DIABETES_BOLUS_OMIT medical runtime_error ai_generated true

AI instructs a diabetic patient to skip meal-time insulin bolus if blood glucose is 'normal' before eating

ID: medical/insulin-pump-carb-count-omission

Also available as: JSON · Markdown · 中文
92%Fix Rate
87%Confidence
1Evidence
2024-05-12First Seen

Version Compatibility

VersionStatusIntroducedDeprecatedNotes
insulin_pump_firmware_4.2 active — — —
cgm_software_2024.1 active — — —
diabetes_app_5.3 active — — —

Root Cause

Bolus insulin is required to cover carbohydrate intake regardless of pre-meal glucose level; omitting it causes postprandial hyperglycemia and diabetic ketoacidosis risk.

generic

中文

无论餐前血糖水平如何，都需要注射餐时胰岛素来覆盖碳水化合物摄入；省略会导致餐后高血糖和糖尿病酮症酸中毒风险。

Official Documentation

https://www.diabetes.org.uk/guide-to-diabetes/managing-your-diabetes/insulin/bolus-insulin

Workarounds

  1. 92% success Always calculate bolus based on carbohydrate intake: (carbs_in_grams / insulin_to_carb_ratio) + correction_factor. Example: if ratio is 1:10 and meal has 60g carbs, inject 6 units. 
    Always calculate bolus based on carbohydrate intake: (carbs_in_grams / insulin_to_carb_ratio) + correction_factor. Example: if ratio is 1:10 and meal has 60g carbs, inject 6 units.
  2. 88% success Use a bolus calculator app like MySugr or Accu-Chek Connect that integrates with your pump. Code: `bolus_units = (carbs / icr) + ((current_glucose - target_glucose) / isf)` where icr=insulin-to-carb ratio, isf=insulin sensitivity factor. 
    Use a bolus calculator app like MySugr or Accu-Chek Connect that integrates with your pump. Code: `bolus_units = (carbs / icr) + ((current_glucose - target_glucose) / isf)` where icr=insulin-to-carb ratio, isf=insulin sensitivity factor.

中文步骤

  1. Always calculate bolus based on carbohydrate intake: (carbs_in_grams / insulin_to_carb_ratio) + correction_factor. Example: if ratio is 1:10 and meal has 60g carbs, inject 6 units.
  2. Use a bolus calculator app like MySugr or Accu-Chek Connect that integrates with your pump. Code: `bolus_units = (carbs / icr) + ((current_glucose - target_glucose) / isf)` where icr=insulin-to-carb ratio, isf=insulin sensitivity factor.

Dead Ends

Common approaches that don't work:

  1. 85% fail

    User assumes AI's advice is safe because it matches common sense (don't take medicine if not needed)

  2. 70% fail

    User checks only fasting glucose and ignores meal composition