t:slim x2 extended bolus

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bigbird42

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Type 1
Hiya, I've just switched to the t:slim x2 but I'm just really struggling with the extended bolus. My problem is, between 2 kids, 4 ponies and 12h shifts, I am not getting my (fully carb loaded) meal any time before 9/9.30. Historically, with the Medtronic, I used the dual wave option over 5 hours. I have tried splitting the bolus into 2 'extended' sittings but that sometimes means I have to stay awake until 11.30 to do my second bolus and with a 5am start, this is killing me. Or I do a one hour then 2 hour extended bolus but again, it is forcing me to take on board insulin faster than my body can release the glucoses. I then crash, followed by spike - both of which alarm me repeatedly during the night. (Incidentally, I do not arm the sleep mode as this only makes everything worse). I then took off the control IQ at night but find myself still being woken by either too high to too low BG. I can probably tailor this but it rather defeats the point of a closed system.

Add to this, the pump repeatedly alarms to say I have lost signal. Yet the pump sites, facing outwards as instructed, in my bra. I can't get much closer than that!! I spoke to Air Liquide about this as it happen from day one. They told me to change sensor, which I did. After 24h it settled but today (Sunday) it has alarmed about 6 or 7 times during to lost signal.

Suffice to say, I am feeling exhausted and more than a little bit down about things. I don't mean to sound ungrateful.....as day time, (and signal loss aside) this pump is the best thing ever, but I dread and hate the nights as I get woken at least 4 or 5 times and am decimating my glucose tablet and nutrigrain bar supplies. I just cannot seem to get it to match my lifestyle. Help!!
 
Sorry you are having such a rough time with the tSlim @bigbird42 :(

Some of the limitations built into the system do seem a little bewildering don’t they?!

I hadn’t even realised that extended boluses were limited to 2hrs and having looked around the menus I can’t see a way of making it any longer. 2hrs is as long as I’d generally use, and often shorter, but I know I’ve used much longer when on Medtronic pumps.

Must be so frustrated to be backed into a corner knowing you have had a strategy in the past that worked for you.

Sorry to hear the sleep mode isn’t working for you either - that’s been amazingly successful for me - especially if I can take my last bolus before 7.

As for the lost signal alarm - that doesn’t sound right to me. as long as my pump is on the same ‘side’ as the arm that has the sensor, mine almost never complains about a signal loss!

I wonder if your tSlim has an issue with its anntenna?
 
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everydayupsanddowns said:
Sorry you are having such a rough time with the tSlim @bigbird42 :(

Some of the limitations built into the system do seem a little bewildering don’t they?!

I hadn’t even realised that extended boluses were limited to 2hrs and having looked around the menus I can’t see a way of making it any longer. 2hrs is as long as I’d generally use, and often shorter, but I know I’ve used much longer when on Medtronic pumps.

Must be so frustrated to be backed into a corner knowing you have had a strategy in the past that worked for you.

Sorry to hear the sleep mode isn’t working for you either - that’s been amazingly successful for me - especially if I can take my last bolus before 7.

As for the lost signal alarm - that doesn’t sound right to me. as long as my pump is on the same ‘side’ as the arm that has the sensor, mine almost never complains about a signal loss!

I wonder if your tSlim has an issue with its anntenna?
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Thanks so much for responding. One thing I haven’t done is have the pump the same side as my sensor- have moved it today so fingers crossed!! And will just need to eat less pizza!
 
Sorry I can’t offer any suggestions, I didn’t know that extended boluses were limited to 2 hours either, that seems a bit rubbish (the old Accu-chek pumps could do up to 12 hours!). I don’t know that I’d want to turn Control-IQ off just to get a few extra hours either, that would bring its own problems as you say. I hope you can work something out.
 
Sally71 said:
Sorry I can’t offer any suggestions, I didn’t know that extended boluses were limited to 2 hours either, that seems a bit rubbish (the old Accu-chek pumps could do up to 12 hours!). I don’t know that I’d want to turn Control-IQ off just to get a few extra hours either, that would bring its own problems as you say. I hope you can work something out.
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It can be extended for 8 hours look at the link I provided.
 
Sally71 said:
Sorry I can’t offer any suggestions, I didn’t know that extended boluses were limited to 2 hours either, that seems a bit rubbish (the old Accu-chek pumps could do up to 12 hours!). I don’t know that I’d want to turn Control-IQ off just to get a few extra hours either, that would bring its own problems as you say. I hope you can work something out.
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Thankyou - think I need a shake up!!
 
Pumper_Sue said:
It can be extended for 8 hours look at the link I provided.
Click to expand...

Interesting! Probably why most of us o started on Basal IQ hadn’t clocked the 2hr limit on Control IQ.

I wonder if that means you could deactivate CiQ, set your extended bolus running for the extra time, and then reactivate CiQ while the bolus was running?

That would be a handy workaround (though a bit of a faff)
 
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everydayupsanddowns said:
Interesting! Probably why most of us o started on Basal IQ hadn’t clocked the 2hr limit on Conteol IQ.

I wonder if that means you could deactivate CiQ, set your extended bolus running for the extra time, and then reactivate CiQ while the bolus was running?

That would be a handy workaround (though a bit of a faff)
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Other option is to just to bolus what you need up front and extend your basal with the remainder over 5 hours
 

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bigbird42 said:
Found it but it says (and I’ve found) that when control IQ is on it’s limited to 2h (see photo)
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Reading this thread, my understanding is that you can override the 2 hour limitation by switching off Control IQ temporarily.
I am not a t-slim user and agree that the limitation is rubbish. Is it worth contacting t-slim to understand why this design decision was made. I guess it could have an impact on Control IQ that we do not understand.

That said, whilst I understand having children and ponies has a huge impact on your life, please remember to look after yourself. Eating at 9pm and getting up at 5am is not ideal ... I am sure you know that. Remember to find time for yourself.
 
helli said:
Reading this thread, my understanding is that you can override the 2 hour limitation by switching off Control IQ temporarily.
I am not a t-slim user and agree that the limitation is rubbish. Is it worth contacting t-slim to understand why this design decision was made. I guess it could have an impact on Control IQ that we do not understand.

That said, whilst I understand having children and ponies has a huge impact on your life, please remember to look after yourself. Eating at 9pm and getting up at 5am is not ideal ... I am sure you know that. Remember to find time for yourself.
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You are so kind. Thankfully my horse is away for 2 weeks so I feel like i have loads of time! I’ll contact t-slim and see what they suggest. If I found any solution I’ll post it! X
 
Why not use TBR into early hours when eating late, do this myself on evenings when eating difficult meals like those with higher ratio of fat & protein.

Strange how extended bolus is just 2hrs, use Omnipod pump & bolus can be extended up to 8hrs.
 
Haven’t checked this with the Tandem suppliers, but our DSN told us that when you do a food bolus, the Control-IQ doesn’t make any adjustments for an hour and a half afterwards, presumably because it’s waiting for the food insulin to do its stuff and doesn’t want to start over correcting. How an extended bolus would affect this I have no idea, but maybe the 2 hour limit is something to do with that. You also can’t do temp basals with Control IQ switched on (because it’s basically doing them for you all the time to keep you in range). Personally I don’t think I’d want to be switching it on and off all the time but if that’s the only way you can get things to work for you then good luck. Hope you can find a solution that’s a bit less fiddly!
 
nonethewiser said:
Why not use TBR into early hours when eating late, do this myself on evenings when eating difficult meals like those with higher ratio of fat & protein.

Strange how extended bolus is just 2hrs, use Omnipod pump & bolus can be extended up to 8hrs.
Click to expand...

With hybrid closed loops like Control IQ they usually remove TBR options because “you won’t need them” 🙄
 
nonethewiser said:
Why not use TBR into early hours when eating late, do this myself on evenings when eating difficult meals like those with higher ratio of fat & protein.

Strange how extended bolus is just 2hrs, use Omnipod pump & bolus can be extended up to 8hrs.
Click to expand...
TBR - temp basal?? I’ll try that tonight!
 
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