I have a Minimed 630 and only use the bolus wizard for breakfast.
I am a bit OCD and pretty much have the same breakfast every day, cereal, banana and tea. I use 80gm for breakfast. My carb ratio is 7. Seems like whatever my BG is 80-200 it tells me to infuse 11.4 units of insulin? Is this right?
I called Minimed but did not really get a good explanation.
I never used the bolus calculator. Didn’t trust it.
But, I don’t think it will adjust according to BG, unless that BG is low.
It certainly wont adjust well. I’d do that on your own.
Did you mean carbs instead of grams?
It is complicated but i will take a stab at it. First it sounds like you pump is working about right. The bolus calculator is mainly used to calculate dosing for your food intake. 80 carbs 7 grams per carb 7,7. Works about right.
One of the major complaints with the 670g is that it takes forever to glide us down to its equilibrium which is 150. It will use basal calculations to dive us below 150 but it will initially set to 150 when giving a food bolus. So all food, + amount to get us to 150 minus the projected Basel. Is the general (not exact but general - Do not jump on me here i know that is not exactly right) bolus calculation.
What that turns into in most cases is the amount we have told our pump we need in terms of U / carb. In your case 1 to 7 carbs.
Ok so why is it doing this, the pump is Incredibly conservative. It will do everything possibile to not drive us low, ignoring the issues we face (namely how bad I feel) if I am high. I am ot scared of lows, The pump programs thinks i should be and maybe you are less of a risk taker than me. The pump is designed to hit the maximum number of people in the sweet spot.
Now the pump does compensate for this low threshold of risk. Remember the Basel is self adjustable. So it will give give more when it is trying to drive us down, and less up to 0u when we need less.
You enter the food amount of carbs and that is usually the bolus no matter where you start. Now this does drive us low. If in particular we have excess IOB. That is why they tell us to not override the pump with more or less carb then we actually eat.
Side note here, knowing the carbs in food is extremely important. If you a re not using a carb caution program I suggest you get one, ti will are 670g pump life much better. I use WW, but you have to be a member to use it. There are other free choices out there. But I do not eat a thing without calculating the estimated carbs,
If you take in 7 carbs, you get 1 unit no matter if are at 50 0r 250…
So why? Well the 670g relies on incredibily tight carb counting and assumes our body will react to the basal amount adjustments. Again this is why they tell us not override the pump and push additional or less carbs than we take in.
Ok so that is the official Medtronic position.
While that is the official position I can say i soften or harden my dose depending on the situation. So if I am 60 and take in 40G of carbs I will wait awhile to decide if I wish to dose. I likely excercsed and BG dropped, so I sit it out for awhile and let it ride. Adding insulin is easy but taking it away is impossibility.
Likewise, I have gotten frustrated and said I want this lower and i forced it lower with more carbs than I have consumed. You might say I have delivered a rage bolus to drive it down faster.
If I do these things You have in essence taken the Pump out of the programed auto mode. We i do this I place it in RIck mode and depending on how wildly i have ignored or bloused the expected impact (usually I go low) follows. But i am in Rick mode then i want to renter auto mode as soon as possible.
How to do that, well first, do not add more bolus. Bolus on bolus can really get me into trouble. In my case insulin will not dissipate for 3.5 to 4 hours, so i have got to let it work. If I ignored a bolus I have to check at 1/2 hour and hour.
Now remember what is just said is not suggested by Medtronic. But i do think most of us who use the pump follow a similar routine. As always remember i am not a doctor (well i am but not that kind). Also remember that for 312 straight weeks I have been declared the weekly best speller on TUDiabetes.
Rick
And for the disclaimer that i am required to give. Or something like what I am required to give.
I am a Medtronic ambassador. My opinions are my own. They did not pay me to say nice things. OK, they sent me a shirt and a cup but even I am more expensive than that.
1 Like
Not sure if I have the terminology correct, but I mean grams of carbohydrate.
Sorry, I’m used to just saying carbs!!
So 80 / 7 = 11.4
If there is also a correction factor to deal with bg, then it should add more to the 11.4, and if you have active insulin from previous bolus it will subtract.
In the link I posted, do you see the screen that shows the 3 numbers for calc?
It shows .3 due to bg of 130,
-.3 due to active insulin
2.3 for carbs.
So sum is 2.3
If you are not getting value to adjust based on bg, there may be a missing setting where you specify how much to adjust for bg. Often called correction factor. Per the details in link, shows that bg must be input to pump.
2 Likes
I have been using Medtronic pumps for 10 years (Now on 670G) and my insulin:carb ratio is 1:7. If you are eating 70 gr of carbs, provided your BG is in range, you will receive 10 units of insulin. However, if your BG is over 150 you should also enter the BG number into the Wizard. In this connection, my BG ratio is 1:40 (programmed into my pump.) Accordingly, if my BG is 190, this will cause an additional 1 unit of insulin To be infused 190 - 150 = 40 - 40/40 = 1
1 Like
That sounds like a lot of insulin. Are u sure ur ratio is correct? Mine is 15 and I thought that was rather low. My basal is around 1-1.2 per hour which should translate to 30 but I’m half that. So it’s difficult to really figure it out.
I go with 15 because that is what has worked for many yeArs
It’s possible @Don1942 is Type 2, using insulin and possibly other meds. With insulin resistance (also possible in T1s), larger doses are typical.
I am indeed an insulin dependent T2 with regular c-peptide readings of < 0.01 And with insulin resistance.
I also use the 630G. I never bolus for food without first checking my bg, which, with the Contour Next, gets automatically programmed into the pump. Since my correction factor and bg goals are permanently programmed in, the Bolus Wizard will correct if my bg is too high, as well as giving me the correct dose for my meal. My ratio is 1:10, and my correction factor is 30. So, for example, if I’m going to be eating 50g carbs, my pump would give me 5 units for the carbs – plus, depending on my bg before eating, it will also give me a correction bolus (plus OR minus).
So, let’s say I’m about 50 above my ideal bg target, and I’m going to eat 50g carbs. The pump would give me 5 units for the carbs, plus another 1.67 units for a correction, for a total of 6.67 units (probably rounded up to 6.7 units). If I’m too low, say 70, and my target is 90 before meals, the pump would give me 5 units for the food, but would subtract some of that because I’m lower than my target, thus giving me something over 4 units, but not the whole 5 units.
In order for the Bolus Wizard to work correctly, you need to have input all your factors: insulin:carb ratio, correction factor, and bg goals (which can vary depending on the time of day, when you typically eat, etc.)