Tandem Diabetes Care announced that they will be offering Control IQ™ technology to those using their t:SlimX2 insulin pumps in the US. This is on top of the Basal IQ™ technology that is already available in the US and set to be launched in Canada in the coming months. But what do these new technological features really mean to people with type 1 diabetes? How do they differ from the features currently available on the Medtronic 670G? Here is what we found out.
What is Basal-IQ™ technology?
Basal IQ™ is a predictive low-glucose suspend algorithm that can be installed on Tandem’s t-SlimX2 ™ insulin pumps. It utilizes the sensor values from an integrated Dexcom G6 sensor to help reduce the frequency and duration of a hypoglycemic event (low blood sugar). Because this system works with the G6, no calibration is required.
Basal IQ™ technology is essentially the bottom half of a closed-loop. It reduces hypoglycemia by suspending insulin delivery when a low is predicted. It does not increase basal rates or correct highs, however.
How does Basal IQ™ technology work?
According to SixUntilMe, Basal IQ™ looks 30 minutes into the future and then uses its algorithm to decide what to do. If glucose levels are predicted to drop below 4.4mmol (80mg/dl) or if it are currently below 3.8mmol (70mg/dl) and dropping, basal insulin delivery is stopped. Basal-IQ™ will then resume insulin delivery once the blood glucose levels start to rise.
Can Basal IQ™ be turned off?
Yes! If you don’t want to use this system or are not currently using a Dexcom G6, this feature can be turned off.
How do you get Basal IQ™ technology
You first need to have a t:slim X2™ insulin pump. You will then have the option to add the Basal-IQ technology to your insulin pump by uploading the remote software. If you are purchasing a new insulin pump from Tandem, your new pump may already be loaded with this latest addition. Contact your sales rep for more details or your country’s Tandem office for details on availability.
What is control IQ technology?
Control- IQ™ technology is another part of the closed-loop equation. It allows the t:slim X2™ insulin pump to again work with the Dexcom G6. This time they use a built-in algorithm to adjust basal insulin delivery and give automatic correction doses of insulin.
How does Control- IQ™ technology work?
As Diatribe explains, Control-IQ™ technology uses a closed-loop algorithm to keep users between 3.9-10 mmol (70-180 mg/dl) as much as possible. It looks at the predicted CGM value for 30 minutes in the future and:
- if a reading is going to be above 10mmol (180 mg/dl) it will give a correction bolus.
- If it is going to be above 8.9 mmol (160 mg/dl) it will increase the basal rate
- should it think blood sugars will be between 6.2-8.9 mmol (112.5-160 mg/dl) it will maintain the user’s default setting
- If it thinks that glucose levels will drop below 6.2 mmol (112.5 mg/dl), it will decrease the amount of basal insulin.
- If it thinks that readings will drop below 3.9mmol (70mg/dl), it will turn off the basal insulin
Users must still bolus for meals and there will only be one automated correction per hour during the day.
Can Control- IQ™ technology be turned off?
Most likely. We are unsure at the moment if this option can be turned off but since Basal-IQ™ can be turned off, we would assume that this is also an optional feature.
How do you get Control- IQ™ technology
For those living in the US, watch your email box for updates on how you can remotely upgrade your system.
Basal IQ™ vs Control IQ™
Basically, Basal IQ™ works to fix your basal rates and prevent lows. Control IQ™ looks at the boluses and works to prevent highs. Unfortunately, at this moment, the two do not work together. You must install one feature OR the other.
How does Control-IQ and Basal IQ differ from the Medtronic 670G technology?
The Medtronic 670G works with the Guardian sensor to adjust basal insulin delivery. It will give more insulin if the sensor says the user is starting to trend above 6.7mmol (120mg/dl). If the sensor suggests that the user is going low, it will deliver less insulin or suspend insulin delivery.
Guardian sensors must be calibrated at least twice per day or every 12 hours. The Dexcom G6 does not require calibration.
The 670G will NOT give automatic correction boluses based on high CGM readings. If you miss a meal bolus on the 670G, you will still go high. The pump will only increase the basal insulin to a certain point but will not give a large correction bolus on its own.
What are their similarities?
- Both require the use of a CGM
- The Tandem and Medtronic systems both require users to manually input food boluses.
- Both systems will correct with an increased basal amount if you make a mistake in your bolus and run high (the amount of correction varies with each system)
- Both systems can be turned off if the user does not want to avail of the technology
Basal IQ™ and Control IQ™ technologies automatically adjust your background insulin by increasing or decreasing it based on CGM readings. If you are not using a Dexcom G6 CGM, these options will not be available to you. Those using a Dexcom who wish to avail of these new technologies, will need to keep in touch with your Tandem rep for updates on when they will be available in your area.
Please note, according to information from Jake Kushner (and confirmed by industry sources) if you upgrade to Control-IQ™, the t:SlimX2 can’t currently be downgraded back to Basal IQ ™ .
Remember that Control IQ ™ works to minimize highs and lows but does it with a different algorithm than Basal IQ ™. Review the two options with a health care provider to decide if Control IQ ™ is right for you.
Keep up with the latest in diabetes technology in the Diabetes Academy.