Dear Dani Grace and Jude,
Note: This page is advice for Grace, Jude and John. For any other reader, it’s information only. No therapeutic relationship is formed – read this.
If you select the CamAPS FX, here are the essentials:
- How the algorithm works
- Starting settings
- Tips & tricks
- Preventing and treating hypos
- High-fat meals
How the algorithm works
The CamAPS FX has four components:
- Dana pump
- Dexcom G6 sensor
- An Android SMART phone
- The algorithm inside the CamAPS Fx APP that you connect to the sensor and pump
This graphic explains how the CamAPS FX algorithm works in a nutshell.
- The algorithm works by auto calculating basal rates and correction factors and delivers as an extended bolus every 10-12 minutes
- Insulin increases when the glucose is rising
- Insulin decreases and suspends if the glucose is predicted to go low
- The target level is set at 5.8mmol/L (105mg/dL) which can be adjusted as low as 4.4mmol/L (80mg/dL)
The algorithms need a weight, average total daily insulin dose, and carb ratios. The algorithm does the rest. This includes active insulin time and carbs onboard time. The algorithm is continually updating and learning.
You will have to remember to keep your pump basal rates, correction factors and carb ratios up to date in case it goes out of the algorithm.
Once the above is set, you will only need to adjust your car ratios and target level depending on time in range!
Tips & tricks
If you want to get 70% or more time in range do not forget the basics:
- Three balanced meals
- Accurate carb counting
- Bolus insulin 10-20 minutes before eating
- Be active for 10-15 minutes after eating
- Rotate cannula sites
Other things to be aware of:
- Enter hypo treatments into the “Add meal” feature under “hypoglycaemia treatment”
- Always suspend the pump when disconnecting (showers, sports, sex)
- Keep the Android phone within 6 meters of you at all times, a waistband is a good idea
- Update pump settings for if it goes out of the algorithm:
- Basal rates
- Correction factors
- Carb ratios
- Target level
Preventing and treating hypos
It would be awesome if hypos were a thing of the past. But this will not be the case.
The algorithm will be able to stop hypos overnight!
However, if you give too much bolus insulin for a meal or exercise without planning, hypos will still happen.
It is likely you will need less hypo treatment than normal because the algorithm will have already slowed or stopped the insulin at least 30 minutes prior.
You may also want to prevent hypos if you see the glucose is 4.0-6.0mmol/L (70-110mg/dL) and trending down.
This is a guide I use based on weight where 30kg is used as an example. Weight can be changed on the PDF.
You can download the hypo chart here if you want to try it?
We know from the Mealtime Insulin Guide that high-fat meals with carbs, such as pizza and takeaways require additional insulin.
The algorithm auto-calculates active insulin and carbs on board so it’s good at responding to the delayed glucose rise from high-fat meals.
However, the best results have been seen by giving 50% of the carbs upfront and adding the other 50% into the “Add meal” feature under “Slowly absorbed meal”. This lets the algorithm know that if the glucose starts to rise it should be aggressive in management.
For example, for a 100g carbohydrate Pizza, give 50g as a bolus and add 50g into the “Slowly absorbed meal” feature.
There is the quick and dirty way and the more comprehensive planned method.
The quick and dirty method
This involves putting on the “Ease Off” before starting, ideally 90 minutes before. Then supplement with small amounts of carbohydrates every 20 minutes as required.
Do not shovel loads of carbs in at once as the glucose might shoot high and the algorithm will increase the insulin and hypo risk.
How many carbs every 20 minutes?
It depends on how much you weigh. Here is an example for a 50kg person.
Comprehensive planned method
To be able to use this method you will need to work your way through the Exercise Guide, so you understand exercise types, bolus reductions, and how to change a plan after trial.
Great, you are up to speed with exercise management.
This table should now make complete sense!
Go forth and conquer.