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If you use an insulin pump, on average, how often do you bolus an amount that is different from the suggested dose from the pump’s bolus calculator? (I.e., entering a number of insulin units without using the calculator at all, editing the bolus calculator’s suggested dose to be higher or lower, etc.)
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Occasionally in no particular pattern. After living with T1D in my body for 60 + years there are times when I know my body and how much or how little insulin I may or may not need better than the pump.
I agree… even though I do not use a pump!!!
Every day. I love playing guessing games like sudoku, jumble, boggle brainbusters, cryptoquip, celebrity cipher, bridge, etc.
Same with the pump. I try (feebly) to out guess the digestive nerve. Some time I hit him right between the eyes and sometimes I miss by a mile.
The digestive nerve has an excuse—he blames his problems on gastroparesis. Hah! A feeble excuse. 🙃
You always make me smile, thank you,
I answered “other.” It’s something that I do but don’t really keep track of. I often change doses based upon my anticipated amount of exercise. Most often, I take correction boluses, instead of waiting for Control IQ to catch up.
I usually adjust up when my SG is high for more insulin given the correction in Control IQ.
I answered rarely, but I realized that I do adjust the bolus by adjusting the carbs up or down, from the actual amount, depending on where I am at the time.
In the “olden days” my first three pumps all had this feature of an extended bolus, which I learned to use when eating things that digest slowly (like pizza or rice). My latest pump also has that feature, but it only works when you switch it to manual mode. I prefer the automatic mode, but occasionally there are times when I want to extend the suggested bolus anyway. So the instead cut the recommended bolus in half and deliver that. Then I put a reminder on my phone’s calendar to give the other half (or portion) at a later time. Before hitting the start button I check my BG level and make adjustments if necessary. It’s not perfect but it seems to work well for me.
I like to correct more aggressively than CONTROL IQ. I also cut back on the recommended dose when I know I will be particularly active.
Since starting to use Afrezza, I only use my pump for my basal insulin. However, I do remember adjusting what the pump suggested for my bolus quite often. So glad those days are over.
I need be on it and educate
Probably every day. I figure the algorithms are based on a goal that is – ley’s say the ADA (or some other D related org) suggested goals for people with T1D, I aim for labs of the “normies” (i.e. non- T1D labs). I start from the pump recommendation, take into account (as does the pump) IOB, FOB (food probably still on board), and the trend arrows. I use Tandem BIQ because I can set the goals and I have access to temp basal as an added tool.
2-3 times a week, sometimes daily tho. Depends on my site. Some sites work better than others so I always have to be vigilant and manually adjust dosing higher to accommodate either for poor absorption or a stubborn high. Or, if I want to eat a full snack to fix a low, sometimes it doesn’t want to calculate any insulin. But I know I’ll go high if I don’t take some insulin so I manually enter then as well. Insulin resistance is a pain.
I hear you, sister … it’s a crap shoot with so many variables …
If BG has been a bit stubborn, and/or ↗️, we will override pump by, most times, .5u.
Most of the time I go with the calculated dose. If my bg value is below the 110 standard “goal” for Control IQ I’m given the option of reducing the calculated amount. I very rarely make that choice because it’s not enough to cover what I’m eating and far too often results in an over 180 high two, two and a half hours later.
Also, CIQ often has stopped basal when below 110, so if I also reduce your bolus, I will always get high.
Depends in what’s going on. Some weeks 0-2, some weeks more often. Stubborn highs, exercise, etc. CIQ seems to be working but sometimes needs a little help.
If hi prior to meal will add .6 insulin
When I first started using the Omnipod 5/Dexcom AID system I was doing exactly what the controller told me to do. I was constantly going high so I went back to doing and taking the amount of insulin that life has taught me that I would need.
I do not use the bolus calculator feature. I use basal IQ, and this seems to work well for me.
My current care plan has me giving a set extra 2 units when eating a high fat meal and using the dual wave bolus. This is 90% of the time I am not going off the suggested amount. The other 10% is rage bolusing when I swear the IOB will not be making the change needed as it has been hours since administering and I know it won’t complete the job. This is not ok but I am working on it.
My response to insulin is non-linear, just like almost everything in nature, it’s more a logarithmic scale. Unfortunately, pumps allow only 1 setting, which I set to the middle range for meals.
But for high corrections, I always have to override with more insulin than suggested.
I do it everyday because Carbs alone do not account for my blood sugar levels, protein and fat also affect amount of insulin needed, so the calculator is good if you are eating fruit, drinking juice, eating a potato, but not much good if you are eating an avacado, steak, chicken, nuts, nut butters etc…
That is usually the reason why take a bolus dose different than what is suggested.
I’ve been walking more (1+ miles every moming) to control morning rise. I’ve had to lower carb count to eliminate the low that happens. I also run Sleep Mode 24/7 on the TSlim X2, so I sometimes have to add my own correction bolus. Also happens as the cartridge drops below 30u…. seem you have to push more insulin through to keep TIR. I normally always take what the Bolus calculates, unless it ignores IOB (which it does on occasion).