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If you use a pump that has an automated insulin delivery algorithm (e.g., Tandem Control-IQ, Medtronic SmartGuard Auto Mode, Omnipod 5 SmartAdjust, etc.), when do you usually turn off the algorithm, if ever? Feel free to share more about your schedule in the comments!
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I tried the algorithm on my pump, but found I can keep tighter control without it. So, I stopped using it completely and have no plans to go back to using it, or any other algorithms.
I finally got my Omnipod 5 (YEAH! After months of fighting with my federal employee health insurance company, and am going next week to meet with my diabetes educator to learn how to use it. I have been waiting my whole life for this system and am very excited.
I always turn it off for my runs and set a temp basal – CIQ is terrible for endurance sports.
Dan, do you lower your basal for sports? How much and for how long? If you don’t mind my asking! I have trouble with my sugar dropping after about an hour of working out hard, even when on ‘exercise” mode.
Robin, apologies for interceding ……… your query is a prime example where you can’t set pump the same as anyone else …. usually to start ….. got to exercise mode two (2) hrs prior activity, set exercise mode to anticipated percentage less insulin ( 50 % ??) Trial & error is the best method to prove proper settings….. NOW … remember that each exercise is percentage wise different , along with time of day / ambient temps etc. The list goes on. Best wishes going forward.
Robin –
Like Don said, it takes a lot of trial and error. I eat right after my morning run, so dropping after the run isn’t much of an issue for me.
Agree!! Itās fine for tennis but I have to do temp basal for long hiking days.
Me too; CIQ exercise mode is not enough, even when started 1-2 hours in advance.
On the Omnipod 5. I only switch to manual mode when my Dexcom sensor is warming up or behaving badly (on it’s first day)
I do this as well – turn to manual mode for the first night with Dexcom when it’s always off. And I switch to “activity” mode when I swim laps.
Rather than shutting Smartguard off on the 770G, it shuts itself off and goes out of auto mode when you donāt even know it, likely due to needed calibration or BG processing. This is a clear drawback of the software of this system, although itās the best pump they have ever made. Wait for the 880G..a game changer.
When exercising, swimming, taking a ling bath i do not want the pump to give me any insulin
I answered, “Regularly at certain points during the day.” I don’t actually “turn Off the algorithm.” When I go for a run (which I’m going to do as soon as I finish this message) I remove my pump from my body and stick it into a drawer until I get back from my run. I drink a protein drink before my run, which gives me more than enough glucose/protein to maintain my blood glucose until I get back home. When I finish my run, I reattach my pump, and I’m good to go. I use a Tandem X2 with Control IQ, using a Dexcom G6 sensor.
I turn it off when I am pregnant because of the stricter goals. I wish it was possible to adjust the targets with Tandem Control IQ! I do turn it back on when I am not pregnant, primarily to help prevent lows (not as helpful for preventing highs IMO)
I use AID full time. I have profiles for sleep and exercise that the t:slim x2 invokes (for sleep) and I invoke when exercising.
The primary time my algorithm is turned off is to recharge the transmitter for the sensor.
The constan nagging during the recharge times is annoying and could be easily fixed in the SW. Just ad a query about recharging the transmitter and wait 45 to 50 minutes.
As Jeffery pointed out, it can also drop out of the algorithm occasionally requiring yet another calibration. I too am wating for the 780G pump. Come on Minimed & FDA!
The only time I am not using the algorithm is if there is a communication issue. This sometimes happens when I am sleeping and laying on the sensor.
I turn mine off if prior to exercising my sugar is trending up as I want, and I don’t want a bolus given. I turn it back on when it’s stabilized so when I go low, it will slow it down or shut off.
Yes, I do this too sometimes.
I keep it off always.
My Endo and I have tried, it does not work for me and my needs, unfortunately. The upper limits and targets are too high, the suspends way too long. It caused roller coasters I never experienced before. We just have to wait until we’re allowed to customize the settings.
I have only turned mine off a few times (maybe 3-4 times?) that I have had my pump. I got my pump in 2019. I unfortunately have to turn off my Tandem algorithm if I use the temp rate for insulin basal. It would be nice if Tandem would change the necessity of turning off the IQ when using a temp rate. I definitely would use the temp rate more often if that wasn’t required.
I only turn CIQ off when Iām basal testing. I do stop all insulin when Iām taking a shower and going for a swim.
I have the omnipod 5 and I tried using the algorithm for three weeks. I kept waking up at 150 which is way too high for me. Now I manage my basal rates on my own.
I don’t stop using Control IQ exactly, but I do put it in Sleep mode to avoid stealth boluses during exercise and I remove my pump completely when I’m in the ocean.
I have Tandem X2. I usually do not turn off the algorithm except during the night If I wake up with a low. I will record my carbs in the pump. However, the algorithm will see a rising glucose and give me more insulin which made me go low again. I’ve learned if I go low during the night i turn off the algorithm.
The issues with CIQ having targets that are too high and not being aggressive enough in corrections, and the loss of the temp basal function are among the reasons I am staying with BIQ. I do better when I am “in the driver’s seat”. I do value the BIQ stopping basal when the algorithm predicts going too low.
I manually bolus all the time to override Control-IQs too small corrections. Works pretty well.
This is to reply to Amanda Barras. My range is really tight 60-120. CIQ , having to override etc, is more work than manually managing corrections that BIQ affords me. I can also give a mini-correction and have an increased temp basal to get things done faster.
I turn off insulin delivery while at the gym. Other than that , Tandem’s Control IQ works great.
I chose never. However if I were to ever be put on a steroid medication I would know that Iād have to turn off CONTROLIQ for a higher temp basal.
While I was on steroids I added another profile for an increased basal rate during the time I’m on them. Plus I take an injection Novolin R at meal’s and 30 min. before IV infusion of it. Once I started this, my sugar’s went a little high at times but not like before where I’d stay above 300.
I’m just now recovering from a steroid injection a week ago. Amazed by how much higher my BG was by the time I got home. I used a “Cortisone” profile with 30% higher basals and 2X meal boluses. My average BG for the week was still almost twice normal, but I was afraid to be more aggressive with insulin without knowing when I’d stop needing extra. On the other hand, my knee feels great š
My son is ten, and has been on the Tslim for three years. We started with Basal IQ which is in all the time. We never set up Control IQ. We have two periods of the day, one in the last few hours of the school day when our son is known to spike. Finger stick shows that, during these times, Dexcom has been known to āovershootā by up to 100 points. As our sonās BG usually comes down on its own, we cannot risk the pump giving even a small percentage of a correction.
That’s what I need to do, but haven’t started yet
When I need to administer a correction bolus above what the algorithm would administer or won’t administer. It also turns itself of when I’m changing sensors because of the length of time required to charge transmitter and go through initial warm up period.
I turn it off when my sensor occasionally is giving me totally in accurate readings over a significant period of time while I am either trying to get it calibrated or deciding to replace it. Especially when itās telling me my blood sugar is 40 or 50 and Iām really in the low 100s. if I leave control IQ on it will keep the pump suspended and then my blood sugars will go high. I also experimented with turning it off during a recent preparation for a colonoscopy but finally got it figured out that I needed to set a profile for 50% of normal and then turn control IQ on. However this was a huge challenge as my insulin needs quickly returned to more normal levels after the prep and just before the procedure. Not anxious to do this again anytime soon.
I use Control-IQ at night and when I’m at home not moving around too much. If I’m working around the yard, walking, biking ……… I will always become hypoglycemic with CIQ even in exercise mode.
Tried it (670G), hated the loss of control over pump functionality, inability to fine-tune, basically a pump that says “you’re too dumb to handle this” under the guise of “it does everything for you!” So I went back to my dumb old pager style paradigm. I’ve since become eligible for a new pump (again) and looked into it, and I see some improvements. But the basic concept seems the same. The new ones have lowered the “target,” but it’s still hardwired and not subject to Doctor–let alone user–adjustment. I can do better on my own with a manual pump.
When my pump is disconnected when I want to take a nice long hot bath I turn off the CIQ as suggested by my Tandem trainer.
When I just Stopped Delivery it would alarm, alarm, alarm!
Thus totally ruining a relaxing time!
Historically the “target” range for the MEDTRONIC 770 is 120, my goal is much lower. My days are so inconsistent the algorithm has no chance to “learn” me, but my lower limit is set to 70. Meaning I get an alert at 70 and I can react, at 65 it suspends the basal dose. Doing this my last a1C was 6.0, for 3 years sat in the 7’s otherwise.
Many factors. In particular, I turn it off when my pump is suspended, Dexcom is acting up and my blood test is actually higher than Dexās reading. I turn it back on when Dex is working properly.
I have a Tandem X2 pump and use control IQ all the time, If I want to do a correction way before Control IQ does it, I just do it. Been wearing a Pump for 40 years. I am the Control of the Control IQ.
I hardly ever turn off the algorithm but, I recently encountered a G6 sensor just applied in the evening. It began waking me up with false lows (60mg/dl and below to 40 when finger-pricks showed readings in the 130’s over a 2 hour period.) By 2 am, I’d had enough but did not wish to start a new sensor until the morning (Medicare keeps a very tight rein on the number of sensors they will pay for and I did not wish to have to change sensors in the middle of the night.) I turned off the insulin delivery algorithm and ripped off the faulty sensor to get a good night’s sleep (what was left of it). I applied a new sensor the next morning and turned the algorithm back on. I did call Dexcom and they replaced the faulty sensor. I use the Tandem t:slim X2 with Control IQ and have created numerous personal profiles to accommodate exercise days and illness days. I LOVE this pump!
I use Medtronic auto mode (770g) and turn auto mode off every morning, give around 1 unit then turn it back on- otherwise my sugar rises too quickly for the algorithm to catch it because of foot on the floor
I turn off control IQ at 1 hour before and during a long cycling event, run a temp basal, and manage things manually. I donāt want a correction bolus or basal if I am predicted >180, because that extra insulin will cause a rapid crash.
Occasionally to use a dual bolus setting
The op5 algorithm was not aggressive enough for me so I turned it back to manual mode.
With the control IQ, I always use the algorithm, with the Medtronic smart guard, I had to shut it off almost 50% of the time.
My Medtronic 770G has Auto Mode, but I don’t use it at all because it won’t target 100 mg/dL.
Sometimes the Dexcom is so far off, the pump stops delivering because it thinks my blood sugar is low, but in reality it is not. I need to stop the Control IQ in order to receive insulin.
If my blood glucose is out of range for more than 2 hours, I turn off the algorithm until I can bring it back around.
Was necessary to be on steroid for a few days. Usually have to adjust for it. This time however with the Medtronic SmartGuard handled it! Worked like a dream!
I have never turned off the algorithm on Tandem or on my Medtronic pump before that. I have not understood the need to turn off the automation.