target ranges on the roche accucheck combi pump

Status
Not open for further replies.
Dory said:
frustratingly, I have just tried to set my meal rise limit to 0.0mmol and the lowest it will go is 2.8mmol!

So i will constantly have to manually work out CF doses from now on!!

HOW UNHELPFUL!!!

EDIT: unless someone knows how you turn that specific bit of bolus advice off on the Roche pumps??
Click to expand...

....in the same boat!.....but used to it now, although irritating!
 
on the phone to them now to see whta can be done about this (if anything)
 
Dory

Since part and parcel of this involves the 'active time' and 'offset time'(in terms of when it will allow/deny more correction) I suppose you *could* artificially shorten those such that it gives you the correct advice more often than not.

I did this myself over the first year I used the Expert. I expeerimented with giving the device the numbers it needed to give me good advice (whether or not I believed that whatever that factor was actually acted over that period in general terms). ISTR I set my 'offset time' to the minimum - 45 mins, and had an artificially short 'active time'.

I also completely ignored 'active insulin' as it was of no use to me really the way they had configured it.
 
Last edited:
Wow you guys are blinding me with science! Had to read al again. Now I get it,I think? Checked my meal rise 2.8 acting time 4 hours, offset time 1 hour

I must admit for me I don't think too deeply as will it get me to mid range, perhaps I should. But I always always think, when did I last eat, grazer too. And I always think nah that will be too much or I need a bit more than suggested, or if I correct at all I will hypo due to stacking, seems to work fro me. You have all made me think a bit more about it though.
 
Tracey I think you have to go with what works for you. so if your guesstimations are working then great, no need to worry about the science bit! 🙂

for me, I'm one of those annoying people that likes to know the whys and wherefores of everything!
 
What a bummer!

No, the only option is upwards, we are stuck with 2.8.

I'll try and check the Manuel tomorrow, but not promising, got a bit on tomorrow esp if the 7 pallets of paving slabs arrive!
 
I have several healthcare professionals i could do with making disappear TW 😉

I was going to leave a reply until Roche phoned me back yesterday.....but they didn't! They last I spoke to the chap though he did mention that there may be an option to make the individual change to the meal rise limit on the accu-chek 360 software - the version that healthcare professionals use, NOT the standard 'diabetes management' software that pump users get (and I've got).

But he wasn't sure and was going to check and call back....which is what I'm still waiting for.....
 
Dory said:
I have several healthcare professionals i could do with making disappear TW 😉

I was going to leave a reply until Roche phoned me back yesterday.....but they didn't! They last I spoke to the chap though he did mention that there may be an option to make the individual change to the meal rise limit on the accu-chek 360 software - the version that healthcare professionals use, NOT the standard 'diabetes management' software that pump users get (and I've got).

But he wasn't sure and was going to check and call back....which is what I'm still waiting for.....
Click to expand...

....this is what they said to me Dory, I think I have the software.....I need to get on to this...will let you know how I get on
 
ooh yes please let me know Phil. They said it wasn't the 'accu-check 360 diabetes management system' but the other one (can't remember the name now).
 
Hi all, I finally had a call back from one of the senior technicians at Roche about the issue above. I explained that linking the meal rise to the acting time (at 4 hours for some of us) was not replicating what happens in rea llife, as in real life you'd expect any meal rise to start decreasing after about 2 hours.

She then helpfully explained that the 'snack size' function played a key part in all this. If you eat something over your snack size limit, any correctional doses within the acting time period will correct to your meal rise. HOWEVER (and this I didn't know) - if you eat something under your snack size limit, then have to do a correctional dose within the acting time of that snack, the the meal rise is not taken into account and it corrects to your target range. Eg:

acting time 4 hours
target 6.0mmol
meal rise limit 9.0mmol
snack size 10g CHO

in the above scenario, eating a 15g CHO snack at midday, then testing at 3pm and finding your bG is 12.0, will mean the meter corrects to 9.0, rather than 6.0

IF however, you reset your snack size to 20g and apply the same situation above, the meter will suggest a correction dose to bring you down to 6.0.

This is news to me (when I got hooked up, I was told that the snack size was to let the machine know how many CHO you eat without needing a bolus) but really helps, as essentially when I graze i eat a banana, yoghurt, apple, basically stuff 20g CHO or less. So I have change my snack size on the meter to read 21g. That means that when I have a medium sized banana at 8pm (20g CHO), and test before bed at 11pm and my reading is higher than it should be, then THEORETICALLY it should correct to 6.0 rather than 9.0.

So, in short:

- if a high bG reading within acting time and last food bolus was larger than snack size = a dose that corrects to meal rise limit.
- if a high bG reading within acting time and last food bolus was smaller than snack size = a dose that corrects to target.

Hope that makes sense! She also advised me that even if I get my renewal tubed pump in Nov 2013 (ie at the 4 year marker) I will still be eligible for hte patch pump when that gets released and it won't cost ant extra to PCTs (quite how they worked that out I didn't bother to ask).
 
Ok,must admit am intrigued. My snack size is 10cho

Would it benefit me to raise this to 20cho in order for corrections to be within my target range? I'm always wanting control to be tighter. I may guesstimate ish but its always based on what I know I need or don't. I think it explains why sometimes I need to correct more than meter is telling me too. I always take factors such as activity,exercise etc into account too. If I just pressed the bonus button to what it tells me this wouldn't work for me.

I mean bolus !
 
I've never entered anything in snack size cos my BG's that boring, if I eat 5g carb I'll get a commensurate increase in BG, which is not to say I don't sometimes eat a snack and think Oh $od it and not bolus. So my snack size is Nil. But no meal bolus for me is ever going to be less than a snack one.

My brain No Funcione; where does that leave me? - correcting to pre-meal test level plus 2.8 meal rise, or top of time block range, or top of time block range plus 2.8; or what?

Yrs confused,
Bedworth
 
Tracey - if you're having hte same problems I am (ie you're noticing it's not suggesting enough correction bring you within your target) then you might benefit from changing your snakc ize, yes. I guess you can only try and see if it works.

TW for you, and going on what the Roche lady told me, I think that because you have no snack size, any food you bolus for would count as a meal and thus if a CF was needed within your acting time, it would take you to your meal rise limit.

But don't quote me on that!
 
well i have just checked my bG level after changing the settings earlier and the CF dosage it's now suggested (90 mins after a 'meal' of 40g CHO) is to bring it down to my target (ie not my meal rise limit).

So that seems to have solved the trick 🙂
 
I was thinking of a sback late this afternoon and was gonna try it but when I tested it turned out I was flipping hypo. Can blame the double glazing salesman at the door I couldn't get rid of for making the hypo be 2 point summat instead of 3 point summat which I'm sure was all it was to begin with.

And in hindsight, we had different bread to normal today and so I checked the package and bolused for lunch on what it said which is always 2 slices = c 35g, but I SHOULD count it as 30 because that's what bread always is for me at lunchtime notwithstanding the packet. Yes I did suspect my carb ratio at lunchtime but any other sort of carb behaves normally. I'm weird .....
 
never mind TW - always another chance (the joy of D!)

as it turns out, I had a stupidly high reading of 20.2 @ 9pm last night. using the new dosage with the new snack size setting, I woke up to a 4.6 this morning. So increasing the snack size from 10g to 21g for me certainly has solved the problem!
 
Dory said:
Hi all, I finally had a call back from one of the senior technicians at Roche about the issue above. I explained that linking the meal rise to the acting time (at 4 hours for some of us) was not replicating what happens in rea llife, as in real life you'd expect any meal rise to start decreasing after about 2 hours.

She then helpfully explained that the 'snack size' function played a key part in all this. If you eat something over your snack size limit, any correctional doses within the acting time period will correct to your meal rise. HOWEVER (and this I didn't know) - if you eat something under your snack size limit, then have to do a correctional dose within the acting time of that snack, the the meal rise is not taken into account and it corrects to your target range. Eg:

acting time 4 hours
target 6.0mmol
meal rise limit 9.0mmol
snack size 10g CHO

in the above scenario, eating a 15g CHO snack at midday, then testing at 3pm and finding your bG is 12.0, will mean the meter corrects to 9.0, rather than 6.0

IF however, you reset your snack size to 20g and apply the same situation above, the meter will suggest a correction dose to bring you down to 6.0.

This is news to me (when I got hooked up, I was told that the snack size was to let the machine know how many CHO you eat without needing a bolus) but really helps, as essentially when I graze i eat a banana, yoghurt, apple, basically stuff 20g CHO or less. So I have change my snack size on the meter to read 21g. That means that when I have a medium sized banana at 8pm (20g CHO), and test before bed at 11pm and my reading is higher than it should be, then THEORETICALLY it should correct to 6.0 rather than 9.0.

So, in short:

- if a high bG reading within acting time and last food bolus was larger than snack size = a dose that corrects to meal rise limit.
- if a high bG reading within acting time and last food bolus was smaller than snack size = a dose that corrects to target.

Hope that makes sense! She also advised me that even if I get my renewal tubed pump in Nov 2013 (ie at the 4 year marker) I will still be eligible for hte patch pump when that gets released and it won't cost ant extra to PCTs (quite how they worked that out I didn't bother to ask).
Click to expand...

Great work Dory! thanks for this.....I've just changed my snack size to 21g....I'll see it how it goes
 
Hope it helps Phil - let us know how you get on!
 
Mine does the same about 2 to 3 hours after last meal the bedtime one does not give a CF I have put my own CF in at times but lately I have not and it has dropped on its own accord
 
Status
Not open for further replies.
Back
Top