
    11. Bob Durstenfeld

      I love the Dexcom G6 with the Tandem’s Control IQ. It definitely lowers the mental management load. And like others, I love waking up to a BG between 100 and 110. It makes the day run much smoother.

      8
      2 years ago Log in to Reply
    12. Karen Brady

      I’ve been on Dex since 2015 and Omnipod since 2017. Just started Looping with a RileyLink in March. It’s not nearly as great as I’d hoped but it’s helped with overnight lows, and when it doesn’t lose connection at night I wake up with an in-range number which, as others mentioned, is huge. I wish there was a “smarter” system out there that learned our bodies’ patterns and was less prone to user error.

      2 years ago Log in to Reply
    13. Janis Senungetuk

      I’ve been using a Tandem t:slim X2 with the Control IQ app for the past year +. I’m very happy with the results.

      3
      2 years ago Log in to Reply
    14. Maureen Helinski

      I love the Tandem IQ/Dexcom G6 combination. I even forget I am diabetic sometimes and begin to eat. My A1c has been 6.1 for a year or so.

      2
      2 years ago Log in to Reply
    15. Kathryn Keller

      My daughter uses loop. We were originally on tandem, but she was too young when Control iq came out so, we decided to try Loop. She loves the omnipod now, so doesn’t want to go back. It is nice that I can set overrides from home when she is at school to try to keep her in range.

      2
      2 years ago Log in to Reply
    16. Bonnie Lundblom

      I use the Tslimx2 pump and the Dexcom 6 but because my Dexcom readings are frequently so inaccurate Tandem told me I can’t use any of the algorithms. I’ve talked to Dexcom many times about this and they recently told me that the CGM 7 will have differences with the sensor that may help. I’m thin and have read a few comments on this site from parents with small children describing problems with accuracy. I’m not sure how long Medicare will wait to change all of us on the 6 over to the 7.

      2 years ago Log in to Reply
      1. KSannie

        I am thin, BMI 20.5, but have no problems with the Dexcom being accurate.

        1
        2 years ago Log in to Reply
    17. Rebecca Lambert

      I previously used Medtronic closed loop, but was not happy with the higher targets used by the algorithm.

      2
      2 years ago Log in to Reply
    18. Adam Wright

      On omnipod dash so waiting for the overlord FDA to allow Insulet to release their loop system.

      1
      2 years ago Log in to Reply
    19. Isis Gregory

      I have a 670g. Tried auto mode for a few months. I think I do a better job myself so I don’t use it.

      1
      2 years ago Log in to Reply
    20. Becky Hertz

      I use Tandem t: slim and Dexcom G6 but neither CIQ or BIQ. As others have said, the Dexcom isn’t as accurate for me as I’d like in order to go hybrid closed loop. My biggest issues are in the low end where my bg is frequently lower than the Dex reading. 20 points (not percent) might not make a difference above 100, but is quite more significant the lower one gets.

      2
      2 years ago Log in to Reply
    21. Brandon Denson

      I have used algorithms and open APS before.

      2 years ago Log in to Reply
    22. BARRY HUNSINGER

      I used to use the Medtronic auto mode system. I found it to be extremely annoying with all the alerts etc. It also kept my BG higher the 120. When I transferred to Medicare I found they don’t pay for Medtronics CGMs. It took six months to get approved for the Dexcom 6 CGMs, they don’t work with the Medtronic 670g pump.

      2 years ago Log in to Reply
      1. Nicole Alexander

        Agree Medtronic auto mode keeps my sugars elevated too, I hate the alerts.

        2 years ago Log in to Reply
    23. Tom Riffe

      Love my Loop App, 2007 Medtronic Pump with Fiasp Insulin, Dexcom G6, Riley Link that adjusts basal every 5 minutes to bring me towards my target of 100. Don’t love you need a Mac to download Loop app on iphone once a year.

      2 years ago Log in to Reply

    If you currently use both an insulin pump and CGM, do you use any of the following automated insulin delivery (also known as “closed-loop”) algorithms to help keep your glucose in-range? Cancel reply

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