Why is no medical establishment or any pump company doing a sanity check on the data they are getting?
No doctor even questions if someone is CORRECTLY calibrating a sensor, if they are using the current blood sugar reading to calculate a meal bolus, etc....
- I do NOT believe the pump/sensor/meter combo is anywhere near "good enough" to make a decision about someone's care, I am ONLY suggesting that something which would upload all available data, do a "sanity check" on it (look at the papers from latest ADA conference on number of people WITH the CGMS and other good equipment who do NOT properly utilize or even calibrate it). If the ONLY advantage of the system was
a) to set all the clocks correctly
b) ensure the person is correctly calibrating
c) ensure blood glucose readings for their correction bolus
d) check pattenrs and overall control for major changes
then we have already accomplished quite a bit.
- Help user to stop eating in evening for long enough to be dealing only with basal insulin. This is NOT a perfect system (is he ill, is he under pressure, is his system correctly calibrated) but it IS a first step to getting a basal rate that is correct set up. Once that is set, work around the clock in as many small steps as needed to ensure that basal is good.
- Determine the lead time between insulin bolus and blood sugar drop (will change depending on the current carb load, the current blood sugar, the general health and happiness of person, etc.)
- Determine the lead time between food and blood sugar rise (and this will change depending on types AND amounts)
- Using the above, intelligent suggestions can be made to the patient, their care team or their medical team about adjusting how much and when to give meal boluses.