RE: Hypos RE: [IPk] Paradigm 512
That's very interesting. I have found that the Bolus Wizard is completely
pointless when it comes to very high readings over a sustained period. I was
not aware of the fact that it calculates insulin duration for 8 hour period
only. That's quite a limitation.
This accounts for some recent high readings where I couldnt figure out why
the BW advised insulin already on board. I had started overriding this but
was unaware of the rationale behind the BW calculation.
Am I right in understanding that when Sasha has a high reading you
administer the correction bolus spread over a 3-4 hour period using the
Square Set function - or do you simply administer CBs manually every hour?
Thanks very much for this info - something I was completely unaware of, let
alone the acronyms!
>From: "Jackie Jacombs" <email @ redacted>
>Reply-To: email @ redacted
>To: <email @ redacted>
>Subject: RE: Hypos RE: [IPk] Paradigm 512
>Date: Sat, 17 Jun 2006 18:41:34 +0100
> IOB is short for" Insulin On Board". This is referring to the fact that
>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
>that is already "active" from the last bolus. Basically you key in
>figures, what your target blood glucose levels are, your correction factor
>Then if you have a high blood sugar level which you want to correct or want
>bolus for a meal, you key in the info into your pump and the bolus wizard
>take into account the "active insulin" that is still working from a
>bolus. This is a simplified example of what the bolus wizard is used for.
>the 512/712 you cannot adjust the duration of insulin action which is
>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"
>the insulin action from the previous correct/bolus is still working.
>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,
>their "duration of insulin action" set to between 3.0 hrs to 4.5 hours,
>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
>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
>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
>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
> > >for 3 weeks/do everything to prevent going hypo" trick for restoring
> > >unawareness. The frequent hypos that you have had may mean that your
> > >is basically empty of glycogen (because of the first few bad hypos) and
> > >need to rebuild the glycogen stores. The new pump definitely won't
> > >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
> > >.
> > _________________________________________________________________
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