Random boluses dragging BG down for no apparent reason

[kneddla]

Describe the bug
Since July we have been observing random (often very large) boluses while BG is already dropping, basal is off etc.
Kenny had a look at our ns.bad.mn nightscout data and did confirm it was very weird. THat was August. We naver got to logging an issue, and instead decided to switch to OREF algorithm. We are now ready to switch to Trio but I still feel this should be looked into.
Some people suggested it is a settings issue but I am convinced it is not. We are now at 97% time in range, settings are very correct. Below is a recent snapshot of a bolus that was administered a few minutes ago, after a loop that saw eventual BG at 98 - perfectly on target. Why 5min later Loop decided to bolus 0.5U is beyond my comprehension.

I will get the remaining details later today when Danny comes back from school and I have access to his phone.

Attach an Issue Report
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To Reproduce
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4. See error

Expected behavior
A clear and concise description of what you expected to happen.

Screenshots
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Phone

• Hardware: [e.g. iPhone XS]
• OS Version: [e.g. iOS 12.0.1]

Loop Version

• Version Number: [e.g. 1.9.2]
• Repo: [LoopKit/Loop, Katie, etc]

CGM
Dexcom G6

Pump
Omnipod Dash

Additional context
Add any other context about the problem here.

[kneddla]

Here is another example from last week, and will dig out the older ones.

[marionbarker]

Those picture are great for establishing the time where the unexpected bolus occurs.

In order to determine whether that was an automatic bolus from Loop or an accidental manual bolus, we need to have the Critical Logs. The Loop Report has an 84 hours lifetime. The Critical Logs contains 7 days of data. Please try to get these off the phone and posted promptly.

Please upload both the Loop Report and the Critical Logs:

• Loop, Settings, Support: Issue Report
• Loop, Settings, Support: Export Critical Event Logs

[kneddla]

Loop Report 2024-11-01 040647+0400.md
Export-20241101T000741Z.zip

Hello - uploading the logs. I have grilled my son about that bolus but he says he never sends himself boluses other than what loop recommends - and in this particular case he swears he didn't touch the watch or the phone...

It would be helpful to distinguish by source: Algorithm, Manual local and Manual remote. Would be awesome to see that in NightScout!

[marionbarker]

Make sure that your son always locks his phone before putting it away. And is his phone configured to require confirmation for a bolus or did you disable that? If you did, please turn authentication back on.

With a maximumBolus setting of 2.0 U (as noted in your Loop Report), it is impossible to get a 2 U bolus delivered automatically. Loop only delivers a partial bolus based on the recommendation and the recommendation (if greater than maxBolus) is limited by maxBolus. If you have GBPA disabled, the max auto bolus is 40% of 2.0 U or 0.8 U. If you have GBPA enabled, that percentage varies between 20% for lower glucose values and 80% for higher glucose values.

Looking at just the current pod

• There are 6 instances of 2 U boluses - all were manually entered
• There are 181 instances of Loop providing an automatic bolus
• There are 65 instances of Loop passing along a manual bolus

If you have access to your son's phone and the pump event is still in history, tap on it to view the full display.
You will see a wall of text. What you are looking for is this text:

• automatic: Optional(false) means a manual bolus
• automatic: Optional(true) means Loop calculated a recommended bolus and issued it automatically

The times (in UTC) included in this pod's record are:

  This pod status:
            Pod active time (hrs) :   69.0
     Insulin delivered by pod (u) :   97.05 (from last 0x1d)

  Report below is for all messages to date for this pod

            First message in log : 2024-10-29 02:58:11
            Last  message in log : 2024-11-01 00:06:36
  Total elapsed time in log (hrs) :   69.1

If you still want me to, I need a specific time stamp including the date and time for that 2U bolus of interest. Your screen shot was noted as being "last week" but there is no date in the graphic. If you give me the date and time for that screen shot and it's less than 7 days in the past, I'll dig into the critical logs to find that exact event. But given the facts above, I'm pretty confident that was a manual entry.

[marionbarker]

If you do not have Tidepool Service added to your son's phone, consider adding it.

You can see a manual bolus that overrides Loop's recommendation in the Tidepool Web display. I just made one on my own phone. Loop recommended a manual bolus of 0.15 U. I modified that to 0.2 U.

I then went to my Tidepool Web display, refreshed the daily plot.
I hovered over the bolus and see this graphic.

[kneddla]

Thanks very much Marion! The bolus I thought was weird took place yesterday at 9:28 our local time in Dubai. It was 0.5 U. Interestingly BG started climbing right after hence my suspicion that Danny ate something and just threw Ina bolus of half a unit. He swears he did not. And they're is no bolus without faceID or lock code, don't worry. We are going offline for the whole weekend but once back I'll use your instructions and learn how to analyze myself. Many thanks for those! Much appreciated, Petr

…

On Fri, 1 Nov 2024 at 5:49 PM Marion Barker ***@***.***> wrote: Make sure that your son always locks his phone before putting it away. And is his phone configured to require confirmation for a bolus or did you disable that? If you did, please turn authentication back on. With a maximumBolus setting of 2.0 U (as noted in your Loop Report), it is impossible to get a 2 U bolus delivered automatically. Loop only delivers a partial bolus based on the recommendation and the recommendation (if greater than maxBolus) is limited by maxBolus. If you have GBPA disabled, the max auto bolus is 40% of 2.0 U or 0.8 U. If you have GBPA enabled, that percentage varies between 20% for lower glucose values and 80% for higher glucose values. Looking at just the current pod - There are 6 instances of 2 U boluses - all were manually entered - There are 181 instances of Loop providing an automatic bolus - There are 65 instances of Loop passing along a manual bolus If you have access to your son's phone and the pump event is still in history, tap on it to view the full display. You will see a wall of text. What you are looking for is this text: - automatic: Optional(false) means a manual bolus - automatic: Optional(true) means Loop calculated a recommended bolus and issued it automatically The times (in UTC) included in this pod's record are: This pod status: Pod active time (hrs) : 69.0 Insulin delivered by pod (u) : 97.05 (from last 0x1d) Report below is for all messages to date for this pod First message in log : 2024-10-29 02:58:11 Last message in log : 2024-11-01 00:06:36 Total elapsed time in log (hrs) : 69.1 If you still want me to, I need a specific time stamp including the date and time for that 2U bolus of interest. Your screen shot was noted as being "last week" but there is no date in the graphic. If you give me the date and time for that screen shot and it's less than 7 days in the past, I'll dig into the critical logs to find that exact event. But given the facts above, I'm pretty confident that was a manual entry. — Reply to this email directly, view it on GitHub <#2254 (comment)>, or unsubscribe <https://github.com/notifications/unsubscribe-auth/A5JVWWOWHGRTZ6K6Y2Z4EQDZ6OBIJAVCNFSM6AAAAABQ5S26KGVHI2DSMVQWIX3LMV43OSLTON2WKQ3PNVWWK3TUHMZDINJRHEYDINJXGA> . You are receiving this because you authored the thread.Message ID: ***@***.***>

[kneddla]

Thanks again I tried Tide pool before but got into regional restrictions that proved insurmountable. This is some time ago though, perhaps I should try again. Many thanks for all your advice Marion! Best Petr

…

On Fri, 1 Nov 2024 at 5:55 PM Marion Barker ***@***.***> wrote: If you do not have Tidepool Service added to your son's phone, consider adding it. You can see a manual bolus that overrides Loop's recommendation in the Tidepool Web display. I just made one on my own phone. Loop recommended a manual bolus of 0.15 U. I modified that to 0.2 U. I then went to my Tidepool Web display, refreshed the daily plot. I hovered over the bolus and see this graphic. tidepool-display-manual-override-of-recommendation.png (view on web) <https://github.com/user-attachments/assets/ce493e24-25d8-47c5-8b63-2f91178ff52e> — Reply to this email directly, view it on GitHub <#2254 (comment)>, or unsubscribe <https://github.com/notifications/unsubscribe-auth/A5JVWWKPTQAQKFJQ52VV2ETZ6OB3RAVCNFSM6AAAAABQ5S26KGVHI2DSMVQWIX3LMV43OSLTON2WKQ3PNVWWK3TUHMZDINJRHEYTENBYGM> . You are receiving this because you authored the thread.Message ID: ***@***.***>

[marionbarker]

If you mean 9:28 pm local, then this is the bolus (UTC time 17:28) and it was automatic. I shortened this to show UTC time, pod command Hex code, total pod insulin delivered to date and interpretation of the command.

2024-10-31 17:28:48,
send,0x1a17,
93.3,
Loop Sent: AutoBolus of 0.50 u

This was one of several AutoBoluses: 0.30, 0.45, 0.50, 0.25 sent at 17:18, 17:23, 17:28 and 17:33. And the scheduled basal continued to keep running at this time. There were probably carbs on board or rising glucose. If you drag to see retrospective display in the NS site and it's within the last 24 hours, you can see Loop's prediction at the time of your cursor. (I can't find directions in NS docs. Lower right - there's a highlighted region for the time set by Hours: 2, 3, 4, 6, 12, 24. Drag that section to the left and see the Loop forecast.) If it's more than 24 hours, then do day-by-day report and turn on the check box to display Predictions.