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Re: Paradigm 515 WAS RE: Hypos RE: [IPk] Paradigm 512

Hi Caroline

I found your explanation of IOB excellent and something positive to go on. 
Thank you very much.  Pat explained about the linear nature of it so I 
understand this.  I would love to get better control after a meal.  I have 
heard others say (I understand) that they try to get their blood sugar back 
to normal after 2 hours.  I can never do this.  I have fasted frequently to 
sort out basels and these seem fine.  If I know the IOB I shall be much 
happier making correction doses.  At present it is purely an educated guess 
and I seem to be very sensitive to insulin even in very small amounts.

----- Original Message ----- 
From: "Caroline Batistoni" <email @ redacted>
To: <email @ redacted>
Sent: Tuesday, June 20, 2006 7:11 PM
Subject: Re: Paradigm 515 WAS RE: Hypos RE: [IPk] Paradigm 512

> Hi again June,
> Seeing you use the word 'algorithm' here has made me think of someting 
> else. The Animas IR1200 IOB (Insulin On Board) is calculated linearly, by 
> which I mean it reduces at the same rate throughout the entire duration of 
> action. So five minutes after delivering a bolus, the IOB will show as 
> having reduced, when in reality the insulin won't actually have kicked in 
> yet. However, I don't tend to find it a problem as long as I remember what 
> the IOB number that the pump gives me means for me.
> When I first got my Animas I played around with different settings for 
> duration of action of Humalog. I tried 2.5 hours, 3 hours and 3.5 hours 
> before settling on three. I then experimented quite a bit with using the 
> IOB information at different times after meals, which is how I came up 
> with the 90 minute strategy I explained in my last email. If I test prior 
> to the 90 minutes, I find the IOB to be somewhat underestimated, so I try 
> to keep this mind if I want to use the IOB number at this stage.
> Playing around with how it works for you is somewhat trial and error, much 
> like setting up basals when you first start pumping, and figuring out carb 
> and correction ratios. I decided on the duration that was right for me by 
> testing my blood sugar every hour after eating. When I used 3 hours as the 
> duartion my blood suagrs became steady at the same time that the pump told 
> me I had zero IOB. When I used a shorter duration, my blood sugar tended 
> to continue to fall after the pump told me IOB was zero. (Your basals 
> obviously need to be correct to do this accurately.) You will also get a 
> feel over time if the information the pump gives you is working correctly. 
> If, for example, you always end up too high after reducing a correction 
> bolus based on the IOB information, it is probably overestimating IOB and 
> the duration may be set too long. If you finish up too low, the reverse 
> may be true.
> Unfortunately, all the while you must keep in mind what I said at the 
> beginning. So I guess what I'm saying is  that the IOB doesn't take all of 
> the brain work out of it, but the pump is at least consistent with its 
> calculations and something concrete to base your management decisions on.
> Caroline
>>Hi Melisssa
>>Sorry I have not replied before.  Thanks for the information regarding the 
>>515 and 522.  What they have done seems very silly to me.
>>I am very interested in the Animas and the miniscule basels it allows.  I 
>>am also interested in the larger screen and particularly want to have more 
>>accuracy with calculating insulin still active in the body when bolussing. 
>>How do you actually work out how long Humalog works for in your body?  Is 
>>it guess work or is there a definite method?  I'm good at mathematical 
>>calculations but using the brain is more time consuming and I am sure not 
>>as accurate as an algorithm.
>>----- Original Message ----- From: "Melissa P. Ford" <email @ redacted>
>>To: <email @ redacted>
>>Sent: Sunday, June 18, 2006 4:07 AM
>>Subject: Paradigm 515 WAS RE: Hypos RE: [IPk] Paradigm 512
>>>Hi June,
>>>Paradigm 515/715 was not fully launched in the UK. The rationale at the 
>>>time that the decision was made was that the 522/722 would be launched in 
>>>Europe before being launched in the US so Europe would get eeeeven cooler 
>>>technology than the US sooner rather than later for once. It is unclear 
>>>to me whether that strategy is being followed through, though.
>>>Cozmo and Animas pumps definitely offer adjustable duration of insulin on 
>>>board and you can get Animas in the UK. If your consultant is willing to 
>>>write, "It is important that June have an insulin pump which permits her 
>>>to adjust the duration of insulin action within the insulin-on-board 
>>>calculation feature. This means that she should have a _____ brand, _____ 
>>>model insulin pump. A pump that does not allow her to adjust the duration 
>>>of insulin action within the insulin-on-board feature (that is, a 
>>>Medtronic MiniMed Paradigm 512) will not meet her needs," you should have 
>>>some bargaining power - but do ring John Davis about this matter. He will 
>>>have more insight than I do!
>>>Of course, you can do like Jackie and work some maths rather than rely on 
>>>the IOB feature within the 512 - that is an option if you're decent with 
>>>a calculator and a clock!
>>>Type 1 13 years; MiniMed pumper 7.5 years; Animas pumper 2 years 6 
>>>months; glad I never had to argue about the model of pump I got and sorry 
>>>that others have had to :|
>>>No virus found in this incoming message.
>>>Checked by AVG Free Edition.
>>>Version: 7.1.394 / Virus Database: 268.9.0/368 - Release Date: 16/06/2006
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