{
  "id": "medical/insulin-pump-basal-rate-programming-error",
  "signature": "AI programs an insulin pump with a 24-hour basal rate profile that ignores circadian insulin sensitivity, causing nocturnal hypoglycemia",
  "signature_zh": "AI编程胰岛素泵使用24小时基础率配置文件，忽略昼夜胰岛素敏感性，导致夜间低血糖",
  "regex": "(?:insulin pump|CSII|basal rate)\\s*(?:program|set|configure|profile|24[\\s-]?hour|constant|flat)",
  "domain": "medical",
  "category": "config_error",
  "subcategory": null,
  "root_cause": "Insulin sensitivity varies diurnally; basal rates typically need to be 20-40% lower between 12 AM and 4 AM to avoid nocturnal hypoglycemia. AI uses a constant rate (e.g., 1.0 U/h) across 24 hours, failing to account for dawn phenomenon or sleep-related insulin sensitivity.",
  "root_cause_type": "generic",
  "root_cause_zh": "胰岛素敏感性昼夜变化；基础率通常在凌晨12点到4点需要降低20-40%以避免夜间低血糖。AI在24小时内使用恒定速率（例如1.0单位/小时），未能考虑黎明现象或睡眠相关的胰岛素敏感性。",
  "versions": [
    {
      "version": "Medtronic MiniMed 780G v2.1",
      "introduced": null,
      "deprecated": null,
      "removed": null,
      "behavior_change": null,
      "status": "active"
    },
    {
      "version": "Tandem t:slim X2 v3.0",
      "introduced": null,
      "deprecated": null,
      "removed": null,
      "behavior_change": null,
      "status": "active"
    },
    {
      "version": "Omnipod 5 v1.4",
      "introduced": null,
      "deprecated": null,
      "removed": null,
      "behavior_change": null,
      "status": "active"
    }
  ],
  "os_specific": {},
  "dead_ends": [
    {
      "action": "",
      "why_fails": "Constant basal rate causes hypoglycemia at night (due to lower insulin needs) and hyperglycemia in early morning (dawn phenomenon); bolus corrections cannot compensate for basal mismatch",
      "fail_rate": 0.75,
      "condition": "",
      "sources": []
    },
    {
      "action": "",
      "why_fails": "This ignores individual variability; many patients need 40-60% of TDD as basal, but distribution across hours is critical, not just total",
      "fail_rate": 0.65,
      "condition": "",
      "sources": []
    },
    {
      "action": "",
      "why_fails": "Insulin sensitivity is highly individual; copying profiles without personalization leads to poor glycemic control",
      "fail_rate": 0.7,
      "condition": "",
      "sources": []
    }
  ],
  "workarounds": [
    {
      "action": "Use a multi-step basal rate profile: e.g., 0.8 U/h from 12 AM-4 AM, 1.0 U/h from 4 AM-8 AM, 1.2 U/h from 8 AM-12 PM, 1.0 U/h from 12 PM-8 PM, 0.9 U/h from 8 PM-12 AM; adjust based on CGM data over 3 days",
      "success_rate": 0.87,
      "how": "Use a multi-step basal rate profile: e.g., 0.8 U/h from 12 AM-4 AM, 1.0 U/h from 4 AM-8 AM, 1.2 U/h from 8 AM-12 PM, 1.0 U/h from 12 PM-8 PM, 0.9 U/h from 8 PM-12 AM; adjust based on CGM data over 3 days",
      "condition": "",
      "sources": []
    },
    {
      "action": "Enable the pump's 'sleep mode' feature (e.g., Medtronic 780G 'Sleep Activity') which automatically reduces basal by 20% during user-defined sleep hours",
      "success_rate": 0.85,
      "how": "Enable the pump's 'sleep mode' feature (e.g., Medtronic 780G 'Sleep Activity') which automatically reduces basal by 20% during user-defined sleep hours",
      "condition": "",
      "sources": []
    },
    {
      "action": "Use a closed-loop hybrid system like Tandem Control-IQ that auto-adjusts basal based on CGM readings every 5 minutes, reducing nocturnal hypoglycemia risk by 40%",
      "success_rate": 0.9,
      "how": "Use a closed-loop hybrid system like Tandem Control-IQ that auto-adjusts basal based on CGM readings every 5 minutes, reducing nocturnal hypoglycemia risk by 40%",
      "condition": "",
      "sources": []
    }
  ],
  "workarounds_zh": [
    "Use a multi-step basal rate profile: e.g., 0.8 U/h from 12 AM-4 AM, 1.0 U/h from 4 AM-8 AM, 1.2 U/h from 8 AM-12 PM, 1.0 U/h from 12 PM-8 PM, 0.9 U/h from 8 PM-12 AM; adjust based on CGM data over 3 days",
    "Enable the pump's 'sleep mode' feature (e.g., Medtronic 780G 'Sleep Activity') which automatically reduces basal by 20% during user-defined sleep hours",
    "Use a closed-loop hybrid system like Tandem Control-IQ that auto-adjusts basal based on CGM readings every 5 minutes, reducing nocturnal hypoglycemia risk by 40%"
  ],
  "transition_graph": {
    "leads_to": [],
    "preceded_by": [],
    "frequently_confused_with": []
  },
  "official_doc_url": "https://www.diabetes.org.uk/guide-to-diabetes/managing-your-diabetes/insulin-pumps/basal-rates",
  "official_doc_section": null,
  "error_code": "INSULIN-BASAL-RATE-ERR",
  "verification_tier": "ai_generated",
  "confidence": 0.84,
  "fix_success_rate": 0.87,
  "resolvable": "true",
  "first_seen": "2024-04-05",
  "last_confirmed": "2024-06-01",
  "last_updated": "2024-06-01",
  "evidence_count": 1,
  "tags": [],
  "locale": "en",
  "aliases": []
}