[Previous Months][Date Index][Thread Index][Join - Register][Login]   Help@Insulin-Pumpers.org
  [Message Prev][Message Next][Thread Prev][Thread Next]   for subscribe/unsubscribe assistance

[IP] Bolus Calculator (like the Bolus Wizard in the MiniMed Paradigm 512) Improves Glycemic Control

MiniMed faxed me a one page flyer which highlights the results from the
following study in an easy to read format.  Unfortunately, I cannot
reproduce the flyer here, but if anyone wants me to fax it to them,
please email me your fax number.  I have also requested the full text of
the article and if it is provided in electronic format, I will be happy
to email it to anyone that wants it.  Although the study was done using
a bolus calculator on a PDA, the conclusion is that a bolus calculator
integrated into an insulin pump would provide the same benefit.
A bolus calculator is an effective means of controlling postprandial
glycemia in patients on insulin pump therapy. 
Diabetes Technol Ther 2003;5(3):365-9    (ISSN: 1520-9156) 
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 empirical estimates. A bolus calculator
(Medtronic MiniMed) uses these five parameters to generate a recommended
bolus insulin dose. This study provides the evidence that a hand-held
bolus calculator is effective in controlling postprandial blood 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 assistant (PDA). Subjects used the PDA to obtain
recommended pre-meal insulin bolus doses. During the Standard Bolus
period, significantly more correction boluses were 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 glycemic
for HELP or to subscribe/unsubscribe, contact: