Adding manual correction with control IQ?

Hi everyone,
Been trying to learn how to use features on tandem pump particularly when I run high after meals. For the past few days my BG after meals shoots up into the low to mid 200’s even when I think I’ve counted carbs correctly. It seems to stay high for 2-4 hours which I think is too long? Do you ever add your own manual correction along with control IQ? Thanks.

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Only if I knew I’ve miss-counted my carbs - realized after the fact that I used too small a quantity, or I added something that I didn’t bolus for at the time. If it happens regularly and you’ve ruled out anything else, you may need to change your carb ratio.
Fatty foods can also cause a delayed spike - an extended bolus can help with that.
Be sure to work with your doctor since you’re new.

Diane @DFBB, I may start a “manual correct Bolus”, but ONLY after checking the pump history to see if and when, how much of an automatic correction [CIQ] has been delivered. Always be cautious when doing a system override with a manual correction.

As Dorie @wadawabbit mentioned, higher fat content meals may need additional insulin a few hours after the meal - more insulin than what was calculated for carb count. For instance, last week when eating at a restaurant, there was way more cheese than I usually might eat in a meal, and I knew if I included insulin, even in an extended bolus, what I thought would cover the cheese, I didn’t dare taking that total dose knowing that my already BGL [around mg/dl] would drop too low long before the cheese began its effect; I did a nanual correction a few hours later.


Hi @DFBB. In my experience, extended highs of that length are almost always due to poor absorption at the infusion site. I do give correction boluses, but they won’t fix a bad site. If I stay high for an abnormal time, for me that would be over 3-5 hours, I change the infusion site. In case you’re not aware, you can insert a new site, then connect the tubing from the suspected bad site, and do Load->Fill Cannula. That way you don’t waste the insulin in the tube. Best wishes, Mike


Thank you all so very much for sharing your thoughts and wisdom, this forum is so helpful in navigating T1. I really learn so much and feel more competent to make some of my own treatment decisions.

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Like Dennis said high fat and even occasionally super high protein meals will cause me to spike my BGL several hours after a meal. I did not know this was happening to me prior to wearing a g6 sensor. I know have learned to bolus a correction amount about 3 hrs after my meal. If i take that amount at the time of the meal i will drop low before all the carbs process and have to correct for a low to then get a big spike about 3 hours later. You will have to figure your body’s timing out but this is a very common issue. The great thing is that you can use all the tandem software to help you figure out when you do need to correct. I keep a small notebook with indo like this and info on my insulin requirements when i am ill to reference at later dates. You will find that many of lifes changes can affect your insulin requirements.


Infusion sites make a definite difference. I’ve had it where I didn’t give any bolus with some sites. Still went low. Not an exact science, but that’s the way it goes. Much better than it was 50 years ago.