{
  "id": "medical/insulin-pump-carb-count-omission",
  "signature": "AI instructs a diabetic patient to skip meal-time insulin bolus if blood glucose is 'normal' before eating",
  "signature_zh": "AI指示糖尿病患者在餐前血糖‘正常’时跳过餐时胰岛素注射",
  "regex": "(skip|omit|delay)\\s*(the\\s*)?(bolus|insulin)\\s*(if|when)\\s*(blood\\s*sugar|glucose)\\s*(is|below)\\s*(normal|\\d{2,3})",
  "domain": "medical",
  "category": "runtime_error",
  "subcategory": null,
  "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.",
  "root_cause_type": "generic",
  "root_cause_zh": "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。",
  "versions": [
    {
      "version": "insulin_pump_firmware_4.2",
      "introduced": null,
      "deprecated": null,
      "removed": null,
      "behavior_change": null,
      "status": "active"
    },
    {
      "version": "cgm_software_2024.1",
      "introduced": null,
      "deprecated": null,
      "removed": null,
      "behavior_change": null,
      "status": "active"
    },
    {
      "version": "diabetes_app_5.3",
      "introduced": null,
      "deprecated": null,
      "removed": null,
      "behavior_change": null,
      "status": "active"
    }
  ],
  "os_specific": {},
  "dead_ends": [
    {
      "action": "",
      "why_fails": "User assumes AI's advice is safe because it matches common sense (don't take medicine if not needed)",
      "fail_rate": 0.85,
      "condition": "",
      "sources": []
    },
    {
      "action": "",
      "why_fails": "User checks only fasting glucose and ignores meal composition",
      "fail_rate": 0.7,
      "condition": "",
      "sources": []
    }
  ],
  "workarounds": [
    {
      "action": "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.",
      "success_rate": 0.92,
      "how": "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.",
      "condition": "",
      "sources": []
    },
    {
      "action": "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.",
      "success_rate": 0.88,
      "how": "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.",
      "condition": "",
      "sources": []
    }
  ],
  "workarounds_zh": [
    "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.",
    "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."
  ],
  "transition_graph": {
    "leads_to": [],
    "preceded_by": [],
    "frequently_confused_with": []
  },
  "official_doc_url": "https://www.diabetes.org.uk/guide-to-diabetes/managing-your-diabetes/insulin/bolus-insulin",
  "official_doc_section": null,
  "error_code": "DIABETES_BOLUS_OMIT",
  "verification_tier": "ai_generated",
  "confidence": 0.87,
  "fix_success_rate": 0.92,
  "resolvable": "true",
  "first_seen": "2024-05-12",
  "last_confirmed": "2024-06-01",
  "last_updated": "2024-06-01",
  "evidence_count": 1,
  "tags": [],
  "locale": "en",
  "aliases": []
}