Insulin dosage calculation

@Scott_Eric

Totally agree.

I think the days of pursuing the perfect static formula to dose insulin are slowly dying. Most people who treat diabetes with insulin and pay attention to what’s happening understand that diabetes is a dynamic game. It’s interactive like running, skiing, and surfing.

It’s amazing to me that it took Sugar Surfing’s Stephen Ponder’s articulation of this a few years back to shake up the static diabetes management philosophy. Once I thought about it, it made so much sense.

Even using Loop, an automated insulin dosing system, I still “surf” by selecting lower and higher temporary glucose targets because I want to steer Loop in a favorable direction. Static formulas place you in the right neighborhood, responding to the latest trend can put you right where you want to be.

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yes, agree - but I wanted to point this topic out as simple as it can get to start a conversation about it. Thanks for raising your attention and feedback.

I’m a T1D since 15 years …

The app is designed to adapt to individual lifestyles. Good carb counting is better however not so good carb counting will not break it. Just think of me … I’m estimating carbs most of the time so its fairly accurate (I think) but not even close to be exact.
For using other insulins we would need to add there specifics into the parameter sets. So far we have implemented Humalog and Levemir and adding more over time.

“I don’t think I understand this - not taking extra boluses”: I know what your concerns are. I’m a T1D myself and I did frequent extra bolus after meals to adjust for e.g. digesting delays. To my own surprise the app is better in dosages calculation and extra boluses became very rare. even in event like your ice-cream example.
Please don’t get me wrong … my intention to write here is not so much promoting “my” app (that is btw. not available right now since not having FDA) but rather discussing other options of diabetes management. And the option here is giving as much control as you feel is good to an artificial intelligence and let it flow … Over decades I received tips from my doctor, books, specialists, consultants on how to manage my live as an diabetic with only limited success. So diafyt is a bit different. Just give it a thought that what is working for autonomous driving could drive your diabetes in the future.

the algorithm works differently. their aim is to level your glucose over time so in your case it would take a day or two to learn your individual habits and than these corrections go away.
The algorithm goal is to reduce the number of insulin shots by estimating insulin dosages as best as possible. The algorithm is not a fixed thing. It learns over time (machine learning)

yep, that’s what we do “minimize the amount of injections needed”. The machine learning is optimized for that.

Perhaps it is a language barrier.
Just as FYI: This is not at all (not even a little bit) how your posts come across.

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Tom, with respect, your A1C is in the high 6s. I understand that is a long way from 8 and is a great accomplishment for you, but to me it demonstrates the software has a long way to go if that’s the best you are achieving. It isn’t helping prove your point. What you are saying is contrary to my experience with the injectable insulins that are available right now and how the digestive system works. It is also contrary to the logic of the AP/loop systems, which aim to give people more boluses, not less, after meals and throughout the day. Rapid-acting insulin is only equipped to deal with spikes that happen in the first 2 hours of digestion, maybe 3-4 for some people and depending on the brand, but that’s about it. There is no way to calculate the initial bolus differently to get around this. If food is digesting 6 hours later, taking more rapid up front will just cause a hypo.

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Tim, I don’t think you are misunderstanding a thing.

If you look at his post history, you will see that he is only posting about his app, and nothing else!

I think your read on it is correct.

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Okee-dokee everyone I think we are in fact dealing with a language barrier here. In addition the OP doesn’t seem to be a PR person for his app but he is obviously proud of it and his own success with it and if he got his A1C to 6.8 from an 8 it is a huge accomplishment. I think we the DOC actually have an opportunity here to give our experience and feedback before this app hits the mainstream diabetic. A complaint I often see on this site is us bemoaning the fact that most diabetes companies don’t seem to have actually talked to a real life diabetic before launching their product. So here’s my 2 cents.

Does this app calculate dosage according to what BG you want to average out at or is it a set number? A lot of people particularly on sites like this are striving for strict control with A1C’s in the 5’s or even 4’s so an average BG of 120 just wouldn’t cut it for most of us.

Since I don’t use Humalog or it’s duplicates in order for me to use this app it would need to be able to be calibrated to the duration of the insulin I am using. BTW, I also don’t use Levemir but Tresiba and they have completely different profiles.

Usability is absolutely key for me to use and keep using almost anything but especially in this case because I am not very good with technology. Ease of installation, a good interface, a decent tutorial are all helpful in my case.

One more thing that doesn’t personally affect me but does affect a lot of diabetics is the ability to change the background color, text color and size to accommodate those with limited vision. I think @Jen would be a good person to give feedback on that issue since she has limited vision and therefore much more experience than I do. Perhaps even voice entry and responses for those who are unable to see the screen.

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To Tom and all that answered and posted here has any of you ever found a true solution in controlling your diabetes like a “healthy” person does.
I haven’t after 50 plus years and spending 100 of thousands of dollars at it, therefore anything is worth trying.

sure … I think I found a solution that works for me - diafyt. It calculates my insulin dosage. It sits on my android phone and anytime I want to take insulin I “ask” the app for advise. I use it for about 8 weeks. It works surprisingly well. The frequent up and downs are all gone. My Glucose level is much more stable. I got a lot of my (healthy) life back after years of struggling with glucose management.

I’m a T1D (since 20 years), engineer and scientist, startup founder of diafyt, manager in a consulting company. I use a CGM (abbott), Insulin pen and diafyt for glucose management.

diafyt is a tool we build for diabetics like myself. We spent years of research and development. Main components are a diabetes simulation (algorithm) and machine learning for parameter tuning (personalization).

You can set your target range.
A1Cs of 5? Congratulations to all f you who are in this group. However diafyt is targeting diabetics with hard to manage glucose levels like me.

its tuned for Humalog and Levemir however insulin types are parameters than can be set (added).

the app is super simple. nothing to tune every day. its only one button to press and it tells the insulin dosage. as I said, for me it takes less than 30 seconds to do all steps including taking the insulin.

good point however out of scope. we need to focus on core functionality and certification to spend time and money wisely.

Something worth considering in all this high tech quest for the Holy Grail of blood sugar normalization is that very large-scale studies in both type 2 and, much later, type 1 patients have shown that blood sugar normalization for some inexplicable reason causes worse results than leaving levels a bit high. The production of complications in relation to blood sugar levels has been described graphically as being distributed like a smile, with very high and very near normal levels both producing greater risks of complications.

In our algorithm we optimize for glucose graphs similar to healthy people, rather than low a1c.

This is not really what those studies showed. They did not measure normal blood glucose levels, they looked at A1C, which can be affected by many things, such as blood disorders or liver problems.

Striving for normal blood glucose levels, maintaining levels within a target range that avoids both highs and lows, really is what diabetics should try to do.

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Yes, Dr. Bernstein’s Diabetes Solution. No technology required!

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Engaging with him on this or any issue is futile I’ve learned. He believes he is right and we’re all doomed.

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