Diabetes Technology Update Carolyn Losure MS, RD, CDE, CD-N

Continuous Subcutaneous Insulin Infusion

Why Pump Therapy? Insulin Pump Therapy is the most physiologic method of insulin delivery. It mimics normal pancreatic function more closely than injections. Basal insulin delivery is the continuous infusion of insulin similar to the daily secretion by the pancreas. Bolus delivery is insulin delivery on demand. There are two types: Meal Bolus and Correction Bolus.

Why Pump Therapy? Insulin Pump Therapy is the most physiological method of insulin delivery and more closely mimics the normal pancreas than injections. Basal insulin delivery is the continuous infusion of insulin similar to the daily secretion by the pancreas. Bolus delivery is insulin delivery on demand. There are two types: Meal Bolus and Correction Bolus.

Customizeable Basal Rates

What do RD’s need to know about Bolus Calculators in Pumps? Calculates insulin bolus doses and the amount of insulin active in the body Calculations are based on preset customized settings for: Blood Glucose Targets Individualized Carbohydrate ratios Insulin sensitivity factors Active insulin time

Carbohydrate Ratio/ Meal Bolus Method 1 : 450 Rule 450/Pump TDD = Ratio Example: 450 / 45 units = 10 1 unit covers 10 grams of carbohydrate Weight Based Calculations Weight (lbs) x 2.8 / Pump TDD 165 lbs x 2.8 / 45 = 10.2 1 unit covers 10 grams of carbohydrate

Insulin Sensitivity Factor 1700 Rule 1700 / Pump TDD = ISF 1700/45 = 37.7 Or 1 unit rapid acting insulin decreases the patient’s blood glucose about 38 mg/dl

Bolus Calculation Formula Current BG – Target BG / ISF = Correction Dose Example: BG = 265 mg/dl Target BG 100 mg/dl ISF = 38 265-100 = 165 165/38 = 4.3 unit correction dose

Checking a Carb:Insulin Ratio

Another Technology Advancement Therapy Management Software Effect of Carelink, an internet-based insulin pump monitoring system, on glycemic control in rural and urban children with type 1 diabetes mellitus. Erin A Corriveaua, Peter J Dursoa, Ellen D Kaufmanb, Betty J Skipperc, Louise A Laskaratosb and Kimberly B Heintzmanb

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Questions?