Diabetes Dialogue: Understanding Control-IQ+ AID Algorithm with Laurel Messer, PhD, RN

Welcome back to Diabetes Dialogue: Technology, Therapeutics, & Real-World Perspectives!

In this episode of Diabetes Dialogue, hosts Diana Isaacs, PharmD, an endocrine clinical pharmacist, director of Education and Training in Diabetes Technology, and codirector of Endocrine Disorders in Pregnancy at the Cleveland Clinic, and Natalie Bellini, DNP, program director of Diabetes Technology at University Hospitals Diabetes and Metabolic Care Center speak with Laurel Messer, PhD, RN, senior director of medical affairs at Tandem Diabetes Care, about the latest advancements in Control-IQ+, the company’s next-generation automated insulin delivery (AID) technology.

With clearance received from the US Food and Drug Administration (FDA) in February 2025, Tandem announced on March 18, 2025, that the Control-IQ+ hybrid closed-loop algorithm is now available for use in adults with type 2 diabetes (T2D) aged ≥18 years alongside people with type 1 diabetes (T1D) aged ≥2 years.1,2

“These new features allow for even greater levels of personalization and flexibility within our algorithm, while still receiving high marks for ease of use across a diverse population of users,” said John Sheridan, president and chief executive officer of Tandem Diabetes.2 “We are proud to offer this life-changing technology to millions more people living with diabetes.”

Enhancements to the algorithm included a broader weight range (20–440 lbs) and insulin dosing parameters (5–200 units), representing a more inclusive algorithm. In this episode, Messer highlighted other new features in the updated algorithm, such as temp basal rate adjustments for exercise or illness and an extended bolus option of up to eight hours, which enhances flexibility in insulin management during meals.

“In addition to optimizing the algorithm for expanded access, these new features, including temp basal rates and extended bolus, we hear over and over that these were important to users, so we want to make sure we meet the needs as people are telling them to us,” Messer said.

Messer also emphasized that Control-IQ+ offers a unique advantage: the ability to fine-tune correction factors, allowing providers to tailor insulin delivery for improved glycemic control. With the AutoBolus feature, Control-IQ+ predicts and corrects hyperglycemia every hour, significantly benefiting individuals who struggle with consistent mealtime bolusing.

The conversation also shifted to practical aspects of access, with current Tandem pump users eligible for a software update to enable the new features. Additionally, new functionalities such as Spanish-language support and an automatic profile-setting calculator aim to improve usability and provider confidence in initiating insulin pump therapy.

Messer highlighted clinical data supporting Control-IQ+ from a randomized trial of 102 children aged 2 to 6, demonstrating a 12.4% increase in time in range (TIR), without an increase in hypoglycemia. Parents reported substantial improvements in children’s outcomes, including quality of life and sleep, and confidence in managing their child's diabetes.

Overall, Messer emphasized how Control-IQ+ represents an essential evolution in AID, offering greater personalization, expanded access, and improved quality of life for both T1D and T2D populations.

“I would say we are the best algorithm out there, but because it’s been out for 4 years, it’s time for a refresh. I’m really about passionate about being able to have labeling that expands who can use Control-IQ, as a nurse and scientist, and as someone who wants to make lives better for people living with diabetes,” Messer added.

Relevant disclosures for Isaacs include Eli Lilly and Company, Novo Nordisk, Sanofi, Abbott Diabetes Care, Dexcom, Medtronic, and others. Relevant disclosures for Bellini include Abbott Diabetes Care, MannKind, Provention Bio, and others.

Important Safety Information: RX ONLY. Indicated for patients with type 1 diabetes, 2 years and older and for patients with type 2 diabetes, 18 years and older. BOXED WARNING: Control-IQ+ technology should not be used in anyone under the age of 2 years old with type 1 diabetes or under the age of 18 years old with type 2 diabetes. It should also not be used in patients who require less than a total daily insulin dose of 5 units of insulin per day or who weigh less than 20 pounds, as those are the required minimum values needed for Control-IQ+ to operate safely. Safety info: tandemdiabetes.com/safetyinfo.

References

1. Tandem Diabetes Care announces FDA clearance of Control-IQ+ automated insulin delivery technology for people with type 2 diabetes. Tandem Diabetes Care. February 25, 2025. Accessed March 19, 2025. https://investor.tandemdiabetes.com/news-releases/news-release-details/tandem-diabetes-care-announces-fda-clearance-control-iq?_gl=1%2A74fjn4%2A_gcl_au%2AMTA5MTAyNTMwNS4xNzQyMzAzNDM3.

2. Tandem Diabetes Care launches new control-IQ+ automated insulin delivery technology in the United States. Tandem Diabetes Care. March 18, 2025. Accessed March 18, 2025. https://investor.tandemdiabetes.com/news-releases/news-release-details/tandem-diabetes-care-launches-new-control-iq-automated-insulin?_gl=1%2A6x86ih%2A_gcl_au%2AMTA5MTAyNTMwNS4xNzQyMzAzNDM3.