Sample of Trend Arrow–Guided Decision-Making (90)

Patient ProfileScanning TimeWhat the Display ShowsWhat the Patient Does
Jane has a target of 100 mg/dL and a correction factor of 1:50. This means she should take 1 unit of insulin to lower her glucose about 50 mg/dL.After breakfastEmbedded Image
Jane sees a reading of 250 mg/dL trending rapidly downward. There is also a high glucose message and the “check blood glucose” symbol.
Embedded Image
Seeing the symbol, Jane performs SMBG before deciding what to do.
Before lunchEmbedded Image
Jane’s glucose is 250 mg/dL and rising.
Before eating, Jane adds 50 mg/dL to her current reading given the rising trend arrow (250 + 50 = 300 mg/dL). She subtracts her target number (300–100 = 200 mg/dL) and divides by her correction factor (200 ÷ 50 = 4). Jane takes 4 units of insulin.
After lunchEmbedded Image
Ninety minutes later, Jane’s glucose is the same. The trend arrow and graph show a continued rise.
Jane does not take a correction dose because it is within 2 hours of her meal dose. This could lead to “insulin stacking” (adding an insulin dose on top of insulin still active from the previous dose) and low glucose. The insulin she took for her meal may still be active. Instead, Jane decides to wait and scan again later.
Before dinnerEmbedded Image
Jane’s current glucose is 250 mg/dL. The trend arrow and graph indicate that her glucose is going down.
Jane asks herself what might be causing her glucose to go down and what she might do to prevent low glucose, deciding to take less insulin before her meal. She subtracts 50 mg/dL from the current value because of the falling trend arrow (250 – 50 = 200 mg/dL) and then subtracts her target number (200 – 100 = 100 mg/dL). She divides this by her correction factor (100 ÷ 50 = 2). Jane takes 2 units of insulin.