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

2. Continuous Subcutaneous Insulin Infusion

3. 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.

4. 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.

8. Customizeable Basal Rates

9. 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

10. 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

11. 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

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

13. Checking a Carb:Insulin Ratio

14. 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

19. Personal Continuous Glucose Monitoring Devices

20. Professional Continuous Glucose Monitoring Devices

21. Does A1C Tell the Entire Story?

22. HbA1c versus Glycemic Variability

23. 288 data points per day

24. Interstitial Glucose Reflects Plasma Glucose

25. Clinical Evidence for CGM

26. Sensor Converts Glucose to Electronic Signals

28. Sensors and Meters measure in different places

31. Minimal carbohydrate consumption during the day

32. Postprandial hypoglycemia and nocturnal hyperglycemia

33. Dual Wave Bolus Option

34. Therapy Management Dashboard

35. Absolute Latest Technology in Connected Care

38. Questions?