Titration

Warning

I am not a doctor. Only purpose of this post is to show how Excel may be helpful. Do your own homework, read at own risk. I take no repsoncibilities

I do not have dieabietes. I just know people who do.

I have moved from Google Sheets to Microsoft Excel for doing Insulin titration for my mother. I am an Android, Linux, Windows shop and felt that Google sheets would be better for being able to move between Windows and my Samsung tablet and phone. From past experience, Google Docs is excellent in collaboration. The issue that I noticed was that sometimes the data that I entered in did not prorogate between devices. I know that SAAS spreadsheets are a hub and spoke. What I think was happening was that the cached version was not being uploaded to the central server. When it was, uploaded, it became the older version because it was changed elsewhere. The issue may have been my work offline settings or how I move from device to device or wifi to wifi. In the end, it does not matter to me. For my well being and mother’s health, it just has to work.

Before I show an HTML table representation of my spreadsheet, here are my sources:

The spreadsheet that I created looks like this:

Date	Blood Sugar	Move Average	Insulin
10/29/2018	53	0	0
10/30/2018	60	0	0
10/31/2018	138	84	102
11/1/2018	198	132	100
11/2/2018	107	148	100
11/3/2018	150	152	100
11/4/2018	64	107	90
11/5/2018	69	94	82
11/6/2018	81	71	82

Underlying cell formulas look like:

Date	Blood Sugar	Move Average
43402 43403	53 60
43404	138	=IF(ISBLANK(B7),,ROUND(AVERAGE(B5:B7),0))
43405	198	=IF(ISBLANK(B8),"",ROUND(AVERAGE(B6:B8),0))
43406	107	=IF(ISBLANK(B9),"",ROUND(AVERAGE(B7:B9),0))
43407	150	=IF(ISBLANK(B10),"",ROUND(AVERAGE(B8:B10),0))
43408	64	=IF(ISBLANK(B11),"",ROUND(AVERAGE(B9:B11),0))
43409	69	=IF(ISBLANK(B12),"",ROUND(AVERAGE(B10:B12),0))
43410	81	=IF(ISBLANK(B13),"",ROUND(AVERAGE(B11:B13),0))

I am using the round function for the moving average because there is no such thing as decimal numbers on the blood glucose monitor.

The current Insulin titration looks like:

=IF(ISBLANK(B31),"",IF(COUNTIF(D27:D30,D30)>=4,IF(C31<70,MROUND(D30*0.9,2),D30+LOOKUP(C31,$H$6:$H$10,$I$6:$I$10)),D30))

The titration uses the fasting simple moving average. From what I understand about Tresiba, does change should happen every 3 to 4 days. The countif function checks to see if the last 4 doses were the same. If they are the same, titrate. Also, if the simple moving average is under 70, reduce dosage by 10%.

Look Up table:

Titration Lookup
min value	Change
0	-2
80	0
110	2
161	4
180	6

Important

As I said, this is a laypersons interpretation. This post is to give you ideas. However, please do your own homework.