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If you use an insulin pump with automated insulin delivery, how satisfied or dissatisfied are you with the target glucose level setting options for your system?
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I use Aaps and its great
Carlos, what are Aaps?
I chose dissatisfied because I assumed the question was referring to commercially available systems. I use diy Loop and am very happy with the target there. Until commercially available systems can have lower targets, I will continue to not choose them.
Right on!
I use DIY Loop and am very satisfied with my target glucose. I would not be able to use as low a target in a commercial system.
My pump has that but for now only guards against lows. It does an ok job of that but my time in range with that ON dropped 30 points so it is turned off. The guards for lows are on but I manage the rest myself. My Time is range is in the upper 80s.
Works a lot better than if I try to do it Constantly fiddling with mini bolusrs, forgetting to check, discovering I’m super high or way low. Heck yeah, give me automation anytime!
I am currently using the Medtronic 670G and would much prefer a lower target glucose than its 140. I’ll be researching other options soon, as the warranty is up on this pump in August of 2023. Until then, I “micromanage” as my Endo wrote in my chart.
140 or 150 should be your high. But i’m Not your doctor.
I use Control IQ and would love to be able to have a lower target glucose and for corrections to happen at a lower level and more quickly. I do small corrections on my own long before the pump would. That being said, my TIR is around 90 and I don’t have too many lows.
Congratulations!
I used automode for several months. Worked great at times and will try again when the algorithm improves. Unfortunately it is to biased to how your sg was yesterday. I have a job where the activity level can be different from day to day and I am lazy as hell on the weekends. So on the weekend my sugar ran high the pump adjusted on Monday I would be hypoglycemic alot. No setting to say I’m not working today or vice a versa
Grey, can’t you input your work schedule into the pump algorithms? What’s the point of artificial intelligence and insulin pumps if they can’t accommodate such a simple variation? Please check with your tech team.
I would prefer 90 or 100 as a target on CIQ. I’m thinking of moving my son to DIY Loop for this reason.
What does CIQ stand for? I’m ignorant. And I admit also to being a fool of the Don Quixote Type. Does DIY stand for Do It Yourself?
My DIY Loop allows me to set target at 90-110.
I think it is important to trust those medical professionals involved with your care. That being said, it is also important to continue learning about diabetes related information. The more knowledge a person has, the better able to have a conversation with medical providers. I like to share my activities, habits, lifestyle information with my endocrinologist. I am fortunate that he is willing to consider my questions and provide his honest answers. It is my responsibility to listen, learn and to do those things everyone agrees lead to improved control like exercise and good nutrition.
I wish the commercially available systems (like Control IQ, which I use) would allow for a lower target but I understand why they don’t. As a result, I only turn Control IQ on at night and keep to a lower target on my own during the day.
Use only the Dex G6 And set Medtronic boluses manually. My experience with G6 false lows and not lasting 10 days tells me So far that I will never be able to use any kind of closed loop or auto delivery system. My last G6 completely failed after just 2 days refusing my attempts to calibrate
Switch to a tandem pump. It seems to be the choice of TIDs on this site.
G6 and CIQ makes me Extremely Satisfied, Best Numbers since 1963
Tandem x2 with Control IQ
Although very grateful to have “smart” pumps I think the algorithm is not very robust – hoping next generation will be better.
I tried 6 months to use the auto mode but I’m insulin sensitive and was never able to avoid lows with auto bolus corrections. I use 24 hr sleep mode which has a lower goal setting and manual corrections. The basal corrections work well for me.
I am satisfied with my Tandem X2/Dexcom G6 Control IQ system. But, like many of the respondents here said, I would like to be able to set my system for a lower target than the preset 115 on the Control IQ system. Overall, I’m happy with what I have.
Thanks for that info.
I answered yes, but it is totally misleading. I use a DIY system, and I can set the target wherever I like.
Use Tandem t:slim X2 w Control IQ app. My TIR is 85 -100% very often, but I would prefer to have a target glucose level at 100. The AID results are certainly better than when I was managing on my own, but I would like to be able to adjust the standard glucose level and IoB time for me.
I answered “Somewhat satisfied”. I like Tandem’s bolus settings where you can set the target BG for insulin dosing. However, the ControliQ feature has a fixed target of 140 with autocorrections. I prefer a 90-110 target so auto-basal adjustments would happen sooner. Sleep Mode targets 110 BG but does NOT do autocorrects. Basal settings are flexible for Sensitivity and Carb Ratios, etc but the activity insulin of 5 hours counteracts the nice basal adjustments in ControliQ.
For almost 30 years my goal for managing my diabetes is to aim toward 100. I have been able to maintain my A1c in the 5s consistently with a fair amount of micromanaging. The pump has not changed that because I have to work against it to point my numbers toward 100. The micromanaging is the same or possibly even more. I think I preferred basal iQ but can’t go back. But I am making do. And I am thankful for the efforts of these companies to keep improving the technology and make T1D easier to manage. The FDA perhaps needs to get on board especially since there are so many people that are choosing unapproved algorithms so that they can have more license to set their own parameters. I would love to go on the “do it yourself” setups but don’t have the tech confidence.
As long as the algorithms have a target beyond what is normal, I will be dissatisfied.
A target that is too high for me is why I stayed with BIQ and did not change to CIQ. I set my target at 80. I also make use of temp basals (both increase and decrease) and prefer to do my own corrections – taking into account the direction of the trend arrows, my knowing what I will be doing for the next few hours and whether or not I still had FOB (food on board).
Satisfied however I wish there was a way to set my pump more aggressive for insulin resistance.
Good point. Thanks.
Thanks to all of you I have many questions before I go on the new omnipod or tandem. I am concerned about set targets being too high I strive to keep no higher than 110 so these will not be a good fit for me.
Tandem in sleep mode’s target is 110. It doesn’t do auto bolus but adjusts basal to keep it around 110. I’m able to stay under 110 for the most part, but have gotten as high as 130- still learning how to dose for protein/fat. I don’t know about O5 yet as my son isn’t able to upgrade yet. But I’ve heard with DIY looping you can set a lower target. My son and I plan on setting this up for him in the next few weeks.
The Tandem system is great, even with the 120mg/dl target. I usually start my days closer to 100.
I keep my A1C at 4.8 using multiple daily injections. Are there any people on a pump at that level? I find the ADA standard of care woefully inadequate and have fired every doctor who has told me my A1C should be higher!
Many on pumps are at that level, yes.
Thanks for your response. Yeah, I grew up with the ADA exchange high carbo but, my brother turned me on to Bernstein, a diabetic who became a doctor. Available in books and YouTube. I ignore supplements unless prescribed by my doctor or a specialist in regenerative medicine.
I am somewhat satisfied with the Tandem CIQ. I would prefer a threshold higher than 90 for insulin delivery pause in sleep mode because I’ve experienced too many night time lows. The insulin duration needs to go higher than 5 hours or include an algorithm that takes into account how much insulin was bolused. My experience has been that the higher the bonus the longer the insulin remains active and pausing insulin delivery will not necessarily prevent hypoglycemia.
I wish the Control IQ system would let me set it a bit lower. However, my A1c is better than ever with the system and my mental management load has been reduced.
I’m very satisfied for the pioneering AID system, only updatable pump until recently. Of course it’s not perfect, and I long for the past when I didn’t have to be my own pancreas. People will complain about anything new to them, but I’m grateful to have it! (And pumps are covered by insurance or they’d be impossible for most of us.
Would like my Minimed 670G/GL3, which is set at 120, to be able to be lowered to 90-110, which is the ‘normal’ BG range.
I started using Loop_dev with Omnipod Dash about a month ago along with my iPhone. Not having to carry a third device around is very freeing. While it’s involved to set up because its a DIY build and install of the software, the AID capabilities are extensive, allowing not only very wide target glucose levels, but every parameter desired. It’s not for the faint of heart, and the learning curve is steep, but doable by many, if not most that are willing to learn.
I need to set the target higher than the 120 max allowed.
I am satisfied with my BG control but not able to adjust much. I am using a Minimed 770G for a year abd a half and have had the best A1c levels since my Dx. Waiting for the 790G to have more control loop gain (more basil insulin delivery) for the next step. Come on Minimed & FDA! Lets get on with it.
Many people wish they could set a lower target on CIQ. But I actually wish I could set two different targets for daytime and nighttime. I cannot sleep when my blood sugar is below 110, so a target of 110 is too low for nighttime. But I, like others, would like to set a lower daytime target, closer to what a non-diabetic experiences during the day, maybe 90-100.
One reason why I haven’t considered any of the automated delivery systems is the target range. I have my high alarm at 115 and try never to be higher than 125.
I use the Tandem X2 with CIQ. The targeted BG is stated to be 6.1(110). I find it works amazingly well over night looking at my history over the last 14 days my am BG has been between 4.9 (88) – 5.7(103). My problem is I am frequently hypoglycemic with CIQ during the day even with the active setting on. Unless I’m sitting at a desk or computer all day I must be on manual and reduce my basal by 30 – 50%.
Being on a pump for a very long time (39 years), mostly Medtronic, where I made all the changes without having to call my Doctor/CDE, I find that the Tandem pump Control IQ is slow in response and designed for “New Bees” and I am not sure that the “T” Slim, (Tandem X2 pump) controls “Stacking”. However, it does a good job in sleep mode. Exercise mode, not so good.
Thanks for this info.
I’m on the tslim but have yet to go to CIQ
Started Omnipod 5 last week. I do wish that I could set my target closer to 95, 110 is the lowest. It’s still in its learning phase, so it’s hard to judge at this time. My TIR was 85% instead of my normal 90% for the week. I will consider Tidepool’s Loop when/if it gets FDA approval.
I said somewhat dissatisfied. On Tandem CIQ and I wish my target could be lower. I also wish the threshold they use for autocorrections was lower. I’d rather it kick in if I’m going to be above 160. Although, I think it would have to be using shorter acting insulin with a shorter active time for those controls to be any more precise. 🤷♀️
There is always a tradeoff between lower targets and thresholds, and potential for more hypoglycemia. That is the safety feature systems have to consider to get thru FDA, but also, to not cause harm from increased lows.
I’d love to switch to one of the FDA approved systems, but while pregnant I need my target ranges to be lower than they allow. I don’t love the DIY nature of my current system.
I understand why they have to do this, but I hope in the future those systems will change!
My insulin pump does have the option for automated insulin delivery. I have tried two versions of it (original for when I got my pump, plus one updated version on the same pump), but I was very dissatisfied with the target glucose of both. 120 mg/dl is too high!! As a result, I stopped using this feature.
I use Tandem/CIQ and it would be nice to be able to adjust the target (so I can drift a little high when I know I will be exercising).
I am satisfied but would like to have the flexibility to reset to 100 at night, now is 110 all the time, CIQ.
I don’t use that type of pump