# Bolus adviser



## treasure_ireland (Feb 18, 2011)

Hi All,

So basically, I think the bolus advisor is wrongly giving me a correction, as shown in the piccie attached.

In all my time blocks my target range is 4.0 - 8.0 mmol/L, so there is no fuault there.

This has happened once before, but my nurse told me to check my target range, and obviously its not that.

Anyone else that could be the reason its correcting?

Thanks,

Becca


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## shiv (Feb 18, 2011)

Sorry to be dense, so the 2nd row down is the correction it thinks you should have?

I would ring Roche and speak to them to see if they have any idea.


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## treasure_ireland (Feb 18, 2011)

shiv said:


> Sorry to be dense, so the 2nd row down is the correction it thinks you should have?
> 
> I would ring Roche and speak to them to see if they have any idea.



Oops yep second row down is correction.

My ratio there is 1.5 unites for 10g.

So it should of been 5.9 (this is what i did, i removed the 0.5).

Strange huh! I think I will ring roche, not looking forward to it, not had much luck so far!


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## shiv (Feb 18, 2011)

It's not trying to correct you down to 4.0mml is it, if that's the bottom of your target range? That doesn't seem logical but I'm not overly familiar with Roche. I'd ring them, personally I would insist on them swapping the handset!

I have an Expert at home, I might experiment with it tonight and see if mine does the same.


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## treasure_ireland (Feb 18, 2011)

No, as long as my BG is within 6-8 it "shouldn't" correct.

I just rang roche, pump support didnt know, so they are getting a rep to ring me back.

Surely it would be the software right?

Im not keen on another handset, on my third now (after a month) had this one a week, and it hasnt packed up yet! Hope it doesnt come to that :\

Let me know how you get on with the expert, is it your spare meter?


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## shiv (Feb 18, 2011)

Yes, I've got it tucked away at home. I'm not overly keen on it to be honest, but I do appreciate that's a nifty piece of kit!

Software issue sounds about right...I'm really curious to hear what Roche will say!

Probably not relevant at this point, but given the issues you've had, would your clinic be willing to let you change onto a different pump if you wanted to?


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## treasure_ireland (Feb 18, 2011)

Well they told me I will have to go into hospital to see my pump rep, and she will take the data, and find out why it corrected.

Apparently even if I didnt do the correction, they can still see it.

I have no idea, they havnt mentioned it, and doubt they will to be honest.


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## everydayupsanddowns (Feb 18, 2011)

Hi Treasure_Island

I use the Expert (same bolus calculation as far as I know).

What is happening is this:

Your range is 4-8mmol/L, and the handset will always aim to get you to *exactly the midpoint of that range* (6mmol/L).

Since you are slightly above the midpoint (6.9), it calculates a correction based on the 'sensitivity' factor you have set for that time of day as long as you don't have any other recent ongoing corrections going (within the 'onset time' of the insulin that you specified). Similarly, if you were 4.0 before a meal, it would knock off a fraction of the bolus (ie negative correction) to aim to get you to your mid-point.

The thing to watch is 'Active Insulin' (top left of the screen). This is slightly misleading terminology as really it only displays 'Active Corrrection'. Bolus advice completely ignores this (assuming that whatever correction you have administered will eventually work perfectly). This can mean that if you have misjudged a meal/correction, or overruled the advice, or if the settings you have in place for that time block are not quite right and you have too much 'active correction' working this will not be taken into account in subsequent bolus advice and sometimes you need to reduce the suggested bolus advice by those numbers depending on your current BG.

Hope that made some sort of sense.

M


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## treasure_ireland (Feb 18, 2011)

Hi,

I didnt think it would give me more insulin as long as I was within that range, weird how roche didnt even state that, or query it. I have noticed it removing a bit of insulin if im 4 before a meal.

This was my first bolus of the day, so there was no active insulin.

I guess it makes sense why it was adding a correction, but it found it weird, because to me 6.9 seems perfect, and 0.5 seemed a lot.

Oops now I feel like I have hassled my nurse for no reason :s

Thanks.


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## everydayupsanddowns (Feb 18, 2011)

I've had a few phone calls with Roche to ask about the ins and outs of the Expert (when it seems to be behaving strangely) and they've always been really helpful. The mid-point of range thing was mentioned by my DSN though, who showed me how to use it initially. Like you say, odd for Roche not to have just explained it straight away... Would have saved you a lot of confusion!

M


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## Ergates (Feb 18, 2011)

I'm with Mike - it's correcting you back to the mid-point of your range.  Both my DSN and Roche sales lady/trainer mentioned this during the pump introduction.


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## bev (Feb 18, 2011)

Hi TreasureIsland,

I hope you get it sorted - I am not familiar with your pump - but doesnt your pump work this out for you anyway.Bev


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## shiv (Feb 18, 2011)

bev said:


> Hi TreasureIsland,
> 
> I hope you get it sorted - I am not familiar with your pump - but doesnt your pump work this out for you anyway.Bev



It was calculating things Rebecca had never been told it calculated (ie correcting to mid point of target range), hence the confusion!


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## bev (Feb 18, 2011)

shiv said:


> It was calculating things Rebecca had never been told it calculated (ie correcting to mid point of target range), hence the confusion!



Hi Shiv,
Thanks for clarifying that - I have just read it again and realised - I am surprised the DSN didnt know this though.Bev


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## Adrienne (Feb 18, 2011)

Hiya

If your target range is 4 to 8 why not change your target range.   My daughter's is set at 5.5 to 6.5 and so will always correct down to 6.5.  This is the Medtronic though and doesn't correct down the average, but to the top number.

Or have I got this wrong.


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## Ellie Jones (Feb 18, 2011)

It also takes in consideration your allow meal range, is default setting is 2.8mmol/l so it looks at your mid-point range, and if the carb amount will take you above a meal rise, it give a correction..

You can change your meal raise range under settings>Bolus Advice>Advice options.. 

I've been using my expert for just find over a month now, and I found it to be rather helpful indeed...


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## tracey w (Feb 19, 2011)

treasure_ireland said:


> Hi,
> 
> I didnt think it would give me more insulin as long as I was within that range, weird how roche didnt even state that, or query it. I have noticed it removing a bit of insulin if im 4 before a meal.
> 
> ...



Like Mike says, although you are in range it will give you a correction to make you midway between your target points. 

My rep did explain this to me initially.


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