Can I Loop while I am red-looping?
The short answer is it depends on whether you are red looping due to a failure to communicate with the pump/pod or due to a lack of CGM data.
The first step is to understand why you are red looping. If you tap on the red loop, the Loop app will give you an error message indicating the issue. The two most common error messages involve (1) failure to communicate with the pump/pod or (2) missing CGM data.
Red-Looping for a Failure to Communicate with the Pump/Pod
If you are red-looping because of a failure to communicate with the pump/pod, you will need to re-establish communication with the pump/pod before you can loop again. To troubleshoot your red loop issue, you should follow the steps in Loopdocs Troubleshooting.
While you are red-looping due to a failure to communicate with the pump/pod, you will continue to get your regularly set basal amount for that time of the day, but you will not be able to bolus and Loop will not make adjustments to your basal delivery. If you were running a temporary basal amount when the red loop started, you will get that temporary amount until it times out. (You can see when a temporary basal amount is set to expire by adding 30 minutes to the time under the temporary basal bar.) After the temporary basal amount expires, you will get your standard basal amount for that time of day.
Red-Looping for Lack of CGM Data
If you are red-looping because of a lack of CGM data (as happens, for example, during the two-hour warm-up period after a new sensor is inserted), you can continue to loop. In that case, you can use Apple Health to input the blood glucose (BG) data from your traditional glucose meter (i.e., the finger prick) as explained below.
Step 1: Set up Apple Health to read/write to Loop
When you set up your Loop app, you should have set up your Apple Health app to allow the Loop app to read and write to Apple Health. Please refer to Loopdocs Apple Health for the instructions on how to set up Apple health permissions with Loop.
Step 2: Finger Prick/Glucose Meter
Prick your finger and get a blood glucose reading as you normally would with your glucose meter.
Step 3: Promptly Insert the Blood Glucose Reading into Apple Health
Open Apple Health. The app icon looks like this:
Once you open the app, you will see a “Summary” section and then “Favorites” listing various health information. If you have not selected Blood Glucose as a “Favorite”, you will need to tap on “Show All Health Data” and then scroll through the list of data to find Blood Glucose. Tap on Blood Glucose and then tap on “Add Data”.
You will then see this screen:
You should input your blood glucose reading from the meter promptly and accurately into Apple Health through this screen.
Within a few moments after you have inserted the blood glucose value into Apple Health, that number will appear in the Loop app. It will be available for predictions by Loop for 15 minutes. During that time, the Loop app will make predictions and calculate projected insulin need based on the BG values it has. If no new blood glucose value is added (from the CGM or manually via fingerstick), the red loop will appear at the next cycle and you will not be able to loop until blood glucose data becomes available through the CGM or through Apple Health.
You can repeat this process as needed while your sensor is warming up to keep looping while the CGM is unavailable.
Quick Bolus without Blood Glucose
This is for experienced folks only. Say your CGM expired and you have no test strips with you. You know your BG is about where is should be. It’s time to eat. You want to keep your carbohydrate count accurate for later in the day, so you enter carbs as usual and go to the bolus screen as usual. (No bolus will be recommended because you have a red loop due to no CGM values.)
So you enter what you judge is a reasonable bolus amount and press deliver. BUT nothing happens – no warning, Loop just doesn’t tell the pump to deliver the bolus.
That’s the way the code works (Jan 2021). But there is a simple fix. You’ve entered your carbs as desired. Just hit the bolus icon on the main Loop screen and enter desired bolus value. Because you asked for the bolus from the stand-alone bolus icon, Loop will tell the pump to deliver the requested bolus. (Remember – you still need good communication between your radio link and pump for this to succeed.)
Tip for Easy Access
It is useful to have Blood Glucose, Carbohydrates and Insulin selected as “Favorites” in the initial Summary List in Apple Health. For Blood Glucose, can do this by tapping on “Show All Health Data”, tapping on Blood Glucose, and then highlighting the star symbol under “Options” “Add to Favorites”. Repeat for all the other items you want handy.
