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[IP] Re: Bolus Dummy

I believe I must agree with Felix regarding the MM bolus software.  The 
problem is that there are several complex variables going on and the pump is 
only aware of several of them.  First of all, are there already fast acting 
carbs in your system digesting and actually the 41 BG is rapidly rising at 
several points per minute? The software is aware of 3 things.  Your current 
BG, the insulin on board, and the carbs you are eating.  The writers of the 
program have chosen to assume that IOB is covering prior eaten food.  This 
may or may not be true, or the timing of your digesting carbs may be off.  I 
believe that if the program were to ignore IOB when below target, a new 
problem would arise of many high BG after meals when eating carbs to correct 
lows. For example, suppose you had a bg of 41 with no IOB, and you ate 50 
carbs. Your pump would recommend some insulin, because 50 carbs  more than 
raises your bg above target.  Ten munutes later, you were at 55 and still 
not feeling well, panicked and ate 50 more carbs. I don't think you would 
want your pump to recommend no additional bolus because most of your 
previous bolus was still active.  I realize that this is an extreme and 
obvious example, but it illustrates the thinking behind the bolus software. 
Summarizing what others have said,  the program can never calculate bolus 
doses accurately for every situation. No bolus program can. It is a tool 
that must be overridden on occasion.
Mike Zeigler
IDDM since 1961 
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