Accu-chek Expert and Combo - Active insulin?

[Phil65]

Note: These posts arose from another thread, and seemed to warrant a thread of their own... EDU&D

I could do with an Accuchek Expert so it could calculate my insulin on board! 🙂

I don't trust my expert for insulin on board! Tells me different things dependant on the time of the day, if it tells me I have lots of insulin on board and it is over 2 hours since I took insulin.....I pay lip service to the meter! I seem to have it mastered though.

The pump has been a major benefit for me when it comes to exercise, if I play golf I give myself a TBR of 20%.....works perfectly and my lucozade sport consumption has gone done dramaticly! 🙂

 

[everydayupsanddowns]

Bolus wizard on pump includes active insulin taken for carbs...

Accuchek Expert uses the same software for calculation as the Combo handset for bolus calc (and I'd assume the 'active insulin' reports in the same way)

Phil65... Re 'Active insulin' on the Expert (and Combo too I think)... Not exactly what is says on the tin. I spoke to some lovely (Danish?) customer service types who helped me get my head around it.

Here's a hypothetical (read easy to work out) example:

You test before a meal and are 9.0

Your target range is 4-8 (midpoint 6). Your sensitivity is set at 1u = 3mmol/L and i:c ratio is 1:10. Offset time set at 1 hour. Acting Time 4 hours.

Meal is 50g

Calculation goes like this...

5u for the Carbs
+1u for being 9mmol/L (1x3mmol/L) to get you to 6.

Making a 6u bolus suggestion.

If you test 1 hour and 1 minute after the pre-meal test you *should* get 1u active insulin (active insulin ONLY counts the positive correction and ignores everything that is supposed to be dealing with carbs, even if you got that wrong).

The active insulin will fall to zero over the next 3 hours (4 hour duration - 1 hour offset)

At least as far as I know that's how it's supposed to work...

If you want to count the 'whole dose' the only way I've found to do it is to cancel/back out of the bolus advice screen before 'confirm' then go to 'add data' and manually add the recommended bolus in there.

Depending on your setting for 'meal rise' correction boluses might, or might not be recommended during the 'acting time', which should help over correcting/stacking doses.

[ THREAD HIJACKED! ]

Hope that helps
M

 

[Phil65]

Accuchek Expert uses the same software for calculation as the Combo handset for bolus calc (and I'd assume the 'active insulin' reports in the same way)

Phil65... Re 'Active insulin' on the Expert (and Combo too I think)... Not exactly what is says on the tin. I spoke to some lovely (Danish?) customer service types who helped me get my head around it.

Here's a hypothetical (read easy to work out) example:

You test before a meal and are 9.0

Your target range is 4-8 (midpoint 6). Your sensitivity is set at 1u = 3mmol/L and i:c ratio is 1:10. Offset time set at 1 hour. Acting Time 4 hours.

Meal is 50g

Calculation goes like this...

5u for the Carbs
+1u for being 9mmol/L (1x3mmol/L) to get you to 6.

Making a 6u bolus suggestion.

If you test 1 hour and 1 minute after the pre-meal test you *should* get 1u active insulin (active insulin ONLY counts the positive correction and ignores everything that is supposed to be dealing with carbs, even if you got that wrong).

The active insulin will fall to zero over the next 3 hours (4 hour duration - 1 hour offset)

At least as far as I know that's how it's supposed to work...

If you want to count the 'whole dose' the only way I've found to do it is to cancel/back out of the bolus advice screen before 'confirm' then go to 'add data' and manually add the recommended bolus in there.

Depending on your setting for 'meal rise' correction boluses might, or might not be recommended during the 'acting time', which should help over correcting/stacking doses.

[ THREAD HIJACKED! ]

Hope that helps
M

I realise that this is a threadnap......sorry! Everything you have listed makes sense to me Mike, but my confusion with the active insulin is still there, for instance the insulin is active for a longer period of time in the morning than at other times of the day! If after 2 and a 1/2 hours after pumping I still have active insulin on board I ignore the total amount and reduce that amount in my head to about half.....because I 'know' it simply isn't all there! The manufacturers settings don't seem to be correct.

 

[everydayupsanddowns]

I realise that this is a threadnap......sorry! Everything you have listed makes sense to me Mike, but my confusion with the active insulin is still there, for instance the insulin is active for a longer period of time in the morning than at other times of the day! If after 2 and a 1/2 hours after pumping I still have active insulin on board I ignore the total amount and reduce that amount in my head to about half.....because I 'know' it simply isn't all there! The manufacturers settings don't seem to be correct.

Hmmmmm... I've not seen that with the Expert. Maybe the Combo has a different method of calculating 'Active' because of your fancy schmancy wave patterns? I can only set one duration...

I had great hopes for Active Insulin, but actually have found it pretty useless in practice (since carbs, and I suspect insulin too, do not act in that linear kind of way.

 

[novorapidboi26]

I have not used this meter but would of had higher hopes than what is being described, if it calculated 6units bolus, taken from mikes example, then I would expect all 6 units to be accounted for in the event you test 2 hours post meal and want to correct (pumping) due to a miscalculation of carbs or other unforeseen circumstance.........

There are wizards that do this are there not............?

 

[everydayupsanddowns]

I think callin it 'Active Insulin' is a mistake and confusing.

However I can see the point in assuming that you go the carb count/dose right. What else could they do really? Otherwise you might check at 2 hours post-meal and find that you are 6.2 but have 2.5u (or whatever) active insulin... albeit that 2u of that is going to be taking care of the parts of your meal which is still being absorbed.

There is, of course, no GI/likely meal absorption information so in a way it makes sense to focus on the correction part.

They should have called it 'Active Correction' though IMO.

M

 

[bigpurpleduck]

I have not used this meter but would of had higher hopes than what is being described, if it calculated 6units bolus, taken from mikes example, then I would expect all 6 units to be accounted for in the event you test 2 hours post meal and want to correct (pumping) due to a miscalculation of carbs or other unforeseen circumstance.........

There are wizards that do this are there not............?

The bolus wizard on my pump does this. I can adjust the active insulin time (currently set to 4 hours), and can set different active insulin times for different times of the day. However, there are so many variables I have never got the basals or carb ratios right yet so haven't got round to looking at the active insulin!

I love the active insulin function on my pump - it stops me overcorrecting & plummeting to a hypo. It is possible to override it and take a correction bolus anyway - but anytime I've done this I've hypo'd within 2 hours!