#920 Best of Juicebox: Control IQ Ninja

Basal Adjustments

Jeremy shares his expertise on fine-tuning basal insulin settings for better stability and control. He emphasizes the importance of making consistent, small adjustments rather than the standard 10% changes, which can lead to inconsistencies. Jeremy explains, "Whenever I first started out, the best thing the CDE could have told me is every single time she kind of showed me on an AGP report, and I'll kind of talk about that a little bit later. But every time you see a change here, I want you to just change the pump by 00:25. That was my quote. Baby step. That's what she called a baby step to me."

Whenever I first started out, the best thing the CDE could have told me is every single time she kind of showed me on an AGP report, and I'll kind of talk about that a little bit later. But every time you see a change here, I want you to just change the pump by 00:25. That was my quote. Baby step. That's what she called a baby step to me.

--- Jeremy

He also highlights the role of insulin sensitivity factor (ISF) in Control IQ, describing it as an "aggressiveness knob" that helps maintain balance by adjusting insulin delivery based on blood glucose trends 1 2 3.

   

Carb Ratios

Precision in carb ratios is crucial for effective insulin management and glycemic control. Jeremy discusses the variability in insulin dosing, noting that understanding the impact of specific doses is key to managing blood sugar levels effectively. He states, "If I was to put three extra carbs in, it may give him 0.2, it may give him 0.7, it may give him 0.6 depending on which way the arrow is going, how his blood sugar is going, if he's had a correction in the last hour or not, if there's been an autobolus in the last hour or not. There's so much variability there. I'm not going to deal with that. I know what a happy unit will do. Hit him with a happy unit, let him go."

If I was to put three extra carbs in, it may give him 0.2, it may give him 0.7, it may give him 0.6 depending on which way the arrow is going, how his blood sugar is going, if he's had a correction in the last hour or not, if there's been an autobolus in the last hour or not. There's so much variability there. I'm not going to deal with that. I know what a happy unit will do. Hit him with a happy unit, let him go.

--- Jeremy

Jeremy's approach involves analyzing AGP reports and pump settings to tailor insulin delivery, ensuring that each dose is appropriate for the individual's needs 2 4.

   

Consistent Management

Consistency in diabetes management is vital, particularly when it comes to treating lows and pre-bolusing. Jeremy stresses the importance of having reliable information, such as calibrating CGMs to ensure accurate readings. He mentions, "If you want better than average control, you need to have better than average information going in. Effort too and in order to get that better than average information going in, you have to calibrate."

If you want better than average control, you need to have better than average information going in. Effort too and in order to get that better than average information going in, you have to calibrate.

--- Jeremy

Jeremy also highlights the value of small, precise adjustments in insulin dosing, which can lead to significant improvements in blood sugar stability over time 5 6.