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    • 35 minutes ago
      kilupx likes your comment at
      When you change your insulin pump site, do you tend to notice a spike in your blood glucose levels afterward?
      I oftentimes give myself a little insulin for when I go unplugged while changing pods, depending on what my current sensor reading is.
    • 4 hours, 43 minutes ago
      Phyllis Biederman likes your comment at
      If you use a continuous glucose monitor (CGM), where do you prefer to view your CGM readings?
      Its a Tandem. The main issue I have with the phone is the inability to do an extended bolus.
    • 4 hours, 44 minutes ago
      Phyllis Biederman likes your comment at
      If you use a continuous glucose monitor (CGM), where do you prefer to view your CGM readings?
      I selected “other” because my preference (smart watch, mobile phone, or pump screen) depends on circumstances. Watch for a quick and discrete view; pump if I’m preparing for a profile or activity adjustment or bolus, mobile phone if just a food bolus.
    • 5 hours, 12 minutes ago
      Amy Schneider likes your comment at
      How well do you understand the details of your health insurance coverage?
      At the risk of being overly simplistic, it boils down to: "Heads, you lose. Tails, You lose." ╰── ──╮
    • 13 hours, 35 minutes ago
      Daniel Bestvater likes your comment at
      When you change your insulin pump site, do you tend to notice a spike in your blood glucose levels afterward?
      There are certain areas on my body where the insulin is more effective than others.
    • 23 hours, 8 minutes ago
      Lee Tincher likes your comment at
      When you change your insulin pump site, do you tend to notice a spike in your blood glucose levels afterward?
      I oftentimes give myself a little insulin for when I go unplugged while changing pods, depending on what my current sensor reading is.
    • 23 hours, 8 minutes ago
      Lee Tincher likes your comment at
      When you change your insulin pump site, do you tend to notice a spike in your blood glucose levels afterward?
      Always, until I began to increase the "cannula fill" amount. I found I need a good bit more than the (1.3u) to "prime the site" to have the next blood sugars be in goal. Just remember "every body is different". Darn than OmniPod does not let you change that amount, have to use "fake carbs". Something to consider.....
    • 23 hours, 9 minutes ago
      KarenM6 likes your comment at
      How well do you understand the details of your health insurance coverage?
      They change all the time. Generally not in a direction to improve my health, but to increase the money in their wallet.
    • 23 hours, 9 minutes ago
      Lee Tincher likes your comment at
      When you change your insulin pump site, do you tend to notice a spike in your blood glucose levels afterward?
      Sometimes, which makes sense to me. It seems like it takes a while til the new insulin is absorbed.
    • 1 day, 3 hours ago
      KSannie likes your comment at
      When you change your insulin pump site, do you tend to notice a spike in your blood glucose levels afterward?
      **cannula
    • 1 day, 9 hours ago
      Kathleen Juzenas likes your comment at
      If you use a continuous glucose monitor (CGM), where do you prefer to view your CGM readings?
      I find a using the T-Connect app I have the main features needed, CMG, bolus, battery level and remaining insulin.
    • 1 day, 13 hours ago
      TEH likes your comment at
      When you change your insulin pump site, do you tend to notice a spike in your blood glucose levels afterward?
      Sometimes, which makes sense to me. It seems like it takes a while til the new insulin is absorbed.
    • 1 day, 13 hours ago
      atr likes your comment at
      When you change your insulin pump site, do you tend to notice a spike in your blood glucose levels afterward?
      Usually the opposite. Fresh insulin sometimes sends me low.
    • 1 day, 13 hours ago
      Lawrence S. likes your comment at
      If you use a continuous glucose monitor (CGM), where do you prefer to view your CGM readings?
      Mostly pump because I want to quickly see insulin on board. Tandem on IPhone when holding my great-niece while she sleeps since getting my pump out of my pocket always wakes her ☺️. Dexcom app if not in need of insulin.
    • 1 day, 13 hours ago
      Lawrence S. likes your comment at
      If you use a continuous glucose monitor (CGM), where do you prefer to view your CGM readings?
      usually the pump; sometimes my phone.
    • 1 day, 13 hours ago
      Lawrence S. likes your comment at
      If you use a continuous glucose monitor (CGM), where do you prefer to view your CGM readings?
      My pump (Tandem X2). Since I have to carry a work phone close to 247, I don't want to deal with two phones (device overload!). As I go about my day, looking at my pump meets my needs, I can decide to bolus etc - and edit the bolus. For more in depth data review and analysis, I use the TConnect.
    • 1 day, 13 hours ago
      Lawrence S. likes your comment at
      If you use a continuous glucose monitor (CGM), where do you prefer to view your CGM readings?
      I read it from my pump.
    • 1 day, 13 hours ago
      Lawrence S. likes your comment at
      If you use a continuous glucose monitor (CGM), where do you prefer to view your CGM readings?
      On my insulin pump
    • 1 day, 14 hours ago
      Lawrence S. likes your comment at
      If you use a continuous glucose monitor (CGM), where do you prefer to view your CGM readings?
      My pump. Keep it simple.
    • 1 day, 14 hours ago
      Lawrence S. likes your comment at
      How well do you understand the details of your health insurance coverage?
      How much of this is intentionally misleading? My mail order prescription service says that can’t possibly know the cost of a medication until after it’s been shipped, which is too late to cancel or return, of course, and makes it impossible to comparison shop.
    • 1 day, 14 hours ago
      Lawrence S. likes your comment at
      How well do you understand the details of your health insurance coverage?
      I have an MA in writing and lit, but gobbledegook is gobbledegook. The fancy term is obscurantism.
    • 1 day, 14 hours ago
      Lawrence S. likes your comment at
      How well do you understand the details of your health insurance coverage?
      They change all the time. Generally not in a direction to improve my health, but to increase the money in their wallet.
    • 1 day, 14 hours ago
      Lawrence S. likes your comment at
      When you change your insulin pump site, do you tend to notice a spike in your blood glucose levels afterward?
      Usually the opposite. Fresh insulin sometimes sends me low.
    • 2 days, 11 hours ago
      Sarah Berry likes your comment at
      If you use a continuous glucose monitor (CGM), where do you prefer to view your CGM readings?
      My pump
    • 2 days, 12 hours ago
      Marty likes your comment at
      If you use a continuous glucose monitor (CGM), where do you prefer to view your CGM readings?
      One nice thing about a watch for readings is that, while it is normally redundant, you can be separated from your phone. For example, when you are in water.
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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.)

    Home > LC Polls > 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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    Sarah Howard

    Sarah Howard has worked in the diabetes research field ever since she was diagnosed with T1D while in college in May 2013. Since then, she has worked for various diabetes organizations, focusing on research, advocacy, and community-building efforts for people with T1D and their loved ones. Sarah is currently the Senior Marketing Manager at T1D Exchange.

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Their collective expertise is central to our mission of improving outcomes for all people living with T1D.  “We’re excited to be working with our advisors given their deep expertise across a broad range of areas in T1D,” said Dave Walton, CEO of T1D Exchange. “Their involvement magnifies our reach, knowledge, and impact. These advisors are shaping the future of diabetes care — driving innovation across research, clinical practice, and quality improvement.”    Meet the Medical & Research Advisory Team  The T1D Exchange Medical and Research Advisory Team brings together four leading endocrinologists, each offering a unique perspective and shared commitment to advancing T1D care:    Jenise Wong, MD, PhD Pediatric endocrinologist at UCSF Benioff Children’s Hospital and Professor of Pediatrics in the Division of Endocrinology at the University of California, San Francisco Focus areas: Diabetes technology adoption and usability; health equity and access to care and technology; community-based and peer-support interventions; culturally responsive care          Jennifer Sherr, MD, PhD Pediatric endocrinologist at Yale Medicine and Professor of Pediatrics in the Division of Endocrinology at Yale School of Medicine in New Haven, Connecticut Focus areas: Clinical trials in diabetes technology (CGM and AID systems), disease-modifying treatments and immunotherapies, and emerging technologies and medications, including continuous ketone monitoring and nasal glucagon     Viral Shah, MD Adult endocrinologist at Indiana University Health and Professor of Medicine in the Division of Endocrinology and Metabolism at Indiana University School of Medicine in Indianapolis, Indiana Focus areas: Diabetes technology and adjunctive therapy trials; translational and data-driven research; T1D complications and bone health         Nestoras Mathioudakis, MD, MHS Adult endocrinologist at Johns Hopkins Medicine and Associate Professor of Medicine at Johns Hopkins University School of Medicine in Baltimore, Maryland Focus areas: AI-driven clinical support tools; EMR-based data analytics for clinical decision making; data-driven quality improvement; health equity in T1D care        This accomplished team’s expertise spans adult and pediatric endocrinology, research, and quality improvement affiliated with leading institutions nationwide. Collectively, they have authored over 500 diabetes publications and secured research funding from organizations such as the National Institutes of Health, Helmsley Charitable Trust, the American Diabetes Association, and Breakthrough T1D — while remaining actively engaged in both clinical care and research.  “These individuals represent an impressive body of work while remaining deeply involved in the day-to-day realities of diabetes care,” said Walton. Their expertise covers the full spectrum of T1D care — from AI and predictive analytics to complication prevention, automated insulin delivery, continuous glucose and ketone monitoring, GLP-1 treatments, health equity, mental health, autoantibody screening, and disease prevention.    Turning insight into impact  The team’s work goes beyond research, focusing on translating insights into real-world practice. 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    30 Comments

    1. Cheryl Weaver

      After I’ve had my pump on for a couple days the insulin I bolus with it doesn’t bring my blood sugar down, or prevent it from going high. I have to inject using a syringe and needle to bring it down. The insurances say to change your site every 3 days, but between that 2nd and 3rd day something seems to happen, where it isn’t being absorbed as well. So the blood sugars go up, and I have to bolus the old fashioned way, with a syringe.

      4
      4 years ago Log in to Reply
      1. LizB

        Ask your doctor to write a new prescription that says to change every 2 days instead of every 3 days. Not every insurance will go for that, but sites sometimes don’t last 3 days for everyone.

        4
        4 years ago Log in to Reply
      2. Sherolyn Newell

        I sometimes have that issue as well, but it’s not consistent. If I see the insulin not working as well, I will adjust my bolus amounts up by 0.1 or so.

        2
        4 years ago Log in to Reply
      3. Larry Martin

        You need to change your carb ratio or insulin sensitivity to fix those issues. Carb ratios and sensitivity vary widely throughout each day.

        2
        4 years ago Log in to Reply
    2. Greg Felton

      I don’t think the tandem’s calculator is aggressive enough when my BG is rising and arrows are pointing up. I will often over bolus.

      3
      4 years ago Log in to Reply
    3. Lawrence S.

      I often make adjustments for exercise, other physical activities, which works out to most days.

      2
      4 years ago Log in to Reply
    4. GLORIA MILLER

      My pump will do this but I chose not to use that function. I feel I can calculate the necessary bolus better than my pump.

      1
      4 years ago Log in to Reply
    5. Sherolyn Newell

      I sometimes have a few days or a week when the insulin seems to be less effective. When I see that happening, I will raise my bolus calculation a bit. I don’t change my settings because it always goes back to normal. Less often, the insulin seems to be supercharged and I have to back down bolus for a couple days. And it varies by time of day, sometimes lunch insulin doesn’t seem to work, other times it supper.

      1
      4 years ago Log in to Reply
    6. Mark Schweim

      I normally don’t but I’ve been fighting a combination antibiotic resistant bacterial and fungal infection in my sinuses and throat since the beginning of April and with this stubborn illness I’m having to usually increase the Bolus amount as much as double what the pump calculates I need.

      4 years ago Log in to Reply
    7. Patricia Kilwein

      If I’m struggling with an illness or on a prescription that causes high BG, my doc or edu will give me instructions on a temp setting for basal. The only time the bolus changes take place is when there’s a trend change and A1C goes up.

      1
      4 years ago Log in to Reply
    8. Maggie Morgan

      I will often give less insulin if I know that I will be working out in the next 2 hours.

      6
      4 years ago Log in to Reply
    9. Angela Pennacchia

      My Dr. Did write me a new prescription for every 2 days, as I have the same problem. I am on Medicare and they accepted it.

      4 years ago Log in to Reply
    10. Linda Zottoli

      Often, for lots of reasons. Pump doesn’t know some things that I know: what I’ve already eaten to deal with a low or otherwise without bolusing, the walk I’ve just taken or exercise I am planning, come to mind. And, for correction boluses, I have the correction amount set to work fine for some bg variations, but for readings above maybe 200, or even lower if long lasting ones, I also have to consider a decrease in sensitivity. And, sometimes, if I know what I want bolused, it’s just easier to just plug in the amount. (though can’t use info about percentage basal/bolus then).

      4
      4 years ago Log in to Reply
    11. AnitaS

      I do at least a few times a week as sometimes my insulin isn’t working because of the infusion site may not be as responsive to insulin as other sites. I may not plan on exercising as I usually do at a certain time. I may bolus more for high fat foods or bolus less for an activity that I am about to do. The reasons are endless.

      1
      4 years ago Log in to Reply
    12. kristina blake

      I am very aggressive in my T1D mgt. For meal boluses, I take into account any FOB (food on board – as best I can guess), I also pay attention to trend arrows. As another response said, only I know what is ahead for the next couple hours. While I do have different settings for about 9 different time zones throughout the day, I also titrate up (or down) based on the bg reading (if bg is under 130, I use the correction setting in my pump, if I am between 130-160, I increase by 10%, etc). I also have this “lovely” symptom of rising bg (lovely, because it comes in handy) – I get heartburn as my bg rises. I use what I can!

      4 years ago Log in to Reply
      1. Patricia Dalrymple

        OMG: I have just started experiencing this when I am high. It feels like I need to burp. It can’t.

        4 years ago Log in to Reply
    13. Bea Anderson

      The pump wizard does not know if I’m exercising or factor in other life issues.

      3
      4 years ago Log in to Reply
      1. Karen Brady

        my system doesn’t have an exercise setting/profile either, so I have to adjust manually for this (or even if I’m at work where I’m active and walking around, vs sitting on the couch at home)

        4 years ago Log in to Reply
    14. dave hedeen

      I add fat ‘carbs’, if eating food high in fat, pizza or pumpkin pie

      1
      4 years ago Log in to Reply
    15. Leon Ullrich

      My pump does a good enough job estimating with all the factors included in the pump. If the factors are wrong they are reviewed with my doctor.

      1
      4 years ago Log in to Reply
    16. William Bennett

      Some stuff you just get a pretty good sense of after you’ve been at this long enough. Things I eat frequently I rarely bother with the Wizard for, and stuff that’s unusual or hard to estimate b/c of fat content I’ve just built up a routine of my own for (pizza, Chinese). Of course it was very different before CGM, when it was much riskier to guesstimate things.

      2
      4 years ago Log in to Reply
    17. Janis Senungetuk

      Since my pump doesn’t read minds or calendars I often need to change the suggested bolus amount.

      2
      4 years ago Log in to Reply
    18. Carol Meares

      I don’t really count carbs. It is difficult when eating low carb. I have my carb to insulin ratio set at 10 to be able to easily calculate insulin I need for a meal due to protein, fat for resistance and yes, some carbs, type of activity level, stress, health condition, etc. The estimate I give may need to be corrected later or maybe not.

      4 years ago Log in to Reply
    19. Carrolyn Barloco

      I respond to upward trend arrows by taking a 1-2 unit bolus

      1
      4 years ago Log in to Reply
    20. TEH

      I adjust the carb estimat based on the fat content and my experience with certain meals. Must dinners average 50 g of carbs…

      4 years ago Log in to Reply
    21. Patricia Dalrymple

      I lower it sometimes with fresh insulin but have started lowering my basal for that because it is very consistent. Every Sunday I visit my dad. Even though I eat the same thing most mornings, when I go there my BG always goes low so I have been lowering my bolus a couple points.

      4 years ago Log in to Reply
    22. mbulzomi@optonline.net

      Except when I’m sleeping, I always self-Bolus. Control IQ is too slow to react. I have no patience with Control IQ. Some time when I used it, it would take 4 hours to bring down my numbers. Good for new kids, not me.

      1
      4 years ago Log in to Reply
      1. mbulzomi@optonline.net

        After reading some comments it evident that we use different Insulin pumps. and delivery systems. Most likely we cannot compare their action.

        4 years ago Log in to Reply
    23. PamK

      I chose 2-3 times/month because I only recently started doing this. I have found that when my BG is over 250mg/dl the calculator doesn’t deliver enough insulin to bring me down.

      4 years ago Log in to Reply
    24. Cheryl Seibert

      There are specific situations where I override a bolus calculation or enter a manual insulin-only bolus.
      1. My Tandem pump will occasionally ignore the IOB in the calculation. If my BG is NOT high, I will override the suggested bolus to the ‘correction calculation.
      2. Manual extended bolus if the site is getting bad and I cannot immediately change it. Extended bolus will act like an aggressive basal rate and absorb better.
      3. Intended exercise after a bolus….. I often reduce the meal bolus if the exercise will be moderate, heavy or of a long duration.

      4 years ago Log in to Reply

    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.) Cancel reply

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