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Higher TT/targets for people with "normally" high blood glucose #3781

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pnharris02 opened this issue Jan 24, 2025 · 0 comments
Open

Higher TT/targets for people with "normally" high blood glucose #3781

pnharris02 opened this issue Jan 24, 2025 · 0 comments
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enhancement New feature or request for_discussion

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@pnharris02
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pnharris02 commented Jan 24, 2025

I find the TempTarget upper hard limit of 10.0mmol/L (180mg/dL) a bit limiting.

Firstly, is seems strange that in a profile, a "normal" target can go up to 11.1 (200mg/dL) but a temp target cannot go this high. I think the hard limit on the max TT should be at least as high as the hard limit on the normal target.

Secondly, the actuality does not match what is found in the docs.
https://androidaps.readthedocs.io/en/latest/DailyLifeWithAaps/TempTargets.html says that the upper limit is "15 mmol/l or 225 mg/dL"
These two numbers do not represent the same glucose value, as 225mg/dL is actually 12.5mmol/L. But rather than just correct the docs, I would strongly prefer that the actual limit be set at 225mg/dL.

Most importantly, I find the upper limit of 10mmol/L a bit limiting, for the following reasons.
I have had Type 1 for over 50 years, and probably as a result of chronically high BG, I experience hypo symptoms at anything below about 5.5mmol/L (99mg/dL). My endo and I set an ideal range of 6-10mmol with a target of 8.0 (144), and a visual in-range of 5.5-12mmol/L (99-216).
When I set an exercise or hypo TT of 10.0, this is not much higher than my normal target. I can effectively shut off SMB, but the basal can still be a bit too aggressive in response to fast-acting carb ingestion.

I switched to AAPS (from Medtronic) because it does at least allow me to set a normal target of 8.0, and I am very happy with the change. This is a great piece of software, and I'm not complaining, just trying to make it better! :-)

How would I suggest remedying this?
The simplest would be raise the TT hard limit from 10.0 (180) to around 12.5 (225mg/dL as stated in the docs). [Or at least to 11.1 (same as the normal profile upper limit).]
But I realise I probably represent a minority case, and perhaps that might upset some people who are used to holding down the + button until the 10.0 limit is reached? If that's a concern, perhaps the TT limit hard limit could be configurable in Preferences? Or derived from the normal target, but I think that may raise too many potential complications.

There are also a few other places where my abnormally high glucose target range is not quite catered for by the hard coded numbers in the software.

  • The algorithm itself. I could have sworn I'd read somewhere that the safety limit that controlled the algorithm was a hard-coded number. But I've been searching for this info in the docs, and can't find it yet. The figure being used as the safety level on my SMB tab appears to be 5.5. Is that a hard-coded number? I will come back and edit this note when/if I find the relevant info.
  • The level at which a "high TT" will turn off SMB. This is defined as anything above 5.5mmol/L. That is actually a very low TT for me, and this restriction means that I cannot effectively use TT before eating, because I would be setting it at a level higher than 5.5, which would disable SMB. I have previously added my comments to another ticket that deals with this issue. Adding target for SMB disabling #2110 - Adding Target for SMB disabling
  • The level at which Hypo TT is automatically enabled. According to the docs "if the user enters carbs with the carb button and your blood glucose is less than 72mg/dl or 4mmol/l, Temp-Target Hypo is automatically enabled by AAPS." I would want that to occur at a higher level, but that's okay, as I can enable that myself via automations.
  • Statistics - the TIR is hard-coded at 3.9-10.0. I realise that is a widely accepted target, and is used to quote/compare the success of various systems at maintaining TIR. But I think that could still be achieved and produce valid results if that TIR could be changed, whilst still maintaining the same difference between top and bottom of range. That is, allow the user, in preferences, to set the lower limit for TIR, and adjust the upper range(s) based on this. If I am the only one wanting this, then of course I will understand why you might not want to change this. It will just mean that I have to ignore the TIR on the statistics page, and refer to online reporting (NS,Clarity,Glooko,etc) where I CAN set my own limits.
@MilosKozak MilosKozak added enhancement New feature or request for_discussion labels Feb 23, 2025
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