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Re: [IPk] Programming the Pump

In message <email @ redacted>, Michael
<email @ redacted> writes
>The question is, how is the determination made about what the basal 
>levels should be?? The program to do that now is a "human" that 
>carefully intreprets the data, throwing out bad data points and 
>things that look unreasonable -- either you or your doc or a 
>combination. Simply plugging numbers into a computer by rote and 
>extracting basal rates would in my estimation be very unsafe. No 
>amount of safeguards will eliminate the slip of a finger on a number 
>or the assumption on the part of the user that the data is good when 
>in reality it is faulty. Using a computer tool as and aid is one 
>thing, having it take over the job of determining safe level of 
>potentially fatal medication administration is entirely another. 

How is a 'slip' of a finger on a keyboard any different to a slip of a
finger on a button?  The same safeguards are in place.  And
keyboards/screens are much easier to see/use than the pump.

>The "closed loop" system scenario which you might mention next is not 
>a good comparison. The computer in this case constantly monitors and 
>adjusts without ever really looking at absolutes, just incremental 
>changes. However in the scenario you paint, it is a set-it and 
>forget-it operation done only once in a while. 

I didn't mention any 'closed loop' system.  I think you must be
confusing me with someone else!
>I think that the opportunity for error is very high and knowing that 
>implies large potential liability when errors occurs. The human 
>body + insulin + carbs, even when modeled as a relatively linear 
>process is still a 2nd order system. I have worked with this kind of 
>model -- see the example on the HOWTO page -- an know that with 
>marginal data it gives results that can easily be out of range but 
>not obvious except that the output is nonsense. Try it, you'll see 
>what I mean.

Again, I think you are completely misunderstanding what I want my
computer to do!  Nothing about imputing carbs (bolusing) at all.

>All that said, I think such tools are very useful and can help a lot 
>in establishing and tuning basal rates. I'm very skeptical that this 
>can or should be done "automatically". Doing it that way implies that 
>the answers are "right" and can be trusted. That's human nature. 
>Afterall, you know how stupid people can be at times :-)

I think I never should have used the word 'automatically' - think
'without having to touch the pump', and you'll get closer to what I

Best wishes,


dm 30+, 508 1+, does not want her computer to 'automatically' adjust her
rates (think auto-dialling at midnight), she wants to use her computer
to adjust her basal rates, rather than using her pump keys to adjust her
basal rates (think of 'autodialling' vs. manual dialling).
Pat Reynolds
email @ redacted
   "It might look a bit messy now, but just you come back in 500 years time" 
   (T. Pratchett)
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