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[IP] Email to CalorieKing about TAG Method



A week or two ago we discussed the TAG method for calculating boluses.  
I just sent this email to Calorie King to see if they'd implement it in 
their Diabetes Log software for Palm OS.  Since I'm kind of new to the 
TAG method, please let me know if you see anything wrong.  Thanks!

Rebecca
Type 1 since 4/84
Animas 1200 pumper since 11/04


I just purchased Diet Diary for my Palm and I love it.  It is very well 
done!  I also downloaded Diabetes Log, but it doesn't have the one 
feature that I was hoping it would have.  Although it does calculate 
insulin required, it does so in only a very rudimentary way.  Almost all 
diabetics I know (and I know quite a few diabetics from online forums), 
use a method that is a least a little if not alot more sophisticated.  
However, it should be easy to implement in Diabetes Log. 
 
The most sophisticated method of calculating insulin required is called 
the Total Available Glucose (TAG) method.  Here is the formula. 

[ ((gCHO - gFIBER) * %CHO) + (gPRO * %PRO) + (gFAT * %FAT) ] / (insulin 
to glucose ratio)

The gCHO, gFIBER, gPRO, and gFAT should be imported from a meal in Diet 
Diary.

The %CHO, %PRO, and %FAT should be configurable by the user.

The insulin to glucose ratio (analogous to the insulin to carb ratio 
currently implemented in Diabetes Log) should also be configurable by 
the user by time of day.  For example, mine is as follows

midnight-4am  = 18
4am-10am = 24
10am-10pm = 16
10pm-midnight = 18

The results of the formula should actually be shown in two parts, one 
for the CHO minus FIBER

[ (gCHO - gFIBER) * %CHO ] / (insulin to glucose ratio)

and the other for PRO and FAT

[ (gPRO * %PRO) + (gFAT * %FAT) ] / (insulin to glucose ratio)

(Confused?  Don't worry, an example is coming soon.)  The reason for 
this is because insulin pump users often take the insulin from each 
component in a different way.  The carbohydrate component is often taken 
immediately and the fat and protein component extended over time.

Here is an example that will hopefully make all of this more clear.

Here a my insulin to glucose ratios.

midnight-4am  = 18
4am-10am = 24
10am-10pm = 16
10pm-midnight = 18

Here are my %'s.

%CHO = 100
%PRO = 60
%FAT = 25

Here is my meal.

time = 12:30pm
gCHO = 69.2
gFIBER = 5.0
gPRO = 21.9
gFAT = 5.6

The result, which is calculated like this

[ ((69.2 - 5.0) * 1) + (21.9 * .6) + (5.6 * .25) ] / 16

Would be shown to the user like this

4.01 U for CHO + 0.91 U for PRO and FAT = 4.92 U of insulin

There are alot of diabetics who ignore the PRO and FAT components and 
calculate insulin required just based on CHO minus the FIBER.  This 
method is known as carb counting.  If the TAG method was implemented, 
the carb counting method would be extremely easy to implement.  Just set 
the %PRO and %FAT equal to 0.

I really hope you implement this in Diabetes Log.  I can promise you 
I'll buy a copy and I'll also inform 5,000 -10,000 insulin-using 
diabetics in the two online forums I participate in.  If you have any 
questions, please do not hesitate to email me or call me.  I have other 
ideas to make your software more powerful for diabetics, but I'll hold 
off on those for now.
.
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