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[IP] A bolus calculator is an effective means of controlling postprandial glycemia in

Diabetes Technol Ther. 2003;5(3):365-9.     <A
t=pubmed_pubmed&from_uid=12828818">Related Articles,</A> >Links</A>
A bolus calculator is an effective means of controlling postprandial glycemia
in patients on insulin pump therapy.

Gross TM, Kayne D, King A, Rother C, Juth S.

Medtronic MiniMed, Northridge, California 91325, USA.
email @ redacted

Accurate bolus insulin doses require calculations based on (1) current blood
glucose, (2) target blood glucose, (3) carbohydrate-to-insulin ratios, (4)
total grams of carbohydrate in meals, and (5) insulin sensitivity factors.
Patients may often forego these calculations for insulin doses based on
estimates. A bolus calculator (Medtronic MiniMed) uses these five parameters
generate a recommended bolus insulin dose. This study provides the evidence
that a hand-held bolus calculator is effective in controlling postprandial
glucose. Subjects (n = 49) with Type 1 diabetes and experienced with
continuous subcutaneous insulin infusion therapy were randomized to begin one
of two
bolus dosing methods. After 7 days, subjects crossed over to the alternate
method. Prior to entering the Bolus Calculator period, physicians established
patients' bolus parameters and programmed them into a personal digital
(PDA). Subjects used the PDA to obtain recommended pre-meal insulin bolus
doses. During the Standard Bolus period, significantly more correction boluses
administered to curtail postprandial hyperglycemia (p = 0.008) and more
supplemental carbohydrate was consumed to raise low blood glucose (p = 0.046).
Similar values were observed between the two bolus dosing methods in average
deviation of 2-h postprandial blood glucose. Subjects reported that the bolus
calculator was easy to use and that they were confident in the bolus doses
suggested by the device. These results confirm that bolus insulin doses
computed by a
bolus calculator, compared with standard bolus techniques, achieve target
postprandial blood glucose but with fewer correction boluses and supplemental
carbohydrate. A bolus calculator, which can be integrated into insulin pump
software, may help patients to more accurately meet prandial insulin dosage
requirements, improve postprandial glycemic excursions, and achieve optimal

PMID: 12828818 [PubMed - in process]
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