diabetes technology update carolyn losure ms, rd, cde, cd-n
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Diabetes Diabetes Technology Technology
UpdateUpdateCarolyn Losure MS, RD, CDE, Carolyn Losure MS, RD, CDE,
CD-NCD-N
Why Pump Therapy?Why Pump Therapy? Insulin Pump Therapy is the most physiologic Insulin Pump Therapy is the most physiologic
method of insulin delivery. It mimics normal method of insulin delivery. It mimics normal pancreatic function more closely than pancreatic function more closely than injections.injections.
Basal insulin delivery is the continuous Basal insulin delivery is the continuous infusion of insulin similar to the daily infusion of insulin similar to the daily secretion by the pancreas.secretion by the pancreas.
Bolus delivery is insulin delivery on demand. Bolus delivery is insulin delivery on demand. There are two types: Meal Bolus and There are two types: Meal Bolus and Correction Bolus.Correction Bolus.
Why Pump Therapy?Why Pump Therapy? Insulin Pump Therapy is the most Insulin Pump Therapy is the most
physiological method of insulin delivery and physiological method of insulin delivery and more closely mimics the normal pancreas than more closely mimics the normal pancreas than injections.injections.
Basal insulin delivery is the continuous Basal insulin delivery is the continuous infusion of insulin similar to the daily infusion of insulin similar to the daily secretion by the pancreas.secretion by the pancreas.
Bolus delivery is insulin delivery on demand. Bolus delivery is insulin delivery on demand. There are two types: Meal Bolus and There are two types: Meal Bolus and Correction Bolus.Correction Bolus.
What do RD’s need to know What do RD’s need to know about Bolus Calculators in about Bolus Calculators in
Pumps?Pumps? Calculates insulin bolus doses and Calculates insulin bolus doses and
the amount of insulin active in the the amount of insulin active in the bodybody
Calculations are based on preset Calculations are based on preset customized settings for:customized settings for: Blood Glucose TargetsBlood Glucose Targets Individualized Carbohydrate ratiosIndividualized Carbohydrate ratios Insulin sensitivity factorsInsulin sensitivity factors Active insulin timeActive insulin time
Carbohydrate Ratio/ Carbohydrate Ratio/ Meal BolusMeal Bolus
Method 1 : 450 RuleMethod 1 : 450 Rule
450/Pump TDD = 450/Pump TDD = RatioRatio
Example:Example:
450 / 45 units = 450 / 45 units = 1010
1 unit covers 10 1 unit covers 10 grams ofgrams of
carbohydratecarbohydrate
Weight Based Weight Based CalculationsCalculations
Weight (lbs) x 2.8 / Pump Weight (lbs) x 2.8 / Pump TDDTDD
165 lbs x 2.8 / 45 = 165 lbs x 2.8 / 45 = 10.210.2
1 unit covers 10 grams 1 unit covers 10 grams of carbohydrateof carbohydrate
Insulin Sensitivity FactorInsulin Sensitivity Factor1700 Rule1700 Rule
1700 / Pump TDD = ISF1700 / Pump TDD = ISF
1700/45 = 37.71700/45 = 37.7
Or 1 unit rapid acting insulin Or 1 unit rapid acting insulin decreases the patient’s blood decreases the patient’s blood
glucose about 38 mg/dlglucose about 38 mg/dl
Bolus Calculation Bolus Calculation FormulaFormula
Current BG – Target BG / ISF = Current BG – Target BG / ISF = Correction DoseCorrection Dose
Example: BG = 265 mg/dl Example: BG = 265 mg/dl
Target BG 100 mg/dlTarget BG 100 mg/dl
ISF = 38ISF = 38
265-100 = 165265-100 = 165
165/38 = 4.3 unit correction dose165/38 = 4.3 unit correction dose
Another Technology Another Technology AdvancementAdvancement
Therapy Management Therapy Management SoftwareSoftwareEffect 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 andKimberly B Heintzmanb
Professional Continuous Professional Continuous Glucose Monitoring DevicesGlucose Monitoring Devices