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RE: [IPk] bolus wizard



Hi Jackie / Pat

It might be better to split the bolus function in to two parts:

Bolus For Food
The duration of insulin action doesn't matter -you key in the carbs and the
pump works out how much insulin. I believe the Paradigm, Cozmo and Animas
pumps all do this.

Correcting a High Blood Glucose Value
Shortcoming with the Paradigm is that the action is set at 8 hours but it
uses a curve to emulate the absorption in most people. So you can use this
figure to come up with a sensible number to correct by. Sadly you need to
know how long ago you last bloused to avoid stacking.

The shortcoming with the Cozmo is that it uses a flat line graph to show
absorption based on the duration you have set. So for instance if you have
it set at 4 hours - 30 minutes after you have bolused 10 units the pump will
assume that you have only 8.75 units left when in reality most people will
have a lot more left. At 3 hours it will assume you have 2.5 units left when
in reality most people will have less left.

The other problem with correcting blood glucose levels while or shortly
after eating is that none of the pumps know what you have eaten (they know
the carbs but not the GI or in fact how the food is absorbed in you - as GI
gives an indication but not a scientific formula of absorption in everyone)

So for a pump to be ideal it would need to use the action curve of the
Paradigm, the customisable duration of the Cozmo and allow you to input the
carbohydrates and how long it takes to be absorbed in you. Unfortunately the
more customisable things are the more room there is for error and the more
complex the pump becomes to use. I wonder how many people use all the
features of the UltraSmart - I for one found it too time consuming and gave
up after a few weeks!

Adrian
   
>The "bolus wizards" or whatever the function is called on other pumps,
>probably
>works fine for most people much of the time.  However those using this on
>the
>Paradigm 512/712 probably encounter problems, as we do, due to the
>inability of
>being able to adjust the "Duration of Insulin action" which on the 512/712
>is
>factory set to 8 hours. But of course you know all this
>already....................
.
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