Hi

[marie11]

Bolus increments same 0.025

I just feel I don't know how my pump works.

How does it work when you have no basal rates to change .
When you hit problems what do you look at ..carb ratio ? Anything else ?

Mx

 

[SB2015]

Morning.

Alert before low is 4.0
BG target 5 5 - 7.5
Smartguard settings 5.5
TIR most days above 75% but some below 50.
IAT is 3 hours .
I belive ISF doesn't cone into it .

I do try 3,4 jelly babies or 6 dolly mixture or most recently small amount of lucozade or coke wait 15m then repeat until I start to.come up about 5 mmol.
This at times takes a very long time compared to pre new pump and sensor(for some reason).taking anywhere between 15m and over an hour .

Highs
Changing max basal to 3h if miss calculated carbs how long do you put this on for.
?


Mx

Going low
Perhaps set you ‘alert before low‘ higher so that you can react earlier and head off the dip. As these dips are happening regularly it would be worth looking at your carb ratio for the evening.

Your ISF will be used by the algorithm when working out corrections. If your levels are above Your target the bolus calculator will use ISF to calculate additional bolus. If this is too high this could also contribute to your dip later in the evening. All these little things have an impact.

 

[SB2015]

I just feel I don't know how my pump works.

How does it work when you have no basal rates to change .
When you hit problems what do you look at ..carb ratio ? Anything else ?

Mx

Is this your first pump? Have you gone straight into Smartguard.
If you have not used one in manual it might be worth talking to your DSN about doing that for a while to get your head round what the pump then does for you when you go into smartguard

In Smartguard the basal rates are changing throughout the day according to your needs, as the pump and sensor have a chat every 5 min. it should then deal with gentle variations in our day, and correct small errors in carbs. I love not having to do fasting basal rate tests.

We have some variables available to us to tweak:
Carb ratios - mine change through the day as I know that I process carbs differently at different times
Insulin Sensitivity
Increments for boluses
Action time of insulin
Temp target - I switch to temp target for any exercise as I know I will drop, eg walking into town
It is a minor juggling act, as always with Diabetes.

 

[SB2015]

Ps
I had burger and chips last week and ended up with TIR of 36% after a bad night of highs. It is not perfect and we still have off days.

 

[marie11]

@everydayupsanddowns
Help Mike .

M

 

[marie11]

@everydayupsanddowns
Help Mike .

M

I put a temp on for 2 hours last night at 23:40 to avoid another hypo ,was only thing I could think of however was a complete guess but can't live constantly with using temp.

Marie

 

[SB2015]

Highs
Changing max basal to 3h if miss calculated carbs how long do you put this on for.
?

Sorry Marie that wasn’t very clear at all When I read it back.

I changed my max basal rate per hour permanently. It then copes with highs a lot better and brings me back in target a lot more quickly.

 

[marie11]

Thank you.
Iv got you now .
Mx

 

[SB2015]

Hi Marie

The images you have sent show you basal deliveries. That is all automated, and with the temp target there will be no correction doses given so worth a try.

Some questions
Can you head off the hypos by setting your Alert to a higher level.

If your pump is giving you hypos in trying to get to your target of 5.5 it wouod be worth lifting that target. I had to do that and now have rare hypos. I seem to be pretty sensitive to insulin so a little change can make a big difference.

Also hot weather makes me more sensitive to insulin so I used to have to drop my basal myself when I was in manual mode. I kind of keep a watch on my levels more as the weather changes to give the system time (as it is using the past 72 hours data for its decisions in the algorithm) to catch up with weather changes.

It will be worth checking you carb ratios.
Can you find the graph which lines up all your meal boluses during different intervals in the day.
this shows you the impact of meal boluses after the meal, and compares them.

You will get there.

 

[marie11]

Hi Marie

The images you have sent show you basal deliveries. That is all automated, and with the temp target there will be no correction doses given so worth a try.

Some questions
Can you head off the hypos by setting your Alert to a higher level.

If your pump is giving you hypos in trying to get to your target of 5.5 it wouod be worth lifting that target. I had to do that and now have rare hypos. I seem to be pretty sensitive to insulin so a little change can make a big difference.

Also hot weather makes me more sensitive to insulin so I used to have to drop my basal myself when I was in manual mode. I kind of keep a watch on my levels more as the weather changes to give the system time (as it is using the past 72 hours data for its decisions in the algorithm) to catch up with weather changes.

It will be worth checking you carb ratios.
Can you find the graph which lines up all your meal boluses during different intervals in the day.
this shows you the impact of meal boluses after the meal, and compares them.

You will get there.

Hi


A question you asked yesterday how long have I been diabetic and was this my first pump.
OK been diabetic 42 years
This is my 4th pump and first sensor .
I can change my target to 6.1 for a wee while got to give it a go .

The graph you mean same as these photos I uploaded but like lunch just now just bolused and temp is on as alarm went off , I think I'm going to hypo .
.
This ?

 

[marie11]

 

[marie11]

I feel whole diabetes needs looked at

 

[marie11]

Lunchtime.
Bolused 10m before eating BG was 5.7 carbs were correct alarm went off ,temp went on and is still on at 14:48 had couple mouthfuls of lucozade .

 

[SB2015]

Sorry Marie I didn’t click on the image and expand it before. When you get the graph if you use the up arrow it will expand to show 6 hours data then press again and you get 12 then again and you get 24 hours showing. This should help to show patterns more.

Have you tried using the minimed app and carelink data on your phone or lap top. This gives you access to a lot more graphs including the one I referred to. When I started I asked for help with using the carelink data and got a zoom session with someone from Medtronic. Very helpful.

I think you definitely need some time with your DSN and you need to be honest with them about how you are feeling. I think once you get to grips with this pump it will remove a lot of pressure, but it isn’t working for you are present. Using temp basal

How were your post meal readings when you were on your old pumps?
How did you test your bolus ratios on them?
To check a bolus is correct I would look at my sensor output after the meal and see if I am back in target after a couple of hours. If it is not working it could be either your carb counting or your ratio is muddled.

 

[marie11]

Hi
Iv got carelink data on laptop,

When you get the graph if you use the up arrow it will expand to show 6 hours data then press again and you get 12 then again and you get 24 hours showing. This should help to show patterns more. ???

 

[SB2015]

Press the top right diamond button and the graph appears showing 3 hours of data. Now press the up arrow and you get to view 6 hours.
Press again to see more hours

Hi
Iv got carelink data on laptop,

When you get the graph if you use the up arrow it will expand to show 6 hours data then press again and you get 12 then again and you get 24 hours showing. This should help to show patterns more. ???

Good that you have Carelink. I guess this enables you to share your data with your team.

I tend to use the data to help me find patterns, and avoid making changes based on a single blip.
Eg If I can see that I always dip after breakfast I know that I need to sort something out there.

 

[SB2015]

How are things going now Marie?
Is it getting any easier?

 

[marie11]

How are things going now Marie?
Is it getting any easier?

Hi
A lot better thank you .
I was going to drop you a message tomorrow.
My blood s are more in target throughout the whole day
A little low 4.9 on wakening but graph pretty steady.
Been using temp and seems to be working well.

Mx

 

[SB2015]

Hi
A lot better thank you .
I was going to drop you a message tomorrow.
My blood s are more in target throughout the whole day
A little low 4.9 on wakening but graph pretty steady.
Been using temp and seems to be working well.

Mx

Glad to read that you are more settled now.
I was surprised how long it took me to adapt to this system.
keep the questions coming as they arise.