Diabetes wizardry

By | 15 July, 2009
No, no that sort of Wizzard

No, no that sort of Wizzard

Wizards and quidditch and death eaters abound in the UK this week as the latest Harry Potter hits our screens. If pushed, I will admit to having read all the books and I will be going to see the film, but I won’t be fighting off the hoards of teenage girls to see it this week. I think I can wait a while until the mayhem calms down a little.

Wizardry is an often overlooked tool in diabetes care. In fact, when I mused about pumps the other day, I completely omitted to mention the mystical marvels of the bolus wizard. Now is the time to correct such an omission (thanks to Roger for pointing it out).

The ultimate book of spells for young wizards acquiring their first pump is Pumping Insulin by John Walsh . It was here, before I’d even attended the Hogwarts Academy for Novice Pumpers that I first discovered the wonders of the bolus wizard.

Basically, once you’ve programmed it with a few ratios – worked out either through a spell provided in Pumping Insulin or with some help from your mystic master (otherwise know as a diabetes specialist nurse) – it’s up and running.

You simply tell the pump what your blood sugar is and how many carbs you’re planning to eat and it makes a recommendation about how much insulin you should take. It cleverly takes into account any other insulin it knows you’ve taken recently so you don’t dose twice for the same high.

Here comes my second admission of this post, not only do I quite like the Harry Potter books, I also rather arrogantly thought I had no need for a bolus wizard. I’d been flying high on the diabetes broomstick for many, many years. I could calculate how much insulin I needed for a bowl of pasta as quickly as Hermione can say “Expelliarmus!” . I didn’t need a machine to tell me how to reverse the impact of the “too much ice cream/not enough insulin” spell.

Listen carefully; you won’t hear this often…I was wrong. My bolus wizard is far more accurate than my previous finger-in-the-air type guessing. That’s not to say I treat it with the reverence of Dumbledore and never challenge its’ teachings. It doesn’t know I have a game of quidditch or a battle with some death eaters planned, so sometimes I’ll knock a bit off the recommendation to allow for that. Equally, if the CGMS tells me I’m rising faster than the Snitch in the final seconds of a game, I’ll add in extra insulin for that.

Overall though, it’s marvellous. And it feels like a real step towards an artificial pancreas. If we already have a machine with the ability to calculate insulin requirements based on glucose level, it isn’t a huge leap to automate that process.

The elves tell me that many people on pumps don’t use their bolus wizard. Perhaps, like me, they felt they were wise enough without it. I can hear the legendary words of Dumbledore now “use the wizard my friend, it will guide you on your journey”.

13 thoughts on “Diabetes wizardry

  1. Tim

    I have to say I’ve never read any of the Harry Potter books – I don’t really like books about elves – so I don’t know what you’re banging on about in most of your article!

    That aside, I wonder why such devices are only available on pumps? Would those on MDI have better control if you could get little handheld device that told you how much short acting insulin to put in and / or had a database of the carb. contents of major food types?

    As is usual when I make a comment like this, someone will undoubtedly reply saying “ah, yes, the Carbatron 3000 does exactly this and has been out for years! Have you never heard of it?”

  2. Ckoei

    You already have such a little handheld device, called cell/mobile phone. Now you just need to wade through some idiosyncratic German English and set up an account with glucosurfer.org (Mortification! I’m giving cyber-advice and I don’t know how to linkify a link)[I’ve just linkified it for you! – Tim].

    As far as wizards go, I prefer T.H White’s Merlin in “The once & future king”. His Wart is not so hoggish.

  3. Tim

    @Ckoei See, I told you someone would know something! My mobile can’t do data – even though it’s a Blackberry Pearl – as I’m using the same SIM card and account that I’ve used for years and years and years. Maybe it’s time to upgrade.

    Have you actually used this system?

  4. Mark

    Beautifully written, Alison! I DO use my bolus wizard on the OmniPod and like it. I make adjustments pending exercise or rest.

    And Tim, I do know many diabetics who are on MDI and use a CGMS. Strange, but true.

  5. Tim

    @Mark I was thinking more of just a simple device that helped calculate the amount to put in (like the wizard above) rather than hard core CGMS. If such a thing doesn’t exist then I will away to the Patent Office!

  6. Mark

    I don’t believe such a device exists…”simple” that is. 🙂 Don’t we have enough complications in our lives?

  7. Ckoei

    @Tim I have, by means of a very unsophisticated piece of fruit (Nokia3500, Pay-as-you-go). Every time you eat/inject, you click on “Diary” in your (WAP-enabled & upgraded) phone’s shortcut menu, and fill in “what your blood sugar is and how many carbs you’re planning to eat and it makes a recommendation about how much insulin you should take” (all based on the carb/insulin factors you mentioned in your account’s “Settings”)

    You can also change mg/dL to mmol/L. All input is stored online and can be rendered graphically to please the eyes of hasty endocrinologists.(Take along 1 of the 2 laptops{R30 000} you exchanged for your pump on the black market)

  8. Tim

    @Ckoei Hmm, maybe I should finally get my phone data-enabled.

    The problem is though I would be forever using it to check out my email, the blog and the forums here – and I need some time off! I should starve, rather than feed, my obsessive compulsive disorders 😉

    However, I’ve opened an account and will check it out and report back.

  9. Ckoei

    Oh,and you can insert a link to your diary on Shoot Up or Put Up so that we all can take a peek at your sweet seesawyering 😉

  10. Lesley

    Hi Alison

    Me too – I thought I didn’t need a bolus calculator until I tried the Roche Combo and now I’m hooked. I don’t even need to “key in” my BG levels as the Combo unit is an Aviva meter combined with a controller for the pump, all using the Bluetooth spell. Now if only someone would cast a spell that makes Bluetooth more reliable…

    (see the INPUT blog on http://www.input-diabetes.blogspot.com)

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