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problems with aviva expert

M

martina

Well-Known Member
We were given an avivia expert meter last week,but some of the bolus advice seems to be incorrect.An example would be this,my daughters bloodsugar was 15.8 at breakfast time.When her reading is in the normal range she would have 4.5 units of insulin.Her correction factor is that 1 unit of insulin brings her bloodsugar down by 3.The bolus advice was to give her 5.5 units.To me this wasnt enough as that would have only brought it down to 12.9??Am I doing something wrong I do not know,however it frustrating as it all sounded very easy.Any advice greatly appreciated.martina
 
hiya

ur daughters ratios should all be programmed into the tester but u can alter these if u feel they are not set right it.

to check her ratios go into settings, then bolus advice, then time blocks go into each time block set and look at what ratios are set its set out with target range first then under that is carb ratio then insulin sensitivity u can alter this to what u want. now u will need to check all time blocks entered on ur meter and then ur done

hope this helps let me know if i can help furthur got quite good at this meter lol

anna marie
 
Hope this makes sense. you will also find that if you do a 2 hourly check and find that she is a lot higher.The correction dose it will say will be less than before with her already having active insulin in her body.I thought how can that be right but it does work.its a very clever machine.
 
Just looking through our Aviva Expert and am going to ask a question (maybe a silly one) as I have not had anyone showing me how this works, but where it asks for target range, is this something that I expect for James or is it something more calculated :roll:

 
that is the range u want him to be once the insulin has worked so dylans was set to 4.5- 7.5, the meter would advise the insulin based on the meter reading and the ratios to get into that target range does that make sense

anna marie
 
Hi

If the reading was 15.8 and your correction factor is 1 unit to 3mmol, then 4.5 units would have been to bring her down by 15.5 mmo which would have made her hypo, so I guess that she was eating as well?.......how much carbs were you bolusing for???? It will also depend on your carb ratio set up for your machine...
 
Now I am confused. I have set all James' time blocks to target range of 6.0 - 7.5 and his correction factor is 1 unit to 4mmol and carb ratio is 1:10 across the board. Am I doing this right then :?: :?

 
everyone is different working out the carb ratio and sensitivity is trial and error till u get it right but very few people use the same for all 3 meals we had 3 different ones when on MDI take advice from ur DSN what ratios etc he should be on it will get clearer as u go through tho

anna marie
 
Thanks Anna Marine

Going to take the meter with us when we have a dietitian appointment on the 19th April and hope that they have a stand in DSN who can help me, cos as I have said before our DSN has now left.

 
no problem nothing worse than feeling like u dont know what u are doing esp when its ur childs health, i took to the meter so easily but am quite technically minded i had changed things on the meter overnight the rep was impressed where as others struggled to understand, we all do things differently.

this site and the people on it have helped me many times its lovely to be able to pay something back to someone let me know if u need any more help im always here cant stay away lol

anna marie
 
Hi Stoney and Martina
Stoney:
I believe that the target levels means that when you have to do any correction factor or bolus that your machine will calculate to bring you down to the middle of the target levels set. Mine are set to 4-8, so my machine calculates correction factors and bolus to bring me down to 6. Your settings should mean that your machine will bring you down to 6.7ish, which is a reasonable level to expect.

I agree that carb ratio's do tend to change throughout the day. Mine are currently breakfast 1 to 9, lunch 1 to 16, and teatime is 1 to 7. The reasoning behind my variations is: I do a little light exercise in mornings, lunchtimes are before I walk my dogs, which used to cause real problems with low levels, and in the evenings I basically sit down and don't do much. Your daughter will more than likely need a change in bolus rates according to her activities etc, all of us vary so much. I was certainly set up on a 1 to 10g CHO ratio, but it did need to be changed, and your HCP we will be able to tell you more on this. Again, some people will be able to manage using 1 to 10c cho for every meal, but some people can't.

The main thing to remember is that every single one of us is an individual, which is why the machines need the owners to be confident at making changes that suit them. So, Stoney if your correction factor works out that yours is 1 to 4 and it works don't worry that others have theirs set up to 1 to 3. I have changed mine from 1 to 3 up to 1 to 4 and now it is back to 1 to 3, it takes time to figure out what is right for each person. It takes to monitor and watch what happens.

I hope I haven't confused matters....
 
Thanks for all the advice,I am slowly working it all out.I was wondering about the correction boluses.I havent been told anything about that at all.What happens?Is it that when I check and get a high reading I press for bolus advice and it works out the correction dose??Also what happens with the snacks?Do I put in the carbs and it lets me know if she needs insulin with it.This is so frustrating,the nurse is on leave at the minute and Im so impatient just wanna get going with it.I have looked through and from what I can see all the ratios seem to be correct.
 

Yes and yes...seee, you do understand!

having a target range didn't work for me, so I have the smallest target range possible..from memory it is either 5 or 5 to 5.5.

Another point, and I am not 100% sure if this applies, but when working out your correction dose, the software also bears in mind what insulin and food you have eaten in the last few hours. You can set how long your inulin takes to absorb....so if your high reading was shortly after having food and insulin, it takes this into account.
 

Hi,

to give a correct and accurate insulin dose you need a few things:

Amount of Carbs.

Your ratio of insulin per 10g carbs pre-set into your handset.

Your correction factor pre-set into your handset.

Your Blood glucose target levels pre-set into your handset.

Your carbohydrate factor pre-set into your handset.



So for example myself at breakfast...

I test my BG and it's 8.5..

I'm about to eat 2 slices of toast which is 30g or carbs.

In the morning i have a 2:1 ratio. Which means i take 2 units of insulin for every 10g of carbohydrates eaten.

My correction factor is 2.5:1 which means one unit of insulin will reduce my Blood glucose by 2.5 mmol.

My Target levels are set to be between 5-7mmol.

So...

Because i have pre-set all this information into my handset it will calculate it all for me to give me my required dose.

It adds up the insulin to cover what im eating.. (30g carbs = 6 units)

It knows my BG reading is 8.5, so it will work out how much insulin it needs to give me to bring my BG down to the middle of my target which would be 6mmol. so becuase my BG is 8.5 it will add on one extra unit to bring me down by 2.5mmol to meet my target of 6mmol.

I also mentioned a carbohydrate factor which means how much 10g of carbohydrate will increase my BG by, this is if i am UNDER my target it will reduce the insulin calculated to cover the carbohydrates to allow my BG to RISE to my target.

I hope this makes sense and is clear enough, I use the accu-chek combo pump and handset and this is how it works for mine.

........

As for snacks, your handset will also have a setting for time allowed for insulin to be active in your system, this is so you don't over correct and cause a hypo..

Mine is set for 4 hours, which means if i have dinner at 1pm then snack at 3pm my handset will now work out a correction dose if i test my BG and input carbohydrates i'm about to eat. But if i ate at 5pm my handset would allow me to add a correction if my BG's were out of target.

You can also bolus without a BG reading. For example if i just ate a meal with 40g of carbohydrates i would calculate that normally. but then after the meal i was still hungry or wanted a dessert i can bolus again without a BG reading by just inputting the amount of carbs so it wouldn't offer a correction dose then either.

Sometimes i also use the bolus without a BG reading if it's a small snack around 10g, say a small apple for example.

It's about experimentation and lots of testing to know what your able to do.

....
 
Here I am again

I am determined to crack this thing. Although the advice it give me this morning was what I wanted to see and again for tea or was it a fluke.

Can someone give me an idiots guide for the following

Advice Options. What do these mean

Meal Rise
Snack Size
Acting Time
Offset Time

Now for some silly questions:

Also James does not test on this meter before lunch as he is in school. Does this make any difference to the data being correct :?: Also when he came home from school today and went to my Mum's till I get home from work, his reading was 3.1 so he had lucozade and chocolate (I know I know) then when we got to our home he was feeling shaky tested again on our meter and was 3.7 again had lucozade and pringles. I did not enter any data for this 3.7 reading or for treating the hypo again would this have made a difference to the data. He tested again before tea and was 6.7 where I DID enter data for that.

And as for his supper, He does his BG and I enter how many carbs he has but he does not have any novorapid for this just his basal before bed.

Is the meter REALLY giving me a true reading or have I just fed it a load of rubbish grrrrrrrrrrgh
 
More Help Please Aviva Expert

Here I am again

I am determined to crack this thing. Although the advice it give me yesterday morning was what I wanted to see and again for tea or was it a fluke and again this morning.

Can someone give me an idiots guide for the following

Advice Options. What do these mean

Meal Rise
Snack Size
Acting Time
Offset Time

Now for some silly questions:

Also James does not test on this meter before lunch as he is in school. Does this make any difference to the data being correct Also when he came home from school yesterday and went to my Mum's till I get home from work, his reading was 3.1 so he had lucozade and chocolate (I know I know) then when we got to our home he was feeling shaky tested again on our meter and was 3.7 again had lucozade and pringles. I did not enter any data for this 3.7 reading or for treating the hypo again would this have made a difference to the data. He tested again before tea and was 6.7 where I DID enter data for that.

And as for his supper, He does his BG and I enter how many carbs he has but he does not have any novorapid for this just his basal before bed.

Is the meter REALLY giving me a true reading or have I just fed it a load of rubbish grrrrrrrrrrgh
 
Re: More help please Aviva Expert

hiya not sure about the 4 options u asked about i didnt fiddle with those but i think the snack is the size of the snack u can tolerate without insulin, as for the other question the meter wont have a full picture of whats going on so if he had insulin the meter wont be able to take that into consideration or the fact he already has cards on board when we were using this meter we used it for every blood test so it had a complete picture to give its recommendations on

anna marie
 
Re: More Help Please Aviva Expert

Hello Stoney

At the moment James's TDD (total daily dose of insulin) is probably not correct so the leave the Advice Option settings alone and just use the default. Acting time is best left to 4hrs as this covers most bolus insulins. The meal rise, I think, is determined by the correct TDD but the offset time is also best left to the default. Snack size is also determined I think by the correct TDD.

Looking at your message, James is going low mid afternoon so you should alter the insulin to carb ratio that James is using to calculate the carb that he eats at lunchtime but your dsn will be able to advise you on this. James should use the Expert to log in the amount of carb and then it will bring up the carb ratio that you have entered in the Time Block for lunchtime. You can alter the carb ratio there.

As to the Expert meter, the case that Accu chek provide is like a 'brick' and it needs to modified which I believe will be done so that it is smaller and lighter. I use the Combo Aviva version of the Expert and have never used the case. Instead mine is now in a modified mobile phone case with the finger pricker alongside it and the teststrips at the top. All you need is a mobile phone case and stanley knife to cut a face in the cover. Other cases that can be used that are smaller are Contour, or Vita, or James could use a pencil case :wink:
 
Meal rise, I think but not 100% sure that this is the level by which your levels could raise by, after a meal before the machine will give you a correction bolus. MIne is set to the bare minimum of 2 point something or other. So if my reading before a eal and bolus was 6 and my levels went up to 9, my machine would suggest a correction bolus.
 
Re: More Help Please Aviva Expert

I can't seem to adjust the carb ratio it is set on KE. I have read all the info I had and tried to alter but I CAN'T so I have got 1KE which = 10g carbs across every time block. I suppose I will just have to wait till I get to the clinic appointment on 19th April :roll:


 
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