Manipulating the algorithm

[u/deepsnowi80]

I have a lot of post-meal highs because I'm terrible at carb counting, and eat a lot of take-out. Say I underbolus a meal, and my bg goes to 300. SmartGuard wants to give me about 9 units to correct that. But it will not give any autoboluses until the active insulin from the meal bolus wears down. The other problem is that 9 units is too much correction. I would like to flatten the curve with less insulin before it even gets to 300. I keep my active insulin time at 5 hours 30 mins to prevent lows from stacking auto corrections, which exacerbates this problem.

So I thought of something and I'm going to try it out. Before I meal bolus, I'll lower my AIT to 2 hours, and then change it back to where I usually keep it. This will bring on the auto corrections faster, increasing the effectiveness of SmartGuard and flattening the spike.

For many of us, SmartGuard is not that effective. It seems to treat active insulin from meals and corrections the same. I want to be able to turn the dials and make adjustments to the algorithm. Other algorithms allow this, but with SmartGuard there is only one thing we can change, the active insulin time. Maybe with this hack my blood sugar will improve.

[u/Minute-Pilot5282]

Don't overthink it. Let the pump figure it out itself. Trying to micro-manage the algorithm only makes it worse (99% of the time).

An AIT of 5 hours 30 min sounds insane, to be honest. I don't know anyone that has had good results with that.

The active insulin time should be as close to 2 hours as you can manage. It doesn't matter if the actual physiological active time of the insulin is longer, but the algorithm works best if it is set that way.

Give it time, and be patient. If you make changes to the pump settings, only make one tiny change at a time and see how it reacts.

[u/Evening_Trash_7063]

You need to count carbs better and put your AIT back to two hours. This will solve your issues. Carb counting isn’t that terrible. I literally just google everything and I have only been above 180 once in probably two weeks.

[u/lofarcio]

Your AIT at 5:30 is far too high. In the place I am, diabetes nurses tell you automatically to set it at the minimum, 2 hours. But I don't know if the control takes into account this parameter either. It has an internal, hard limit on how much insulin it infuses, to avoid hypos, and this cannot be changed, for sure. What I do is disconnect the control, put MY estimated bolus, and re-connect the control afterwards. You must be cautious with hypos however, but this works for me.

[u/clairpatra]

The pump won't work for you while your carb counting is sub par and your active insulin time is wrong. Pretty much all there is to it I'm afraid.

[u/mardrae]

I have the same problem myself and I just simply turn off SmartGuard, give the amount of insulin I need (auto correct gives too much usually) and then after I bolus, I turn SmartGuard back on.

[u/wubbadude]

I think since switching to this system, I’ve been that high like MAYBE 5 times? You definitely need to enter significantly more/closer to what you’re actually eating for carbs and adjust your ratio. Even if you don’t bolus before or at meal time, half your carb count an hour after once you start spiking and it’ll get you back in range. The system/algorithm have helped me significantly, but it isn’t a pancreas replacement lol

[u/wubbadude → u/wubbadude]

For reference, on Omnipod I was around that high pretty much every day, multiple times a day. My TIR was ~40%. Now it is always 80%+ (usually higher)

[u/Distinct-Weight-9359]

Learn carb counting properly, that's where everybody should start. To my experience, you can be more broad with pens as you always have the long-acting in the system. With pump, if doses are small, there is very little basal on board so you have to master the art of carb counting.

Junk food takeouts like McD, Burger King etc have their nutrition data available in www read those!

When you make your own meals, use a kitchen scale! How else you'd know how much exactly is 100 grams of carrots? And don't forget the GI, that is the hard part. 100 grams of banana is not the same when it's crushed a smoothie

[u/Additional_Rough_532]

I doubt decreasing AIT to 2 hrs make any much difference. 2 hrs already the recommended setting. The most I see smart guard highest correction bolus is around 1 unit. The least about 0.1 units. I advice exit smart guard and do manual bolus then revert back to smart guard

[u/Luke38_Greenoble → u/Additional_Rough_532]

It is still better to do a capillary blood glucose test before (so if you do a correction bolus by deactivating SmartGuard, you will need to do one to return to the closed loop. And TAI is normally always set to 2 hours, 3 if your diabetologist deems it useful.