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Re:[IP] 0.1 unit delivery - Disetronic H-Tron & Plus

Jan & Bluda Sue
From: "JHughey" <email @ redacted>
      Date: Mon, 3 Apr 2000 18:58:07 -0500
Subject: [IP] 0.1 unit delivery
described MiniMed bolus button technique.
and inquired about how it is done on Disetronic pump.
I, a user of the Disetronic H-Tron Plus will describe
how bolus is done with it;
Also for the older Disetronic H-Tron (before "Plus")
is the same. The soon-to-come D-Tron I don't have any
idea about how it will be operated.
Bolus with either H-Tron ( first edition or Plus)
is by preset (at Minnesota for USA customers)
amount-per-beep, 0.5u/beep is the "standard" default
I have been ridiculed here for describing my usage of
0.2u/beep in the past.
Were one to choose 0.1u/beep, then 4.0 unit bolus would
as Jan, you suppose, require 40, actually 41 pushes of
one of the H or M buttons at the top edge of the
Disetronic pump.  They are labeled with up down arrows,
but those directionalities are not used for bolusing,
only for temporary basal settings of the "Plus", and
hourly basal-rate settings for both models.
The "standard setting" of 0.5u/beep I am sure was also
the foundation of the D-company suggestion of 1.0u
priming bolus for the Tender infusion set which Ruth
inquired about last week. With my setting of 0.2u/beep,
4 beeps (5 pushes) would produce the appropriate 0.8u
(Tender is D-speak for what Silhouette is M-speak...)
I have found this a reasonably convenient compromise
between the too-many pushes and beeps which 0.1u steps
would require, and the too-coarse 0.5u steps of the
standard distribution.
0.3u/step might seem a strange number ?
  So for 2.5 unit calculated bolus I would
1) choose either 2.4 or 2.6 units
2) push either button H or M once and hear 3 rapid beeps
3) after that response,
(any attempts before are ignored by the pump)
count in my calculated number of beeps , here 13
and yes, it does require actual release and push again
that many times, with maximum of 8 seconds intervals,
holding does not "add up"
4) retreat is available at any time up to 8 sec after
last beep-up, by pushing the "other" button to cancel
or "clear" the count. If you were pushing H, M clears it.
If you started on M, then H clears it.
5) After that 8 seconds, it beeps-back the count at about
1 beep-per-second, either during which or at the end of
which, it can again be cleared/canceled.
6) Then the motor starts delivering at about 0.17 u/sec
or 6seconds/unit
The smallest amount I've ever seen delivered while
trying to "cancel" such an already-started bolus
is around 0.6 unit maybe 0.5
  I suggest the setting of 0.2u/beep is very easily
used with 50 points/unit insulin sensitivity as 1 beep
per 10 points to be "corrected". All without having to
look at the display to see what numbers are on a flashing
MiniMed display, and without fiddling with whatever an
"Act(ivate)" button is.

David C. Winegarden
Fremont, CA

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