What are Overrides?
Overrides allow you to change your target range and/or insulin sensitivity for a set duration or indefinitely, starting now or in the future. If you modify sensitivity away from 100%, then basal, ISF and Carb Ratio are all adjusted by that percentage – this is different from selecting a temporary basal on a pump.
Details on how to configure overrides are explained here: Loopdocs: Overrides page.
In addition to Overrides, you may want to implement the Manual Temp Basal feature.
Warnings:
- Sensitivity of 200% is a factor of 2 (more insulin) change for all your settings
- Sensitivity of 50% is a factor of 2 (less insulin) change for all your settings
- Be cautious about overrides with sensitivity changes when entering meal carbs
- Avoid sensitivity below 50% because it can wreak havoc on Loop’s prediction algorithm
- Looper must be within range of the phone/link for overrides to work
Tip & Tricks:
- If a situation requires restricted basal, change target range to a higher number, then next Loop cycle should set temp basal to zero
- For exercise, adjust sensitivity to what the Looper would need if going into it with zero IOB and select a higher target
- You can schedule an override to happen at a specific time
- You can edit an active override
- If exercising with significant IOB, expect to need fast-carbs and with experience, you’ll figure out how many carbs to preload before exercise begins
Types of Overrides:
Preset overrides are generated by the Loop User, given an emoji and name, then saved for future use. They can be quickly started by these methods:
- Select on Loop phone
- Select on a paired Apple watch
- Select Remotely on Nightscout if configured
Custom overrides are configured and used one time and are not saved.
Pre-Meal button is a special kind of override found on the main screen that only changes the target range and is configured in the Settings Menu.
How to Edit an Active Override:
Go to the Main Loop Screen in portrait mode. The override icon and end time are located just below your HUD. Tap on the icon and the override screen will pop-up. Modify the override as desired and then Save changes. Please note that changes are temporary, i.e., they are discarded when override is canceled.
Override Examples
Here are some ways Loopers use overrides.
Tap on the icon to the right of each title. Don’t see your favorite method – or your approach to the same scenario is different? Send us your suggestion via the feedback link – or offer it on the LoopAndLearn Facebook group – and we may add it to this page. (All information will be kept anonymous.) If appropriate, include indication if override is used by a child, adult or senior and include some information about the scenario when it’s used.
Remember: YDMV (Your Diabetes May Vary)
Exercise
Going into exercise with zero IOB helps, a lot. If you have significant positive IOB, a zero temp basal is unlikely to be enough so have quick acting carbs available.
Example 1: Senior, Normal Range 85 to 100 mg/dl, select PreExercise about 1 hour ahead, select Exercise (70%) at start of 2 to 3 hour moderate bike ride
Sick Days
If you have a suggestion – please send it via the feedback link – or offer it on the LoopAndLearn Facebook group
New Pod / Site
Some people experience higher than desired blood glucose after inserting a new pod or changing a site. It can take a while for a new site to begin absorbing well, and in some cases, the previous site may have been starting to fail.
This one is trial and error – figure out what works best for you – and it may be a combination of more than one option.
Option 1: Use an override
- Increase the percent of insulin needed to 110 or 120% for 1 to 3 hours (you need to experiment)
- If you plan to eat, turn off override, add carbs and bolus, then turn override back on
Option 2: Get an extra bolus without causing Loop to restrict basal
- Enter fake carbs to provide the bolus you think you need
- or
- Follow the customization instructions to add extra insulin as part of the insertion process
- Normally 0.5 U (10 clicks) are used to fill the cannula after it is inserted
- This LoopDocs: Customization Link explains how to customize to add “extra” insulin that will not be added to your IOB
- After you do this modification, you can count “extra clicks” as part of insertion
- Each click is 0.05 U of insulin
Menstrual Cycles
If you have a suggestion – please send it via the feedback link – or offer it on the LoopAndLearn Facebook group
Remote Overrides with Nightscout
Remote Overrides through Nightscout can be an important resource for parents monitoring their children while they are at school. For example, a parent can turn on an override an hour before physical education class to reduce the insulin on board before the exercise begins. Remote Overrides are particularly useful when parents would like to intervene without interferring with the school day.
To set up Remote Overrides, please follow instructions in Loopdocs: Loopdocs: Remote Commands page. To use Remote Overrides, the overrides must have already been saved in Loop and turned on at least one time. With Loop 3, there are remote commands to bolus and add carbs as well as to modify an override.
Preset overrides have the advantage that they can be used remotely (using Nightscout) and the duration time (once a preset override is set-up and saved in Loop) can be changed during activation an override in Nightscout:
Example: First a preset override with duration of 30min is initiated via Nightscout and later changed to 60 minute duration time.
Your Scenario Goes Here
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Sensitivity Table
This table shows how each of your settings changes with a sensitivity change:
Manual Temporary Basal Rate
In addition to the overrides, Loop also offers a manual temporary base rate to be explicitly set for a specific time period while the Looper.
- The basal rate and duration can be selected
- Manual Temp basal puts you into Open Loop for the duration of the setting, in other words, there will be no automatic adjustment of dosing
- When the duration expires, Loop restores Closed Loop (if it was enabled before)
What differentiates this feature from the overrides described above is that it only impacts your basal rate and the Looper can leave their gear behind. For example, this feature is helpful for swimming or other sports where it’s not practical to carry your link and/or phone with you.
This feature is provided for Pods (tap on the pump icon and scroll down to “Set Temporary Basal” row). The user can choose any basal rate from 0 to their max basal rate and any duration up to 12 hours in half-hour increments.
For users with a Medtronic pump, you must manually enter open loop and then set a temporary basal rate on your pump.