Ah, well that’s a problem. With AndroidAPS I can just do a bolus. I use this pre-emptively for when I’m suffering from FOTF; I don’t record (or bolus for) the carbs but I do bolus 1 or 2IU.
I also use it for sticky-highs; AndroidAPS is somewhat conservative if my BG ends up stuck at over 200/11 (normally around 14mmol/L), this is understandable because after a while I have a large IOB. A simple rage bolus of 2IU seems to help and, because AAPS knows I’ve done it, it drops my basal back to 0 to help avoid a low.
So when I know better than AAPS I just bolus (which everyone does on MDI) but then, unlike MDI, AAPS will handle the potential low by cancelling the basal.
The problem with a carb bolus is that the basal might be reduced but it won’t get cancelled until a high rate of BG decrease happens. That’s too late.
Another solution that works but not that well is the additional pen injection; bolus some insulin from a pen. The problem with this is that most of the software programmes do not support that either and the software can, again, cause a low as a result. (AndroidAPS does support this.) I’ve only seen people recommend that for lost insulin such as a detached canula.
A basal change is also a reasonable, but less convenient, approach. That’s an inherent part of the approach used with both Insulet’s software for the Omnipod Dash and AndroidAPS; set a “temp” (temporary) basal for a certain amount of time. That’s pretty common for this type of software.
An even less convenient alternative is a temporary change in insulin sensitivity; so enter the correct carbs but use a carb/insulin ratio which gives the required bolus (e.g. adding 2IU to the result). I think that’s the worse than phantom carbs because the calculation is easy to get wrong, though it could be programmed into a programmable calculator or a spreadsheet. It’s also necessary to change the IC (Carbs to Insulin ratio, backward) back; forgetting that is a disaster.
Some day all these apps will use exercise as input. Since the infusion set is always attached to our bodies exercise can be measured at that point by integrating an accelerometer with the infusion set; accelerometers are really small (2mm) and fairly cheap (USD0.6). ATM this could be done inside a 'phone app using the 'phone’s built in accelerometer and, of course, most “health” watches support this too.
ATM try leaving it for a few weeks, two should be sufficient, and seeing what happens. Maybe the 780g software will catch up enough. What commercial software does is a closely guarded secret; it might be able to cope with FOTF, it might have a built in accelerometer to detect getting up. We just don’t know what this stuff does so often the best thing is to conduct an experiment, obey all the instructions to the max and watch the commercial software fail.
