Absolutely true. But all the input required for the carbs needed to bring up to target are already in the pump. It has all the information required. If anything is wrong in the pump then it needs to be corrected to make other dosing decisions accurate. This is why this one in particular gets me. The pump HAS EVERYTHING!!! AGGGGHHHH. It would have taken a programmer one extra subroutine to build this in.
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i like the idea that eric puts forth. i believe, and i have only learned this recently since i began swimming, that knowing how much basal is on board is mandatory for making decisions from one moment to the next. when i prep for my swim, i turn my pump off for 2.5 hours before i even put my bathing suit on. if i have IOB, i will crash mid-stroke in the pool. it has happened, so i know this to be true. when, on the other hand, i wait for 0% (or as close as i can get to that) IOB, i can swim for hours without crashing.
i also use my TB for so many things.if i plan on going for a long walk; if i am am planning on going for a long walk either before or after i bolus for a meal or correction. if i am ill, how ill i am (do i have fever, or just a cold) am i stressed…the list goes on and on.
the point being, i would deffinately like to know how much actual insulin is running through my system at any one point during the day. if i had this kind of information by way of my pump, i think it would definitely improve the quality and sensibility of many of my decisions.
i hope that i have not misunderstood the comments that i have been reading. i mean absolutely no disrespect.
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totally agree! I wish the math convention for insulin was to assume that 0 IOB = 0 actual insulin in your body, not 0 + basal.
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glad i made some sense to someone 
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Yeah, even though I’ve never considered “basal” in my IOB calculations, it does make sense that basal IS insulin and it IS onboard and it can impact BG’s with exercise.
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It may not give you exactly what you want, but on MM 523 pump and others, there is history that shows how much basal has been delivered so far each day.
Check utilities, daily totals, then scroll down to select today, hit enter/act.
Hit any other day and you can see detail breakdown for them.
It would be nice if there was basal detail history, showing active basal at the moment, but I doubt I would use it.
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just to put another 2 cents into the conversation: as some of you know, i have been ill for the past week. during this week, i have been very dependent upon my TB% to counteract insulin resistance. basically, my body is consuming more insulin than my typical basal amount requires just to fight against this bug.
when i first got sick, i needed to bump up my TB% to 140%. 24/7 . then, i just needed 135% TB during the day, and as the day progressed into the evening, i needed the full 140% again and throughout the night. (you know how we all start to feel more ill as the day progresses and by night time, we feel like death…LOL ) well, as i started to get on the mend, the time spent on the 140% TB lessened and the time spent on the 135% TB increased.
now, day 7 of my being sick, i just lowered my TB to 130%. how did i come to this decision? well, i do not use a CGM, but i do test as much as every 1/2 hour, depending on how my body feels. for the most part, though, i test every hour (at least while i am sick). if i feel that i am going low, i look at what IOB is, when was my last bolus, what have i eaten, what is my current BG? if i ate one hour ago, for example, and my BG before i ate was 100, and i bolused for 30 grms of carbs, and 1.5 hours later, i feel low, and i test, and my BG has dropped to 70, i know that i have too much insulin in my body. if, at that time, my TB is 135%, i lower it to 130% and monitor it closely.( and of course, i must wait for this new basal IOB to “kick in.” before i will see/feel any change.)
wouldnt it be great if i had a way to know exactly when the higher dosage of basal insulin was leaving my body and the newer, lesser dosage were taking over? if my pump could tell me that, provide me with that information, it would help me in making so many other decisions. i would be able to anticipate lows, highs, in betweens. when i should take a snack,a sip of juice, a bolus, etc. i know that you folks with CGMs might find this silly (yes, i used to be on a Dexcom) , but for the others of us who are not on a CGM, i would love to be able to simply look at my pump and preemptively make decisions.
so, all that being said, i believe it would be an outstanding function to know just how much basal insulin i have on board at any given moment.
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DM, if I understand what you are saying, I think we are on exactly the same page. That was why I started this post. That same thing.
Are we on the same train here?
Maybe it’s the crazy train, but that’s ok. All aboard!
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yup; we’re both on the crazy train…i’ll meet you in the bar car in five minutes
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So, to interpret the exact meaning of this thread (if I am capturing it correctly):
When the basal level changes for any reason (segment change temp basal, manual change), it takes a while for basal IOB to catch up with new basal level, sine there is IOB from the “old” basal. We would like to have an up-to-the-minute display of exactly how much actual basal we have including IOB calculations from the old basal(s).
I can see how this would be useful. One issue is that some pumps do not use non-linear formulas for IOB, they often use a straight line. So their approximations for IOB are way off.
Another issue is that,for practical reasons such as wanting to stack, patients often do not enter true numbers for DIA in a pump, so, of course, IOB calculations would be totally wrong in that case.
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Right. So if you remove IOB from the equation, which I always try to do when running, I would like to be able to see an actual basal number for that moment.
If I have go to zero basal, the pump will immediately say “zero”, but I know that for the previous several hours since I have been using basal, it’s still in there. I am not actually at zero until 4 hours has passed.
Much the same way they have IOB slowly drop down after a bolus, why not something similar for basal?
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that would be excellent and very helpful. and, it does t seem like it should be so difficult to implement. i mean, if they can do it for bolus insulin, why not do it for the basal as well, right?
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But then they would have to implement a real mathematical estimation of IOB, which pretty much no pump manufacturer really does.
Even their non linear estimates, when they make them, appear very approximative.
i would be much happier with an estimate than with nothing at all, though.
i mean, everything is always just an “estimate.” carbs, boluses, BG readings, meters with inaccurate readings. we must take everything with a grain of salt and just do our best from one moment to the next. this is mind, yes, and estimate that could be as close as possible to the reality would suit me fine.
but how about if there were 2 separate apps; one for bolus IOB and one for the basal…separate (or both; separate and together) you could just go into your pump screen and scroll down to wherever the location and see clearly whats going on in the pump and in your body all at once. decision making would be a lot more accurate even with its limitations and flaws. NO?
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Just thought of a way of doing this. At least on the OmniPod it would work. I can just turn off all basal 4 hours prior to running, and do all my pre-run basal-ing as an extended bolus. Then it would show up as IOB. I could stop the extended bolus whenever I want before I run (going to zero), and the IOB display would still be showing the “bolus” (which was actually a basal)…
Of course, their IOB formula is linear, so it is not great, but it would be somewhat of a basal display.
@daisymae, think through it and see if something like that would work for you with your pump also.
this would work the same way on my pump as well.
of course, you would be the only one crazy enough to try this experiment…but thats why we keep you around in our secret club.
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There is no crazy required. This is easy.
Your morning basal is .625 right? The next time you swim, turn off your basal at 8am and give yourself a 2 hour extended square bolus of 1.25 units. Your bolus-basal will be over at 10am. That begins your zero basal time. Go swimming at 12pm. That will be 2 hours of zero basal, but the early morning basal will still show up on your pump as IOB.
Do it one time, and you will always know what your basal is when you start after 2 hours.
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my morning basal is .55 btw. but you hooked me, so its sink or swim…
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Ok, so that 2 hour square is 1.10, but the rest is the same. Give it a try. I will on Monday.
When you say your bolus-basal will be over at 10 am, what do you mean ? Delivery is over, not activity.
If stop basal at 8 am, then basal delivered between 6-8 would still be active 10-12, although less potent. That should be gone by 12.
But added to that is the bolus suggested at 8am, as square wave for 2 hours. That means delivery through 10, which means active until 2 or 3 pm. This would be visible on pump as IOB when begin swimming at 12.
So if goal is to have some insulin active during swimming, and see it as IOB, then this works. IOB would gradually decrease from 12 to 3, depending on your pump setting for duration of insulin.
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