Tandem’s Control-IQ Just Got An Upgrade: Here’s What You Should Know

Tandem Diabetes Care has rolled out big updates to its algorithm – Control-IQ+ Technology! Already available in the US, the updated system introduces expanded eligibility, smarter insulin delivery, and an easier setup process. I’ve been trialing Mobi for the last few weeks so I’m excited to share what’s new and how I plan to use it myself.

Control-IQ+ unlocks Tandem pumps to more users than ever!

One of the biggest changes is that Control-IQ+ expands the system to more people with widened age, weight and insulin usage indications. The system has lowered its age requirement to include children as young as 2 years old, providing younger kids with access to automated insulin delivery. The updated system also supports people with type 2 diabetes (T2D)—a major expansion from its previous type 1-only use. Additionally, the system now covers a broader range of weight (20-440 lbs.) and total daily insulin (TDI) values (5-200 units), making it accessible to more individuals with varying insulin needs. With these changes, Control-IQ+ is bringing the benefits of automation to a more diverse group of users.

One limitation still present with this system is there is no follow feature when Tandem pumps are used alongside the Libre 2 Plus continuous glucose monitor (CGM). The Libre 2 Plus can only connect to one system, in this case the Tandem pump. Until this changes, I anticipate parents of young children will opt to use the system alongside a Dexcom CGM.

Temp basals while in AID for more precise control

Control-IQ+ takes automated insulin customization to the next level with Temp Basal rate adjustments in auto mode. Now, users can fine-tune their basal insulin needs from 0% to 250% while still benefiting from automatic corrections and adjustments from the Control-IQ+ algorithm. Temp Basals can be set for up to 72 hours, making it easier to manage short-term glucose challenges—like exercise, stress, or illness—without turning off automation.  We’ve all dealt with stubborn highs when sick—now, you can increase your basal insulin without leaving auto mode! 

This makes Control-IQ+ the first FDA-cleared AID system in the U.S. to offer this level of customization—a feature the DIY community has used since 2016 called Overrides. I’m hopeful that other insulin pump companies will introduce a Temp Basal option to their algorithms!

Extended bolus for improved meal coverage

One of the most anticipated updates is the expansion of the Extended Bolus functionality. This feature allows users to split their bolus delivery over a set period of time, making it easier to manage slow-digesting or high-fat meals. Users can now extend their bolus for up to eight hours, a significant increase from the previous two-hour limit. This is a huge advantage for tricky meals that can cause a delayed glucose spike like pizza! I’ve already been playing around with this new functionality, but need to speak with my diabetes educator about how to best implement it. So far I’ve used it for pizza and a burger and fries–both times I’ve delivered about 60% of the insulin immediately with the other 40% delivered over the next 5 hours.

It’s important to note that if you set up an Extended Bolus and change out an insulin cartridge in the middle of it, the setting will cancel and you will lose any pending delivery–-I found this out the hard way. One thing I’m still trying to wrap my head around is what happens when you have a hypo while an Extended Bolus is activated? Will the Extended Bolus continue even if you are well below target? I still need to investigate this…

Easier t:slim X2 setup could help doctors prescribe the pump

Tandem has introduced a simplified setup process option for the t:slim X2 pump. Instead of requiring detailed settings, users have the option to enter just their weight and TDI to get started—a streamlined approach similar to the Beta Bionics iLet pump. This easier setup process could help primary care doctors feel more comfortable prescribing a t:slim X2 pump to patients. The setup process is also now available in Spanish, making it more accessible for Spanish-speaking users. These changes make it faster and easier for people to begin using the system.

When will Control-IQ+ expand internationally?

Control-IQ+ is anticipated to make its way outside the US, but no dates have been announced. The updated algorithm has been submitted for CE Mark approval in Europe, bundled with both the t:slim X2 and Tandem Mobi pumps. This means that once approved, people in Europe and other CE-regulated regions will soon gain access to the same advanced features that are currently available in the US.

In our recent podcast episode, David Ahn and I recap some of the biggest headlines from ATTD, including a deeper dive into the Control-IQ+ algorithm, Dexcom’s upcoming 15-day sensor, the twiist and Kaleido 2 pumps, and the controversial conversation about “normal” glucose ranges. Watch the episode below or listen here.

Stay tuned for updates on my experience with the Tandem Mobi pump and the latest in diabetes tech by following along on my TikTok, Instagram, Youtube and podcast. 

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