My apologies @Rphil2. No disrespect intended. It just come to my mind all the negative complaints about medtronic when I read your disclosures, every post you make. Just me. I might be a future convert to medtronic, from Animas. Not much of a choice. I resent the fact that there’s not much choices. I liked the Cozmo. But it died due to litigation against medtronic. (secret). Perhaps the same happened to Animas. Medtronic is a front runner in pump technology. Any hint of copying their patents can be suicide for the competition. Commerce is a dog eat dog world unfortunately. And we the users are the victims.
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I hope for Tandem’s sake that they will not fall into the same trap.
Let’s take a hypothetical case:
Litigation, Medtronic vs. Tandem? Who will win?
Medtronic market cap. $108.3 B
Tandem market cap. $332.6 M
David vs. GOLIATH!
I am having this very issue on the 670g. VERY low right after eating and then spiking 1-2 hours later. Especially at dinner. I’m thinking I need to adjust carb ratios just at dinner. That has been difficult because what it does is makes me stay high at night. On the flip side I’ve always in the last 9 run high at lunch after eating and then dropped significantly 4-5 hours later, but on the 670g I now have a much more stable line throughout my afternoon! That’s something I’ve been trying to figure out for the last 5 years!
With the 670g your options are extremely limited - correct? My understanding is either it works all by itself or you have to kick it out of auto mode to do anything more substantial. I don’t have one so perhaps I am simply not understanding the operations.
In any event, what about adding some exercise an hour after dinner?
Perhaps a 20 minute walk (about an hour after eating dinner) would be enough to mitigate the problem without having to get into a head-to-head battle with a mechanical device?
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Yeah, the correction boluses are tiny. Like .5 units to correct a high because the whole point I guess is to “train” the pump (my words) to learn to give you more basal after to bring you down. I have walked to bring down some afternoon highs but the after dinner ones are like 9pm and I’m in bed. Also, I’m not 100% sure, but I think the point is to NOT exercise so that the pump can learn what you need. It’s crazy. Totally different from pumping as I’ve know it the last 5 years. A lot of people tend to get upset over this new way and think Medtronic is ridiculous, but actually I think this is just going to be the new way of closed loop technology. Hopefully, Medtronic and others will fine tune and only get better. But the whole point in the end is to trust the machine. I’m only a week in and head to my trainer (again) who is also a T1. I am anxious to hear her take and fixes.
I was having the same problem. I started calculating the “carbs” as 100% of the carbs, 60% of the fat, and 10% of the protein to be eaten. I then extend the portion of the bolus related to the fats and proteins. I haven’t gotten it exactly right yet (I think I need to use something more like 80% for the fats), but it is doing much better as far as spiking after a meal.
Before I started on my current automated insulin dosing system, for many years, I dosed insulin based on 100% of the carbs minus fiber, 50% of the protein and 10% of the fat. @Tim34, I’m curious that your fat and protein percentages are roughly flipped from what I used to use. I also extended the protein/fat bolus. I found it to be a stable and repeatable system.
@Terry4 I started with those percentages for two reasons: 1) I read an article that recommended them, and 2) fat has a much more dramatic impact on my sugar levels. I’m thinking about increasing the fat count to 100% and extending the bolus longer because lately my sugar levels have been increasing 3 or 4 hours after I eat.
I try to do this too. I find I end up giving myself about 10-15 extra “carbs” for fats and proteins for most meals. Even with a grilled chicken salad, I end up needing insulin for the dressing and proteins.
There are several old discussions about dosing insulin for carbs, protein, and fat. It uses a method known as “total available glucose” or TAG. I used a TAG system successfully for several years based on TAG concepts. Here’s a link to one of those discussions.
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Have you tried adjusting your Active Insulin Time or Duration of Active Insulin time? Adjusting for a shorter period of time will make the algorithm more aggressive and could help limit those post-prandial highs!