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I like that we can use different patient types to ensure safety with hard limits, it is especially helpful for kids so they are not able to enter bolus/carb count too high by accident (110 carbs when meaning 10, mirroring 81 instead of 18 etc). However there is a considerable gap between max bolus 5 for Child and 10 for Teen. Puberty can start as early as age 8-9, causing higher insulin needs, even if by age they are still a "child", maybe teen or even adult patient type is needed due to hard limits.
I suggest indicating in the patient type documentation something based on TDD numbers for when to consider switching up, i.e. how high insulin usage is expected for each patient type and the corresponding hard limits. For example I found for my recently (june'24) diagnosed 9yo, he was using 8-10U per day in the beginning, which meant hard limits for child patient type were never a problem. Then insulin need increased to 20-30U, still few problems, maybe hitting max_bolus for large bowl of candy, or McDonalds meal, where we can easily add another bolus. Now he is using 40-50U per day, and can use 7U for a regular breakfast bolus, so obviously need to move to Teenage patient type. Meanwhile brother at 13yo after more than 4 years on AAPS has used Child, Teen, Adult (when TDD was 80U), and is now back to Teen (TDD 50U). Point being, insulin need measured in TDD would probably be more precise for choosing the patient type than whether one is a child, teen or adult based by age.
Another thing that would be helpful is to increase max_dia for all patient types to 10 hours like it is for Pregnant patient type, since any age/tdd could have need for a longer DIA, and it is safer if we could set that more easily than by editing code in Android Studio :)
The text was updated successfully, but these errors were encountered:
I like that we can use different patient types to ensure safety with hard limits, it is especially helpful for kids so they are not able to enter bolus/carb count too high by accident (110 carbs when meaning 10, mirroring 81 instead of 18 etc). However there is a considerable gap between max bolus 5 for Child and 10 for Teen. Puberty can start as early as age 8-9, causing higher insulin needs, even if by age they are still a "child", maybe teen or even adult patient type is needed due to hard limits.
I suggest indicating in the patient type documentation something based on TDD numbers for when to consider switching up, i.e. how high insulin usage is expected for each patient type and the corresponding hard limits. For example I found for my recently (june'24) diagnosed 9yo, he was using 8-10U per day in the beginning, which meant hard limits for child patient type were never a problem. Then insulin need increased to 20-30U, still few problems, maybe hitting max_bolus for large bowl of candy, or McDonalds meal, where we can easily add another bolus. Now he is using 40-50U per day, and can use 7U for a regular breakfast bolus, so obviously need to move to Teenage patient type. Meanwhile brother at 13yo after more than 4 years on AAPS has used Child, Teen, Adult (when TDD was 80U), and is now back to Teen (TDD 50U). Point being, insulin need measured in TDD would probably be more precise for choosing the patient type than whether one is a child, teen or adult based by age.
Another thing that would be helpful is to increase max_dia for all patient types to 10 hours like it is for Pregnant patient type, since any age/tdd could have need for a longer DIA, and it is safer if we could set that more easily than by editing code in Android Studio :)
The text was updated successfully, but these errors were encountered: