HCL-Meal-Mgt.-ISF-and-IC-settings

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HCL-Meal-Mgt.-ISF-and-IC-settings

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Profile tuning and meal mgt. in Hybrid Closed Looping (HCL)

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# HCL-Meal-Mgt.-& Settings

*This is a repository of documents that support setting up a well-performing Hybrid Closed Loop. To access files, you may need to go to "<> code" on very top left side of this page; if the selected file does not open, go to  "raw  / download icon" , and open (e.g. downloaded xls files) from your PC*

Good meal management and a well tuned ISF profile are essential in **Hybrid Closed Loop (HCL)**

**Please observe that making your settings should be done step-by-step in this sequence:** 1. Set insulin model (time-to-peak, DIA)  2. Set a correct basal rate (that keeps you stable at iob and cob near zero in open loop) 3. Determine your
Factors (ISF, carb ratio) and other settings 4. Do your Meal Management such that your desired (realistic) %TIR results. Besides an initial meal bolus (and anti-hypo snacks, if needed), try not to interfere with your closed loop  5. Observe if/when you have altered general insulin sensitivity (e.g. during and after exercise), and learn to temporarily adjust settings (and/or use Autosens, an Automation, or individually tuned dynamic factors).
Never copy what others report to use, but investigate and adjust to **your** data. Neglecting safety instructions, and just using the “buttons” that are made available in a supposed “learning by doing” mode, can be dangerous.

**Stable Bluetooth** connectivity, **reliable CGM values**, and selecting/changing cannula sites for **reliable insulin delivery** is the solid foundation you cannot do without. Resort to bg meter measurements and to using an insulin pen if/when the necessary conditions are not given!

Stay connected with your doctor/medical team. (Even if not knowing much about your DIY loop, they should be valueable experts in setting a correct basal, and also valueable consultants in other issues). 
Please also stay connected, and share experiences, with the DIY looper communities.

**Disclaimer – Important to read and understand -** 
Authors are no medical professionals but T1 diabetics (or parents of a T1D child) who report their -limited - understanding and experience, in an effort to contribute to a growing body of knowledge, to support proper use and further development of patient centered solutions. 
Nothing in this site is medical advice. Also, the loop is no medical product, but only a toolset that many found useful to improve their diabetes management. You take full responsibility to use it with caution, and on an informed basis. 
Meanwhile, there are looping alternatives available as registered medical products, with more or less manufacturer and medical support backing them up. Preferably use one of those if they offer all you really need, or if you find the DIY route too challenging

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