Tandem sleep mode

Hi all,

Is there anyone out there using their Tandem G6 pump with control IQ who are keeping their setting on “sleep” mode perpetually? I am dealing with lots of over corrections, even though I, along with my doctor, have tried many different settings ie: basal rates, correction factors, insulin sensitivity, etc, etc… This had been an issue with Medtronic before I used Tandem, and needed to take myself off the Medtronic auto setting completely. Tandem is better, but I still find myself on that roller coaster once or twice a week. It is always due to the pump’s (over) correction. I do very well at night on sleep mode. And I check my BS every hour or so, so catching unsuspected highs and manually correcting them is not a problem. My doctor recently had me add a 2nd “sleep” mode in the afternoon to avoid the almost dailiy lows I get at 5pm. But I’m thinking of trying sleep mode 24/7. Any thoughts?

Terri @TJC, I have been using CIQ successfully with very little of my need to interfere with the algorithm beginning with the first month CIQ was released for use. I use sleep mode automatically every day beginning 36 to 90 minutes before I go to bed [during this time I most often sitting, reading, and snacking] until, the time I usually get up for breakfast.

What I do, is try not to make [unnecessary] adjustments of BGL, but rather allow the algorithm to have sole authority; you will see this advice when reading the literature from both Tandem and Dexcom. The G6 chip has the programmed technology to “be predictive” but will only work properly if it has all information; for this reason, I enter [almost] all carbs I eat and, accept estimated dose BUT will at times cancel insulin after waiting the 10 second delay time when I’m aware of an activity that may negate my need for insulin. What it comes down to is that I trust the settings I’ve entered in my various Profiles.

  • The setting that took me longest to reconcile myself to is the ISF [insulin sensitivity or correction factor] which I have in my Profiles other than the "Sick Day - which worked really well when I had the SARS- virus, is ranged between 90 and 100 depending on time of day. Somehow in my old age I have become very sensitive to insulin.
  • Another point to consider, is ALL insulin you infuse - basal as well as bolus - has a “duration” of activity in your body. Some of the basal you infuse between 2 and 4 PM is still active in your body at 5 PM. My “low time” was occuring late afternoon as delay reaction to my usual 2-hour morning activity so my 2 to 4 PM basal is set as 0.00/uph.
  • Keeping Sleep Mode active for 24 hours would disable the key feature of CIQ - the automatic correction feature - and would also lower the basal correction target to 110 mg/dl. I prefer seeing my daily average BGL in the 117 to 122 range.

My Tandem trainer confided in me that she’d heard from some patients who were using it in permanent sleep mode, to good effect. (And when I forgot to turn off sleep mode one day, my BGs were better than usual.) When I mentioned it to my endo, though, she seemed horrified. Diabetes, though, is a very individual thing. We all have unique metabolisms, activity schedules, eating habits, etc. If it works for you and your endo is okay with it, why not?