[IP] Re: Correcting for lows
Sue Ann Wrote:
Yes, but the correction in the Paradigm (and I think for the others
also) does not take into account the amount of insulin on board when
correcting for a low. Example from my own pump history: BG 70 at
lunch. Ate 60 carbs. Pump calculated 3.7 bolus for food, - 1.0
correction--fine. But the 1.1 U IOB it calculated was totally ignored,
as the recommended bolus was 2.7. I took it, and was fighting lows by
an hour after lunch.
Based on the current definition for IOB it should not be taken into
account when we are below target.
In my opinion current pumping technology is an insulin delivery system
with a built in calculator (for bolus recommendations) and some
programability (for basal changes, reminders, etc.). I think the
confusion with IOB comes about when we tend to project too much
intelligence onto the pump.
Current pumps make bolus recommendations with assumptions of correctly
set basals, insulin to carb ratios and insulin durations. When we are
low too soon after a meal it is indicative of an incorrect basal or
carb ratio or the effects of stress, hormones etc. The pump does not
correct for any of these factors or even give you a warning. The only
warning my Animas IR 1200 gives is for high or low BG. low cartridge,
etc. Other than the effect of IOB on correction boluses it does not do
any evaluations on the pump settings I entered. In order to take IOB
into account when below target it would have to do an evaluation
outside of the current definition for IOB.
If I ate a meal , gave a bolus and was 70 a few hours later I would
love for my pump to show a warning that says
"Your BG has been below target within 2 hours of your bolus for the
last 5 days. Please check your basal rate or carb ratio."
Intelligent pumps would do some diagnostics on our data and make
recommendations based on variables as well as the assumptions. Current
technology does not offer this. I think future pumps are moving in this
direction with web links but the logic would lie on the servers instead
of the pump.
Dx'd 1967, Pumping since 1/14/2004 w/ Animas IR1000 and since 7/2/2004
w/ the Animas IR1200
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