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Anyone ever ask their Dr. or pump rep this...

Discussion in 'Parents of Children with Type 1' started by rutgers1, Jul 31, 2012.

  1. rutgers1

    rutgers1 Approved members

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    I am wondering why a pump doesn't tell you how many carbs to give when there is a low reading. From what I gather, it has all of the information plugged into it that would enable it to make such a suggestion.

    I do it in my head, but it would be nice to have the pump tell me, too.

    I wonder if there is a reason why pumps don't include this information.
     
  2. jbmom1b2g

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    Ours will tell us. If Taylor is low and she is eating our pump says low bolus not recommended but then I put everything in and it subtracts the insulin for the low.
     
  3. sooz

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    I guess a pump could be able to calculate suggested carbs based on different carb ratios but they would not be able to factor in things like activity level, illnesses, growth spurts ec. Those kind of random factors make d management as much an art as a science. Omnipod does not let you bolus with a low. You have to bring the low up, retest, then enter carbs and bolus. I would guess it's a safety factor.
     
  4. kiwikid

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    The Cozmo can (or could :( ) - it had a Hypo Manager feature which worked brilliantly IF you had all your settings correct. :cwds:
     
  5. rutgers1

    rutgers1 Approved members

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    But if Taylor wasn't anticipating eating and simply tested because of a low, would your pump recommend how many carbs should be eaten to treat the low?

    With the MM pump, I have read where people have suggested the following:
    1) Input a random number of carbs.
    2) If the pump doesn't suggest insulin, back up and input another number that is higher.
    3) Continue until the pump recommends insulin.
    4) So, if the pump recommended insulin at 15 carbs, then you should treat the low with 14.

    While that makes sense, I think it would be nice if the pump would simply come out and tell me from the start.:)
     
  6. lynn

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    Yep, Cozmo had that feature. It still amazes me how basic MM seems after using Cozmo for five years.
     
  7. ecs1516

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    Yes, just as Jane said. The Cozmo did this!!
     
  8. jbmom1b2g

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    No didnt even think of that. If shes low I just treat 15g . Didnt even think of the pump doing that
     
  9. Bigbluefrog

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    I was thinking the same thing, maybe for stubborn lows to give more then just recommended amount.

    Although she often over treats then we have a high following the low.

    It would be a helpful feature to add to the pump program:)
     
  10. Lizzy731

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    The Omnipod does this as well but if I went by what it told me she would end up high....just my 2 cents.
     
  11. swellman

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    I'm not entirely sure that the carb -> BG factor is actually "in" the pump. Raising BG by carbs is not the same as the inverse of the IC ratio using the CF.

    By that I mean to cover carbs it uses the IC ratio and to reduce BG is uses the CF and those are not related.

    I don't think.

    Now I have to break out my spreadsheet ....

    I took a closer look at the setting and I'm not comfortable equating the I/C and the CF and here's why.

    Current settings: CF = 140 mg/dL per U and I/C = 1U per 20 g Carbs

    Equating them would mean: 140 mg/dL = 20g Carbs

    Which would imply that 20g Carbs uncovered should increase BG by 140 mg/dL, if I'm looking at this correctly, and that seems off. However, looking closer that would mean that a 4g tablet would raise him 28 mg/dL. Hmmmmm .... that might actually be close. I need to go back and look at a few times where he was flat and took a tablet - if I can find them.

    I would be interesting to see how others report this if they think there I/C and CF are tuned properly.
     
    Last edited: Jul 31, 2012
  12. tiger7lady

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    Yes I think they do correspond. For my son 1U will lower his BG 60 points. We also dose 1U for every 15 carbs. So I know that 1 carb will raise his BG 4 points. His target is 110. If he is 70 he will eat 10 carbs and land right about there 9 times out of 10. We've gotten fantastic results where we never over correct highs by using this logic.
     
  13. hawkeyegirl

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    In my opinion, it wouldn't do much good to have this setting in the pump. Too much depends on whether BG is flat, rising, or falling at the time carbs are ingested. Now if you could link it to the directional arrows on the CGM, then we'd be talking.

    We never use the reverse correction on the pump. It would always send him high.
     
  14. rutgers1

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    But wouldn't this be the same issue when giving a bolus for a meal, or any type of correction? Or do you not allow the pump to suggest dosages at all? Whenever I test Matt, I enter the situation knowing that I may or may not listen to the pump's suggestion. If I feel he is going to go low because of recent exercise, I will look at the suggested insulin dosage and cut some off. If I think he is going to go high because of a fatty meal, I will consider adding some more insulin to the bolus. Unless I am interpreting this incorrectly, treating a low would work the same way if the pump were to make a suggestion.

    What is the issue with a reverse correction? I remember people saying that they didn't like it in the past. If my understanding is correct, it is when you eat a meal while low but still bolus for PART of the food. What is the alternative? Is the alternative involve treating the low with some carbs first, test again after a while, and then eat and dose as normal?
     
  15. swellman

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    We use reverse correction religiously.
     
  16. hawkeyegirl

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    Well, as to your first question, yes. That is an issue with any pump suggestion. I override an awful lot of suggested doses, and I guess I just see this as one more thing I'd be overriding.

    As for the reverse correction feature, that is one alternative. I usually just shave some carbs off, but always fewer than the pump would like me to shave. The calculation just does mot work for us.
     
  17. mom24grlz

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    just what i was going to say.
     

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