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Treatments
Since version 2.0.0 Spike now supports the following treatments:
- Bolus: Administration of insulin, either by using a pen or a pump. It normally represents a correction done when glucose levels are running high.
- Carbs: Ingestion of carbohydrates. Usually done when glucose levels are running low or the user eats a snack.
- Meal: Represents a meal consisting of carbohydrates and an insulin bolus. A meal treatment combines the carb and bolus treatments into one.
- BG Check: A visual representation of the current glucose level measured with a meter.
- Note: A brief record describing a specific event like "out for a run", "launch with friends", etc.
- Calibration: Calibrations are added automatically to the Chart whenever the user calibrates the sensor.
- Sensor Start: Sensor Starts are added automatically to the Chart whenever the user starts a new sensor.
All treatments are automatically added to Spike's chart.
Before adding treatments the user needs to configure a few settings.
Settings -> Treatments -> Profile.
Spike supports multiple insulins with different DIAs (Duration of Insulin Action). To determine the DIA of a specific insulin please perform the steps described in this guide. Although most manufacturers supply an average DIA for their insulins, it's a good idea to determine it yourself. Each person can react differently to the same insulin brand.
The DIA value will be used by Spike to calculate the user's IOB (Insulin On Board) after a bolus or meal treatment is added. Spike will calculate a combined IOB of all different types of insulins used by the user in his/her treatments.
Once all insulins have been set up, the user needs to configure his/her carb absorption rate so Spike can calculate COB (Carbs On Bard) after a carb or meal treatment is added. To determine the carb absorption rate please follow the steps described in this guide.
If having a perfect COB value is not mandatory and the intention is to only use it as a reference, leaving the default carb absorption rate of 30g per hour will work for most users. Spike takes into account digestion time. Normally it takes about 20 minutes for medium-low glycemic carbs to enter the blood stream. After the user adds a carb or meal treatment, COB value will start decreasing after 20 minutes.
Now that the profile has been configured, additional settings can be found in Settings -> Treatments.
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Enable: By default, treatments are enabled for all users. They can be completely disabled by turning the enable switch off.
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Display On Chart: Treatments can be enabled in Spike but disabled on the Chart. If this option is disabled, the user will be able to add treatments and they will also be synced to his/her Nightscout site. IOB and COB values will still by synced to the Today Widget and Apple/Pebble Watch but no treatments, IOB and COB will be displayed on the chart.
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Display IOB: When this option is disabled, the IOB pill will not be displayed on the chart.
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Display COB: When this option is disabled, the COB pill will not be displayed on the chart.
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Download NS Treatments: When this option is enabled, Spike will try to sync treatments that the user adds on his/her Nightscout site. If a treatment is added in Nightscout, Spike will attempt to fetch it every time a new reading arrives from the transmitter or Spike is brought to the foreground. Treatments from Nightscout will show on the chart and will also be saved to Spike's internal database. When this option is enabled Spike will consume a bit more battery but it should not be too significant.
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Loop/OpenAPS User: If the user uses Loop or OpenAPS this option should be enabled (MDI/Pen users should leave it disabled). When this option is enabled, Spike will not use its internal IOB and COB algorithm, instead it will display IOB and COB fetched from Nightscout. These IOB and COB values represent the data calculated by Loop/OpenAPS and sent by these apps to Nightscout. When this option is enabled, Spike will only show current IOB and COB values, the user will not be able to see IOB or/and COB values from previous times of the day. MDI/Pen users that have this option disabled will be able to scroll on the chart and see retro IOB and COB values calculated by the internal algorithm.
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Colors: Colors can be customised for each treatment. These colors will be used by Spike to display treatments on the chart.
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Load Default Colors: Will reset all your treatment's colors to default values.
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Read Instructions: Will take you to this WiKi.
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Email Widget/Watch Configurations: This button will present the user with a popup asking for an e-mail address so Spike can send an e-mail with instructions on how to configure a Today Widget and Apple/Pebble Watch in order to remotely insert treatments. For the Today Widget and Apple Watch, Spike uses the free app Workflow. For Pebble Watches, Spike can either use the Careportal or PinIt app (both free).
Treatments can be added directly in the Spike app, from a Today Widget or an Apple/Pebble Watch.
In Spike, treatments can be added by going to the + menu on the chart screen. The user will be presented with a list of available treatments. Selecting a treatment will show a popup where different values can be inserted (insulin, carbs, notes, etc.). The user has the option to define the time when the treatment occurred (past or present).
After the Workflow Today Widget has been configured with Spike treatments, the user just needs to select the desired treatment, insert the corresponding values and click ok. The Today Widget will send the treatment to Spike's internal server and it will be added to the chart and synced to Nightscout, Apple/Pebble Watch, HealthKit, etc.
Unfortunately Workflow doesn't have an alphanumeric keyboard (only numeric) so there's no way to add a custom note on the fly. The user can only have predefined notes on the Today Widget and Apple Watch. Instructions on how to create predefined notes are available in the configuration e-mail sent in Settings -> Treatments (Email Widget/Watch Configurations button).
Apple Watch also uses the Workflow app to insert treatments in the exact same way it's done on the Today Widget. After installing the Workflow app on the device, make sure it's also installed on the Apple Watch (this can be done inside the Watch app on the phone). The Today Widget workflows will be synced to the Apple Watch automatically. It's highly recommended to keep the Workflow app on the Apple Watch dock for easy and quick access.
Pebble can be used to insert treatments in Spike by either using the PinIt or Careportal app. Please refer to the configuration e-mail to learn how to add these apps to your Pebble Watch. It's important to note that the Careportal app has some treatments not supported by Spike (mainly directed to pump users). Spike will only accept supported treatments, the ones listed at the top of this WiKi.
All treatments on the chart are interactive. The user can touch on a treatment and a callout will appear with details specific to that treatment. Options to move or delete the treatment are also available.
For more editing granularity it's recommended to use the Treatments Manager. The manager is available from the + menu on the chart screen, by selecting the last option "Treatments". A new screen will appear with a list of all treatments inserted in the last 24H. The user will be able to delete treatments or edit them with more granularity than the callout displayed on the chart.
Spike will automatically sync treatments to Nightscout if the user has Nightscout enabled in Settings - Share. The syncing process is done automatically and doesn't require user interaction. Treatments can also be synced from Nightscout to Spike if the "Download NS Treatments" option is enabled in Settings - Treatments. All treatments added, deleted, edited or moved in Spike are synced to Nightscout and all treatments added, deleted, edited or moved in Nightscout are synced to Spike.
Real time IOB and COB is synced to the Today Widget every time a new treatment is added, deleted, edited or moved. Synchronisation to the Today Widget will also happen every time a new reading arrives from the transmitter.
Real time IOB and COB can be synced directly to the Apple Watch complication. To enable this feature, please go to Spike's Settings - Watch. The user can enable IOB, COB or both. Due to space constrains, IOB and/or COB can't be displayed at the same time as the user's name, the user will need to choose one or the other.
IOB and COB can also be synced to compatible Apple Watch apps that are able to connect directly to Spike (see Settings - Integration - Internal HTTP Server for instructions).
IOB and COB can be synced directly to a Pebble Watch when using compatible watch faces like CGM Skyline. To configure Pebble watch faces to connect directly to Spike please read instructions in Settings - Integration - Internal HTTP Server.
Compatible Garmin watch apps will also display real time IOB and COB. To configure your Garmin watch to connect directly to Spike please read instructions in Settings - Integration - Internal HTTP Server. A list of compatible Garmin watch apps is available here.
Spike can add insulin, carbs and glucose directly to HealthKit. This option can be enabled in Spike's Settings - Share - HealthKit. The user can also manage what type of treatments are synced to HealthKit by opening the Health app and selecting Spike from the Sources tab.
Adding, deleting or editing treatments can also trigger IFTTT applets. The same is true for changes in IOB and COB. To learn how to configure Spike to use IFTTT please read the WiKi available here.
Spike followers can see all of the master's treatments, either by following through a Nightscout site or Spike to Spike mode if both phones are connected to the same WiFi network.
Followers will only be able to see the master's treatments. They won't be able to add, delete, edit or move treatments. The master's IOB and COB will also be displayed on the follower's phone.
All sync options like having real time IOB and COB on the Today Widget, Apple/Pebble Watch, etc. are available to followers as well.
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