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RE: Hypos RE: [IPk] Paradigm 512


 IOB is short for" Insulin On Board". This is referring to the fact that on some
pumps they have a system, which on the Medtronic pumps is called "The Bolus
Wizard, which can help you calculate what bolus to give based on the insulin
that is already "active" from the last bolus.     Basically you key in certain
figures, what your target blood glucose levels are, your correction factor etc.
Then if you have a high blood sugar level which you want to correct or want to
bolus for a meal, you key in the info into your pump and the bolus wizard will
take into account the "active insulin" that is still working from a previous
bolus.  This is a simplified example of what the bolus wizard is used for.  On
the 512/712 you cannot adjust the duration of insulin action which is "factory
set" to 8 hours duration.  This means that if you have recently bolused to
 correct a high BG levels and it is still high 2-3 hours later the pump is
to "tell" you than a further correction is not needed because it "assumes" that
the insulin action from the previous correct/bolus is still working.  Medtronic
have newer models available in the US that have an adjustable "duration of
Insulin action.  Most people, adults and children that I have come across, have
their "duration of insulin action" set to between 3.0 hrs to 4.5  hours, the
most usually figure seems to be 3.5 hours.   So for Sasha we do not use the
bolus wizard on the model of the Medtronic pump we have. 712, as the bolus
wizard would "tell" us that no correction is needed, whereas experience has
 shown us that for Sasha, 12 years old, that the duration of insulin action
probably work best if set to about  around 3.5 - 4 hours.  When we do
corrections we tend to work them out in our head or use a calculator  using
3.5 - 4 hours as our basis for the duration of insulin action.

 There are other pumps in the UK like the Cozmo, Animas and the newly, or soon
be released Medtronic 522 sensor augmented pump that all have adjustable
"duration of insulin action" features.

The Dual or Square wave functions are a different things.

For instance if you were eating a meal with a lot of fat or protein you may
calculate the total carbs and you might choose to bolus half with the meal but
deliver the rest of the bolus over two to three hours.

Some more info about IOB here



Jackie mum of Sasha aged 12 years

> Hi Melissa
> What's an IOB feature?
> Also, what do you mean about adjusting the duration of insulin action? I
> thought the Dual Wave and Square Set functions did that - or is there
> something smarter available on some of the other pumps?
> Thanks!
> Seos
> >From: "Melissa P. Ford" <email @ redacted>
> >Reply-To: email @ redacted
> >To: email @ redacted
> >Subject: Hypos RE: [IPk] Paradigm 512
> >Date: Sat, 17 Jun 2006 01:11:59 -0500
> >
> >Hi June,
> >
> >It sounds to me like you may be a candidate for the old "aim-for-8 mmol/L
> >for 3 weeks/do everything to prevent going hypo" trick for restoring hypo
> >unawareness. The frequent hypos that you have had may mean that your liver
> >is basically empty of glycogen (because of the first few bad hypos) and you
> >need to rebuild the glycogen stores. The new pump definitely won't hurt:
> >having the IOB feature, even though you can't adjust the duration of
> >insulin action on a 512, may help you prevent hypos too.
> >
> >If you want references on avoiding hypos for 3 weeks to restore hypo
> >awareness, I can find some. But your DSN should know the technique too.
> >
> >Good luck getting this situation sorted. It must be No Fun :[
> >
> >Melissa
> >Type 1 13 years, MiniMed pumper 7.5 years; Animas pumper 2 years 5 months
> >.
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