Insulin pump settings (pumpSettings)

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NB: All fields are required unless otherwise noted.

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type

[ingestion, storage, client] The string pumpSettings.

QUICK SUMMARY
Required:
    jellyfish: yes
    platform: yes

This is the Tidepool data type to represent insulin pump settings at a given point in time, usually the time of an upload of data from the device. Most insulin delivery devices do not, unfortunately, keep a historical record of all insulin pump settings whenever a settings change is made. When ingesting data from Medtronic pumps through the CareLink cloud service, we have been able to build up the full insulin pump settings history from a combination of records of current pump settings (at the time of each upload to CareLink) and records of changes to particular settings. Thus, for data originating from CareLink, the time on a pumpSettings object should represent the time at which the settings became effective. For all other devices, however, the time on each pumpSettings object simply represents a (single) time when the settings were effective, not the first moment when the settings became effective.

In general, the functionality available across the various insulin pumps on the market is remarkably similar, making the task of standardization to a common data model quite simple. The only major difference between pumps is how many alternative settings the pump provides an interface to store. In particular, the majority of pumps only allow the storage of one "schedule" for bgTarget, carbRatio, and insulinSensitivity. Historically, Tidepool worked on integrating data from devices of this type first, and as a result our data model assumed a single schedule for each of these settings. When we started integrating data from Tandem insulin pumps that allow the storage of several schedules (in parallel fashion to how all insulin pumps allow the storage of several basalSchedules), we decided to simply add alternate pluralized fields—bgTargets, carbRatios, and insulinSensitivities—structured as a set of key-value pairs, with the schedule names as the keys and the schedules as the values. Thus, either the singular version of the field (e.g., bgTarget) or the plural version (e.g., bgTargets) must be present for a pumpSettings event to be valid. In practice, all pumpSettings objects should have all singular versions of these fields, or all plural versions. There are no devices currently on the market (at least not that we at Tidepool know of) that would be best modeled with plural bgTargets but singular carbRatio and insulinSensitivity, for example.


activeSchedule

[ingestion, storage, client] A string value encoding the name of the PWD's active basal schedule.

QUICK SUMMARY
Required:
    jellyfish: yes
    platform: yes

Note that for Tandem pumpSettings, the activeSchedule will allow a client application to identify not only which of the basalSchedules is active but also the other settings that fall under Tandem's notion of a "personal profile"—i.e., bgTargets, carbRatios, and insulinSensitivities.


basalSchedules

[ingestion, storage, client] A set of key-value pairs encoding the PWD's programmed basal schedules, where each key is a basal schedule name and each value is an array of basal schedule segment objects.

QUICK SUMMARY
Required:
    jellyfish: yes
    platform: yes

Each basal schedule segment object within each array value contains the following properties:

  • rate
  • start

basalSchedules.rate

[ingestion, storage, client] A floating point number >= 0 representing the amount of insulin delivered in units per hour.

QUICK SUMMARY
Required:
    jellyfish: yes
    platform: yes
Numerical type: Floating point value rounded to the appropriate significant figures for the device's precision.
Range:
    min: 0.0
    max: 20.0

basalSchedules.start

[ingestion, storage, client] An integer encoding a start time as milliseconds from the start of a twenty-four hour day.

QUICK SUMMARY
Required:
    jellyfish: yes
    platform: yes
Numerical type: Integer value representing milliseconds.
Range:
    min: 0
    max: < 86400000

Different insulin pump manufacturers use different terminology for the set of (pre-)programmed and timed basal rates, one of which is generally active and running in the background (without any user intervention) during normal device operation. Tidepool has adopted the term "schedule" to refer to the rates covering a twenty-four hour day. There must be at least one rate in a schedule; if the schedule has only one rate, we often call this a "flat-rate" schedule since the same rate will always be in effect, temp basals and suspensions aside.

The basalSchedules object encodes all of a PWD's programmed basal schedules, where the keys on the object are the basal schedule names (user-customizable on some pumps; manufacturer-preset on others) and each value is a basal schedule.

A basal schedule, in the Tidepool data model, is an array of objects, where each object has a start and a rate. (We sometimes refer to each of these objects that compose a schedule as a "segment" of the schedule.) The rate is a typical basal rate value, in units of insulin per hour. The start is an integer value representing the milliseconds into a twenty-four hour day when the rate should go into effect. Thus, the first object in the schedule must always have a start of 0 representing the start of the day at midnight. If there is more than one rate in the schedule, then subsequent start will be positive and non-zero; for example, 21600000 would be the start for a basal rate scheduled to go into effect at 6 a.m. each day when the schedule is active. Each start must be < 86400000, the number of milliseconds in twenty-four hours, as such a value would be equivalent to 0 (midnight).


bgTarget

NB: Either bgTarget or bgTargets (but not both!) must be present for a pumpSettings object to be valid.

[ingestion, storage, client] An array of objects describing the PWD's target blood glucose at different times of day; the format of this object varies according to the make of the insulin pump.

Each blood glucose target segment object in the array contains a subset of the following properties:

  • low
  • high
  • target
  • range
  • start

bgTarget.low

[ingestion, storage, client] An integer encoding the lower bound of a PWD's blood glucose target.

Numerical type:
    mg/dL: Integer value representing a `mg/dL` value.
    mmol/L: Floating point value representing a `mmol/L` value.
Range:
    mg/dL:
        min: 0
        max: 1000
    mmol/L:
        min: 0.0
        max: 55.0

bgTarget.high

[ingestion, storage, client] An integer encoding the upper bound of a PWD's blood glucose target.

Numerical type:
    mg/dL: Integer value representing a `mg/dL` value.
    mmol/L: Floating point value representing a `mmol/L` value.
Range:
    mg/dL:
        min: >= `low` or `target`, whichever present
        max: 1000
    mmol/L:
        min: >= `low` or `target`, whichever present
        max: 55.0

bgTarget.target

[ingestion, storage, client] An integer encoding the PWD's target blood glucose as a single value.

Numerical type:
    mg/dL: Integer value representing a `mg/dL` value.
    mmol/L: Floating point value representing a `mmol/L` value.
Range:
    mg/dL:
        min: 0
        max: 1000
    mmol/L:
        min: 0.0
        max: 55.0

bgTarget.range

[ingestion, storage, client] An integer encoding the allowed deviation above or below the PWD's target blood glucose.

Numerical type:
    mg/dL: Integer value representing a `mg/dL` value.
    mmol/L: Floating point value representing a `mmol/L` value.
Range:
    mg/dL:
        min: 0
        max: min(`target`, 1000 - `target`) such that `target`-`range` >= 0 and `target`+`range` <= 1000
    mmol/L:
        min: 0.0
        max: min(`target`, 55.0 - `target`) such that `target`-`range` >= 0.0 and `target`+`range` <= 55.0

bgTarget.start

[ingestion, storage, client] An integer encoding a start time as milliseconds from the start of a twenty-four hour day.

QUICK SUMMARY
Required:
    jellyfish: yes
    platform: yes
Numerical type: Integer value representing milliseconds.
Range:
    min: 0
    max: < 86400000

Changelog for bgTarget

_schemaVersion 2: The minimal {target: [val], start: [milliseconds]} schema was added as valid to handle Tandem's bgTarget settings.

_schemaVersion 2: The nonexistent (in currently handled devices) {low: [val], target: [val], high: [val], start: [milliseconds]} schema was removed.

A blood glucose target value is used in combination with an insulin sensitivity factor in an insulin pump's bolus calculator to calculate a recommended dose of insulin to bring the PWD to the target.

The bgTarget array on a pumpSettings event represents a single schedule of target blood glucose values. A common use case for scheduling more than one blood glucose target is to schedule a more conservative (higher) target during the night-time hours in order to help prevent nocturnal hypoglycemia.

Each segment in a bgTarget schedule is an object with a start - an integer value representing the time into a twenty-four hour day in milliseconds (see above under basalSchedules for a fuller explanation). The remainder of the keys on each object in a bgTarget array vary according to the manufacturer of the insulin pump but will be a subset of low, high, target, and range. See the documentation for the wizard type for a breakdown of which insulin pump manufacturers use which of these fields to represent a blood glucose target.


bgTargets

NB: Either bgTargets or bgTarget (but not both!) must be present for a pumpSettings object to be valid.

[ingestion, storage, client] A set of key-value pairs encoding the PWD's programmed blood glucose target schedules, where each key is a schedule name and each value is an array of blood glucose target segment objects.

See bgTarget above for documentation of the fields within each blood glucose target segment object.


carbRatio

NB: Either carbRatio or carbRatios (but not both!) must be present for a pumpSettings object to be valid.

[ingestion, storage, client] An array of objects encoding the PWD's insulin carb ratio starting at a time in milliseconds from the start of a twenty-four hour day.

Each carb ratio segment object in the array contains the following properties:

  • amount
  • start

carbRatio.amount

[ingestion, storage, client] An integer encoding the grams of carbohydrate "covered" by one unit of insulin for the PWD.

QUICK SUMMARY
Required:
    jellyfish: yes
    platform: yes
Numerical type: Integer value representing grams of carbohydrate per unit of insulin.
Range:
    min: 0
    max: 250

carbRatio.start

[ingestion, storage, client] An integer encoding a start time as milliseconds from the start of a twenty-four hour day.

QUICK SUMMARY
Required:
    jellyfish: yes
    platform: yes
Numerical type: Integer value representing milliseconds.
Range:
    min: 0
    max: < 86400000

An insulin-to-carb ratio value is used in an insulin pump's bolus calculator in combination with a carbohydrate value input by the user to calculate a recommended dose of insulin to "cover" the carbohydrates about to be consumed by the PWD.

The carbRatio array on a pumpSettings event represents a single schedule of insulin-to-carb ratio values. A common use case for scheduling more than one carb ratio is to schedule a more aggressive I:C ratio during the morning hours (for breakfast), as due to the Dawn Phenomenon many PWDs need more insulin to "cover" a given number of grams of carbohydrates ingested at this time of day.

Each segment in a carbRatio schedule is an object with a start and an amount. The start is an integer value representing the time into a twenty-four hour day in milliseconds (see above under basalSchedules for a fuller explanation). The amount is an I:C ratio in grams of carbohydrate per unit of insulin.


carbRatios

NB: Either carbRatios or carbRatio (but not both!) must be present for a pumpSettings object to be valid.

[ingestion, storage, client] A set of key-value pairs encoding the PWD's programmed carb ratio schedules, where each key is a schedule name and each value is an array of carb ratio segment objects.

See carbRatio above for documentation of the fields within each carb ratio segment object.


insulinSensitivity

NB: Either insulinSensitivity or insulinSensitivities (but not both!) must be present for a pumpSettings object to be valid.

[ingestion, storage, client] An array of objects encoding the PWD's insulin sensitivity starting at a time in milliseconds from the start of a twenty-four hour day.

Each insulin sensitivity segment object in the array contains the following properties:

  • amount
  • start

insulinSensitivity.amount

[ingestion] A numerical representation of the estimation of blood glucose value drop per unit of insulin delivered in either mg/dL (integer) or mmol/L (float), with appropriately matching units field.

[storage, client] A numerical representation of the estimation of blood glucose value drop in mmol/L (float, potentially unrounded), with appropriately matching units field.

QUICK SUMMARY
Required:
    jellyfish: yes
    platform: yes
Numerical type:
    mg/dL: Integer value representing a `mg/dL` value.
    mmol/L: Floating point value representing a `mmol/L` value.
Range:
    mg/dL:
        min: 0
        max: 1000
    mmol/L:
        min: 0.0
        max: 55.0

insulinSensitivity.start

[ingestion, storage, client] An integer encoding a start time as milliseconds from the start of a twenty-four hour day.

QUICK SUMMARY
Required:
    jellyfish: yes
    platform: yes
Numerical type: Integer value representing milliseconds.
Range:
    min: 0
    max: < 86400000

An insulin sensitivity factor is used in combination with a blood glucose target in an insulin pump's bolus calculator to calculate a recommended dose of insulin to bring the PWD to the target.

The insulinSensitivity array on a pumpSettings event represents a single schedule of insulin sensitivity factors (ISFs). A common use case for scheduling more than one ISF is to dose more aggressively to bring down hyperglycemia in the morning hours, when the Dawn Phenomenon reduces insulin sensitivity for many PWDs.

Each segment in an insulinSensitivity schedule is an object with a start and an amount. The start is an integer value representing the time into a twenty-four hour day in milliseconds (see above under basalSchedules for a fuller explanation). The amount is an integer or floating-point value (depending on whether the blood glucose units are mg/dL or mmol/L) representing the expected drop in blood glucose for each single unit of insulin dosed.


insulinSensitivities

NB: Either insulinSensitivities or insulinSensitivity (but not both!) must be present for a pumpSettings object to be valid.

[ingestion, storage, client] A set of key-value pairs encoding the PWD's programmed insulin sensitivity schedules, where each key is a schedule name and each value is an array of insulin sensitivity segment objects.

See insulinSensitivity above for documentation of the fields within each insulin sensitivity segment object.


units

[ingestion, storage, client] An object encoding the units for carbohydrates and blood glucose on the PWD's insulin pump.

QUICK SUMMARY
Required:
    jellyfish: yes
    platform: yes

Contains the following properties:

  • carbs
  • bg

units.carbs

This field is optional when ingesting data through the jellyfish service but required when ingesting data through the new platform APIs.

[ingestion, storage, client] A string value encoding the (universal) units for carbohydrate input as grams.

QUICK SUMMARY
Required:
    jellyfish: no (optional)
    platform: yes
Range: The string `grams`.

units.bg

This field is optional when ingesting data through the jellyfish service but required when ingesting data through the new platform APIs.

[ingestion, storage, client] A string value encoding the blood glucose units exposed in the user interface on this insulin pump.

QUICK SUMMARY
Required:
    jellyfish: no (optional)
    platform: yes
Range: Must be one of:
    `mg/dL`
    `mmol/L`

Changelog for units

_schemaVersion ? (future): exchanges may be added as an accepted value for units.carbs in the future.

The units object on a pumpSettings event represents all the relevant units for the included settings.

For carbs, the only currently allowed value is grams, but some insulin pumps allow the use of the now-outdated "exchange" scheme for counting carbohydrates, where one exchange is ~15g of carbohydrate. We may add support for this in the future, although we will likely only allow exchanges as the units.carbs (and for carb-related values like carbRatio) on ingestion, then convert to grams based on the 1:15 ratio similar to how all mg/dL blood glucose(-related) values are converted to mmol/L on ingestion.

For bg, the value may be mg/dL or mmol/L on ingestion, but in the storage and client data formats all blood glucose and related values are converted to mmol/L, and the value of units.bg is updated to mmol/L. See units for further explanation of blood glucose units.


clockDriftOffset

See common fields.


conversionOffset

See common fields.


deviceId

See common fields.


deviceTime

See common fields.


time

See common fields.


timezoneOffset

See common fields.


uploadId

See common fields.


_active

See common fields.


_groupId

See common fields.


_schemaVersion

See common fields.


_version

See common fields.


createdTime

See common fields.


guid

See common fields.


id

See common fields.


example (client)

{
    "type": "pumpSettings",
    "activeSchedule": "Normal",
    "basalSchedules": {
        "Normal": [
            {
                "start": 0,
                "rate": 1.775
            },
            {
                "start": 48600000,
                "rate": 0.475
            }
        ],
        "Vacation": [
            {
                "start": 0,
                "rate": 1.575
            }
        ],
        "Weekday": [
            {
                "start": 0,
                "rate": 0.875
            },
            {
                "start": 3600000,
                "rate": 0.775
            },
            {
                "start": 63000000,
                "rate": 0.525
            }
        ]
    },
    "units": {
        "carbs": "grams",
        "bg": "mmol/L"
    },
    "bgTarget": [
        {
            "start": 0,
            "low": 4.440598392836427,
            "high": 8.3261219865683
        }
    ],
    "carbRatio": [
        {
            "amount": 21,
            "start": 0
        },
        {
            "amount": 5,
            "start": 10800000
        },
        {
            "amount": 18,
            "start": 25200000
        },
        {
            "amount": 16,
            "start": 63000000
        },
        {
            "amount": 9,
            "start": 73800000
        }
    ],
    "insulinSensitivity": [
        {
            "amount": 4.662628312478248,
            "start": 0
        },
        {
            "amount": 3.2749413147168647,
            "start": 61200000
        }
    ],
    "clockDriftOffset": 0,
    "conversionOffset": 0,
    "deviceId": "DevId0987654321",
    "deviceTime": "2018-05-14T18:17:08",
    "guid": "b9a8484b-a90a-406a-b876-1cd3c36a01ce",
    "id": "c1414f92dc0a4e06bb3cc6bee6a6a491",
    "time": "2018-05-14T08:17:08.996Z",
    "timezoneOffset": 600,
    "uploadId": "SampleUploadId"
}

example (ingestion)

{
    "type": "pumpSettings",
    "activeSchedule": "Normal",
    "basalSchedules": {
        "Normal": [
            {
                "start": 0,
                "rate": 1.05
            },
            {
                "start": 12600000,
                "rate": 1.25
            },
            {
                "start": 72000000,
                "rate": 1.85
            }
        ],
        "Sick": [
            {
                "start": 0,
                "rate": 0.15
            }
        ]
    },
    "units": {
        "carbs": "grams",
        "bg": "mg/dL"
    },
    "bgTargets": {
        "Normal": [
            {
                "start": 0,
                "target": 90
            },
            {
                "start": 28800000,
                "target": 85
            },
            {
                "start": 72000000,
                "target": 90
            }
        ],
        "Sick": [
            {
                "start": 0,
                "target": 90
            }
        ]
    },
    "carbRatios": {
        "Normal": [
            {
                "amount": 22,
                "start": 0
            }
        ],
        "Sick": [
            {
                "amount": 25,
                "start": 0
            },
            {
                "amount": 21,
                "start": 32400000
            },
            {
                "amount": 12,
                "start": 55800000
            }
        ]
    },
    "insulinSensitivities": {
        "Normal": [
            {
                "amount": 94,
                "start": 0
            }
        ],
        "Sick": [
            {
                "amount": 44,
                "start": 0
            }
        ]
    },
    "clockDriftOffset": 0,
    "conversionOffset": 0,
    "deviceId": "DevId0987654321",
    "deviceTime": "2018-05-14T18:17:08",
    "time": "2018-05-14T08:17:08.997Z",
    "timezoneOffset": 600,
    "uploadId": "SampleUploadId"
}

example (storage)

{
    "type": "pumpSettings",
    "activeSchedule": "Normal",
    "basalSchedules": {
        "Normal": [
            {
                "start": 0,
                "rate": 0.825
            },
            {
                "start": 14400000,
                "rate": 0.625
            },
            {
                "start": 82800000,
                "rate": 0.525
            }
        ],
        "Stress": [
            {
                "start": 0,
                "rate": 1.225
            },
            {
                "start": 37800000,
                "rate": 1.175
            }
        ],
        "Vacation": [
            {
                "start": 0,
                "rate": 1.4
            },
            {
                "start": 36000000,
                "rate": 1.525
            },
            {
                "start": 46800000,
                "rate": 0.3
            },
            {
                "start": 68400000,
                "rate": 0.925
            },
            {
                "start": 73800000,
                "rate": 0.675
            }
        ]
    },
    "units": {
        "carbs": "grams",
        "bg": "mmol/L"
    },
    "bgTarget": [
        {
            "start": 0,
            "target": 6.383360189702364,
            "high": 8.048584587016023
        }
    ],
    "carbRatio": [
        {
            "amount": 7,
            "start": 0
        }
    ],
    "insulinSensitivity": [
        {
            "amount": 0.7215972388359193,
            "start": 0
        },
        {
            "amount": 3.5524787142691414,
            "start": 9000000
        },
        {
            "amount": 0.7771047187463747,
            "start": 28800000
        },
        {
            "amount": 0.6660897589254641,
            "start": 39600000
        },
        {
            "amount": 3.830016113821418,
            "start": 61200000
        }
    ],
    "_active": true,
    "_groupId": "abcdef",
    "_schemaVersion": 0,
    "_version": 0,
    "clockDriftOffset": 0,
    "conversionOffset": 0,
    "createdTime": "2018-05-14T08:17:13.999Z",
    "deviceId": "DevId0987654321",
    "deviceTime": "2018-05-14T18:17:08",
    "guid": "7d965b73-53f3-44b0-9920-716799fbc6c8",
    "id": "e8b564c185484cd9b28447e6ad97a76d",
    "time": "2018-05-14T08:17:08.999Z",
    "timezoneOffset": 600,
    "uploadId": "SampleUploadId"
}

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