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Re: [IPk] Temp rates



Hi Jackie and Terry

Thanks very much for going to all that detail.  I understand these 
percentage temp changes on the Paradigm now.  It sounds quite a lot of work 
for one night though once you know what you are setting I would presume it 
can be set very quickly if your memory is good enough to remember it has to 
be set!!!!!

June

----- Original Message ----- 
From: "Jackie Jacombs" <email @ redacted>
To: <email @ redacted>
Sent: Wednesday, July 05, 2006 5:56 PM
Subject: RE: [IPk] Temp rates


> Hi June Sue et al
>
>
> I have asked Terry to explain some of the things which happen when you set 
> temp
> basals using the Paradigm 512/712 pump and the way it rounds down.  I have
> pasted what he has written below.  I dont think that it will help Sue and 
> June
> with their very small basal requirements.
>
> **********************************************************
>
> The Paradigm Pump delivers basal insulin in increments of 0.05 units, so
> basal rates can be set from 0.05 units per hour up to the maximum basal 
> rate
> per hour that you have set into the pump. (Sasha's maximum is currently 2
> units per hour, I think you can set the maximum rate up to 15 units per 
> hour
> at least).
>
> Temporary basal rates can be set at any percentage i.e. from 1% up to 999%
> (I have not verified it goes this high, but it allows three figures so in
> theory it could), however the pump will not allow you to set a temporary
> basal which causes the rate to exceed the maximum basal rate set into the
> pump. e.g. With Sasha's current highest rate of 0.75 per hour and the
> maximum of 2.0 per hour, the highest temporary basal we could set is about
> 265%.
>
> The temporary basal is also affected by the delivery in increments of 
> 0.05,
> and the rate is rounded down to the nearest 0.05 unit.
> e.g. if the normal basal is 0.75 units a 50% temporary basal gives a rate 
> of
> 0.375 but this would be rounded down to 0.35.
>
> In some circumstances this means that a small percentage increase will not
> make any difference to the rate. e.g. if the rate is 0.50 per hour, a
> temporary basal of 105% would give a rate of 0.525 which would be rounded
> down to 0.50 (no change).  With these figures a temporary rate of 110% 
> would
> be needed to reach 0.55 per hour.
>
> Note that any temporary rate of less than 100% will produce a lower basal
> because the rate is always rounded down. However because of the rounding,
> different figures can produce the same end rate. e.g. if the rate is 0.75
> per hour, temporary basals of 85% and 80% both result in a rate of 0.60 
> per
> hour because of the rounding.
>
> The two ways to check the result are:-
>
> 1. Do the arithmetic.
>
> 2. Set the temporary rate and review the status screen (press ESC). The
> actual temporary basal rate, duration and time left is shown on the first
> few lines of the status screen.
>
> Finally, all basals whether normal or temporary are delivered in 
> increments
> of 0.05 units and because the Paradigm delivers basal in bursts every few
> minutes over the hour, precise determination of the exact amount of basal
> insulin in any hour is not possible if basal rates change during the hour
> (e.g. if a temporary basal is set at 11:20, calculating how much basal
> insulin is delivered in the hour from 11-12 will be approximate (but still
> accurate to within 0.05 units).
>
> Hope this helps.
>
> Kind Regards
>
> Terry Jacombs
>
>
>
>
>
> Jackie Jacombs mum of Sasha aged 12, diagnosed 1999, twin sister Rebecca 
> both
> coeliac, two older girls, Nicki and Danni, husband Terry
>
>
>
>
>>
>> Hi
>>
>> As my main problem is the same as Sue's I have been interested to see 
>> this
>> way of using the Paradigm to get unusual basal rates.  Can you tell me 
>> the
>> lowest I would be able to set a basal for at night using percentages and
>> temporary basal rates?
>>
>> The problem I see with this method is that from Jackie's booklet, it 
>> appears
>> that the rate would have to be set every day or night to achieve this. 
>> Am I
>> correct?  If the rate is required permanently, it would appear very
>> difficult to use this method.
>>
>> Sue do you think it would solve your problem?
>>
>> June
>>
>> ----- Original Message -----
>> From: "Jackie Jacombs" <email @ redacted>
>> To: <email @ redacted>
>> Sent: Wednesday, July 05, 2006 12:20 PM
>> Subject: RE: [IPk] Temp rates
>>
>>
>> > Hi Simon/Andrea
>> >
>> > I find the setting the temp basals on the Paradigm slightly confusing.
>> > Terry
>> > usually sets these up if we only need a small increase or we have found
>> > that a
>> > certain percentage increase is not making enough difference and its not
>> > obvious
>> > what basal percentage is actually going to be delivered.  He has 
>> > mention
>> > that
>> > sometimes going into the screen and increasing the basal rate by , say 
>> > 10%
>> > ,
>> > results in no change at all. He then checks the screen to see what the
>> > pump has
>> > worked that out as.  Or he might have said that the there is no 
>> > difference
>> > between choosing a temp basal of 120% or 125%. I may have misunderstood
>> > what he
>> > said, as it didn't really make sense to me.  However, as  I am 
>> > definitely
>> > mathematically challenged, I just assumed it was something normal that 
>> > I
>> > didn't
>> > grasp.  I do see what you mean though about the increase or decrease.
>> > Terry is
>> > out on a long bike ride otherwise I would ask him to explain it 
>> > properly
>> >
>> > There are two way in which you can set up a temp basal either a 
>> > percentage
>> > of
>> > basal or an insulin rate.  You have to switch between one or the other.
>> > Currently we find it easier to use the percentage as Sasha can quickly
>> > increase
>> > or decrease by a percentage without having to calculate the actual 
>> > basal
>> > amount
>> > per hour.
>> >
>> > I think that the amount must round down.  I believe that the Animas 
>> > pump
>> > and
>> > maybe the Cozmo have much smaller basal rate increments.
>> >
>> >
>> > This is the user guide for the 512/712 the blurb about the temp basal
>> > rates is
>> > show on pages 105 onwards on the PDF doc.
>> >
>> > http://www.minimed.com/pdf/x12_user_guide.pdf
>> >
>> >
>> > If I have explained this incorrect please will someone else who has 
>> > this
>> > pump
>> > explain.
>> >
>> > Jackie
>> >
>> >> -----Original Message-----
>> >> From: email @ redacted [mailto:email @ redacted]On
>> >> Behalf Of simon fraser
>> >> Sent: 05 July 2006 11:48
>> >> To: email @ redacted
>> >> Subject: [IPk] Temp rates
>> >>
>> >>
>> >>
>> >> Can someone please explain to me how the temp rate works on the 
>> >> Paradigm.
>> >> On the Cozmo we can set a temp rate in increments of 5% of the 
>> >> original
>> >> basal
>> > > rate eg 110% temp rate on a basal rate of 0.25 would give a temp 
>> > > basal
>> > > rate
>> > of
>> > > 0.275. The whole basal pattern would be increased by 10%. Does this 
>> > > not
>> > happen
>> >> with the Paradigm?
>> >>
>> >> Ive been trying to explain to Sue how to achieve a tiny increase in
>> >> basal.
>> > > Either Im not explaining myself very well or the Paradigm works
>> > > differently
>> > to
>> >> the Cozmo!
>> >>
>> >> Thanks,
>> >>
>> >> Andrea, mam to Oliver 5 dxd Jun02 pumping Cozmo Aug05, partner to 
>> >> Simon
>> >> .
>> >
>> > ---
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>> > avast! - copyright (c) 1988-2006 ALWIL Software.
>> > http://www.avast.com
>> > .
>> >
>> >
>> > --
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>> > Version: 7.1.394 / Virus Database: 268.9.9/382 - Release Date: 
>> > 04/07/2006
>> .
>
> ---
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> Virus Database (VPS): 0627-1, 05/07/2006
> Tested on: 05/07/2006 17:55:58
> avast! - copyright (c) 1988-2006 ALWIL Software.
> http://www.avast.com
> .
>
>
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> Version: 7.1.394 / Virus Database: 268.9.9/382 - Release Date: 04/07/2006
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