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[IP] Re: bolus "cheat sheets



Charlie-

Sorry for the length of this message.  At the end
of the message, I've pasted a portion of the
instructions from my bolus table web page.

You can see the original, as well as create your own
bolus tables at http://home.attbi.com/~mtherieau/bolus

If dealing with a low bg, my correction table shows
how much to subtract from a carb bolus.  Of course
this only makes sense if you're sitting down to a
meal anyway.  I don't have a table (yet) that would
show how much carb to bring a low bg back to target.

Here's my steps to deal with a non-pre-meal low:
1) Take 10-15g carb
2) Wait a bit
3) Figure out how much unused insulin is
   still working: using the elapsed time since last
   bolus and the bolus amount, reference the unused
   bolus table
4) Use the correction bolus table to figure out if
   this residual insulin is going to bring me low
   again.  If it is, then take 10-15g more carb

If it's a pre-meal low, then I eat immediately
(before bolusing). After eating, I figure out the
carb bolus for the meal (from the carb bolus table)
and subtract the correction bolus (from the
correction bolus table). I don't bother with the
unused bolus table here, because the previous bolus
is almost always completely spent by the time I'm
sitting down for another meal.

regards and healthy pumping,
markt
age:36 dx:'94 Paradigm:7/02

Personal Bolus Tables How-To Guide

Reading Bolus Tables

Each table is designed as a cheat sheet to easily
look up the bolus amount.  Before using the tables,
make sure that you've set the table parameters to 
match your own needs.

Reading the Correction Bolus Table

The Correction Bolus Table is used for glucose
readings that are too high or too low.  If glucose
is too high, the table can be used to determine the
amount of extra insulin to bolus.  If glucose is too
low, then the table can be used to determine how much
insulin to subtract from a carb bolus.  This table
may be skipped if the reading is within the target
range.

Correction Bolus When Glucose is Too High

Correction boluses are used when you measure a
glucose level that is too high.  If the high
measurement is after a meal, then the correction
bolus is taken by itself.  If the high measurement
is before a meal, then the correction bolus may be
added to the carb bolus.

If you measure a glucose level that is too high, scan
the table data to find the closest match to your
glucose reading.  Add the row and column headers of
your closest match to determine the bolus amount.
The row headers are full units of  insulin.  The
column headers are fractional units, in 0.1 unit
steps.

Adding the row and column header values yields the
total correction bolus.

Example:

    * Row Header: 4.0
    * Column Header: 0.8
    * Correction Bolus: 4.8

This bolus may be taken on its own, or added
to a pre meal carb bolus.

Adjusting Carb Bolus When Glucose is Too Low

If you measure a glucose level that is too low, you
should take carbohydrates to bring your level back
up. Sometimes a low reading is obtained just before
a meal, when a carb bolus is needed.  When I'm faced
with this situation, I eat first and bolus after I
feel better.  The carb bolus may be reduced, based
on the low reading.

If you are adjusting a carb bolus based on a glucose
reading that is too low, scan the table data to find
the closest match to your glucose reading.  These
numbers are always in a shade of red as a visual
indicator that a negative adjustment is being made.
Combine the row and column headers of your closest
match to determine the bolus adjustment.  The row
headers are full units of insulin and always marked
as negative numbers.  The column headers are
fractional units, in 0.1 unit increments.  Note that
in the red row, the glucose reading decrease
from left to right, as the bolus adjust gets bigger
(more negative)

Combining the row and column header values yields
the total correction bolus.

Example 1:

    * Row Header: -0.0
    * Column Header: 0.8
    * Correction Bolus: -0.8 (subtract 0.8 from carb
bolus)

Example 2:

    * Row Header: -1.0
    * Column Header: 0.9
    * Correction Bolus: -1.9 (subtract 1.9 from carb
bolus)

Reading the Unused Bolus Table

The Unused Bolus Table determines the residual
insulin that is yet to be absorbed, based on the
elapsed time since the previous bolus. The Unused
Bolus Table may be used to decrease a correction
bolus or a carb bolus.

To determine the residual insulin from the previous
bolus, find the row header that is the closest match
to your previous bolus. The rows are in whole unit
increments. Next find the column that is the closest
match to the elapsed time since the previous bolus.
Use the row and column to find the cell that
indicates the remaining bolus.

The unused bolus amount can be cross-referenced to
the Correction Bolus Table to determine how much the
residual insulin will lower the glucose level.

Example:

    * Last bolus insulin type: Humalog
    * Bolus amount: 5.0 units
    * Time elapsed: 2 hours 45 minutes (2:45)
    * Unused bolus: 0.9 units

-----------------------------------------------------
Mark and Kerri,

I am not following the bG correction and unused bolus
and unused insulin
chart info you are speaking about.

Can you 2 provide some step-by-step examples of how
you do all of this
(either to me personally or the whole group)?  I feel
they would be of great
value, but am not sure I know exactly what to do.

Charlie Flugel

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