{
  "id": "medical/insulin-pump-basal-rate-circadian",
  "signature": "AI programs an insulin pump with a 24-hour basal rate profile that ignores circadian insulin sensitivity, causing nocturnal hypoglycemia in a Type 1 diabetic",
  "signature_zh": "AI编程胰岛素泵时使用了忽略昼夜节律胰岛素敏感性的24小时基础率方案，导致1型糖尿病患者夜间低血糖",
  "regex": "insulin.*pump.*(?:basal|rate|profile).*(?:circadian|nocturnal|dawn|hypoglycemia)",
  "domain": "medical",
  "category": "config_error",
  "subcategory": null,
  "root_cause": "The AI set a constant basal rate (e.g., 0.8 U/h) across 24 hours, failing to account for the dawn phenomenon (increased insulin need 3-8 AM) and nocturnal insulin sensitivity (decreased need 12-3 AM), resulting in hypoglycemia at 2-3 AM.",
  "root_cause_type": "generic",
  "root_cause_zh": "AI设置了24小时恒定基础率（如0.8 U/h），未考虑黎明现象（3-8 AM胰岛素需求增加）和夜间胰岛素敏感性（12-3 AM需求减少），导致凌晨2-3点低血糖。",
  "versions": [
    {
      "version": "Medtronic MiniMed 780G v3.2",
      "introduced": null,
      "deprecated": null,
      "removed": null,
      "behavior_change": null,
      "status": "active"
    },
    {
      "version": "Tandem t:slim X2 v2.7",
      "introduced": null,
      "deprecated": null,
      "removed": null,
      "behavior_change": null,
      "status": "active"
    },
    {
      "version": "Insulet Omnipod 5 v1.4",
      "introduced": null,
      "deprecated": null,
      "removed": null,
      "behavior_change": null,
      "status": "active"
    }
  ],
  "os_specific": {},
  "dead_ends": [
    {
      "action": "",
      "why_fails": "Uniform reduction may still cause nocturnal hypoglycemia if the rate during 12-3 AM is still too high, and may cause daytime hyperglycemia.",
      "fail_rate": 0.7,
      "condition": "",
      "sources": []
    },
    {
      "action": "",
      "why_fails": "This ignores the dawn phenomenon; the rate may be too low for 3-8 AM, causing hyperglycemia upon waking.",
      "fail_rate": 0.65,
      "condition": "",
      "sources": []
    },
    {
      "action": "",
      "why_fails": "This removes a critical safety feature that can prevent severe hypoglycemia; the root cause (incorrect basal profile) remains unaddressed.",
      "fail_rate": 0.9,
      "condition": "",
      "sources": []
    }
  ],
  "workarounds": [
    {
      "action": "Program a multi-step basal profile: 12 AM-3 AM: 0.5 U/h, 3 AM-8 AM: 1.0 U/h (dawn phenomenon), 8 AM-12 PM: 0.8 U/h, 12 PM-6 PM: 0.7 U/h, 6 PM-12 AM: 0.6 U/h. Validate with 3-day CGM data.",
      "success_rate": 0.9,
      "how": "Program a multi-step basal profile: 12 AM-3 AM: 0.5 U/h, 3 AM-8 AM: 1.0 U/h (dawn phenomenon), 8 AM-12 PM: 0.8 U/h, 12 PM-6 PM: 0.7 U/h, 6 PM-12 AM: 0.6 U/h. Validate with 3-day CGM data.",
      "condition": "",
      "sources": []
    },
    {
      "action": "Use the pump's built-in 'Basal Pattern' feature to create a 'Night Safe' pattern with reduced rate 12-3 AM. Set low-glucose suspend threshold at 70 mg/dL. Train patient on pattern switching.",
      "success_rate": 0.85,
      "how": "Use the pump's built-in 'Basal Pattern' feature to create a 'Night Safe' pattern with reduced rate 12-3 AM. Set low-glucose suspend threshold at 70 mg/dL. Train patient on pattern switching.",
      "condition": "",
      "sources": []
    },
    {
      "action": "Implement an algorithm in the pump management software that adjusts basal rates based on historical CGM data and circadian models. Example: 'AutoBasalCircadian' script that analyzes 14-day glucose patterns.",
      "success_rate": 0.8,
      "how": "Implement an algorithm in the pump management software that adjusts basal rates based on historical CGM data and circadian models. Example: 'AutoBasalCircadian' script that analyzes 14-day glucose patterns.",
      "condition": "",
      "sources": []
    }
  ],
  "workarounds_zh": [
    "Program a multi-step basal profile: 12 AM-3 AM: 0.5 U/h, 3 AM-8 AM: 1.0 U/h (dawn phenomenon), 8 AM-12 PM: 0.8 U/h, 12 PM-6 PM: 0.7 U/h, 6 PM-12 AM: 0.6 U/h. Validate with 3-day CGM data.",
    "Use the pump's built-in 'Basal Pattern' feature to create a 'Night Safe' pattern with reduced rate 12-3 AM. Set low-glucose suspend threshold at 70 mg/dL. Train patient on pattern switching.",
    "Implement an algorithm in the pump management software that adjusts basal rates based on historical CGM data and circadian models. Example: 'AutoBasalCircadian' script that analyzes 14-day glucose patterns."
  ],
  "transition_graph": {
    "leads_to": [],
    "preceded_by": [],
    "frequently_confused_with": []
  },
  "official_doc_url": "https://www.diabetes.org/technology/insulin-pumps",
  "official_doc_section": null,
  "error_code": "PUMP-BASAL-ERR-03",
  "verification_tier": "ai_generated",
  "confidence": 0.86,
  "fix_success_rate": 0.8,
  "resolvable": "partial",
  "first_seen": "2024-05-20",
  "last_confirmed": "2024-06-01",
  "last_updated": "2024-06-01",
  "evidence_count": 1,
  "tags": [],
  "locale": "en",
  "aliases": []
}