If in case you have sort 1 diabetes you’ll be taking insulin both through a number of every day injections (sometimes called a basal-bolus regime or MDI), or through a steady subcutaneous insulin infusion (CSII), additionally known as an insulin pump.
On MDI you’d take round three injections per day of rapid-acting insulin earlier than fundamental meals and one or two injections of long-acting insulin that can work within the background. The rapid-acting insulin injections are known as bolus doses or boluses. This insulin is there to minimise any glucose spikes after a meal. The background insulin is known as your basal insulin and is supposed to maintain your glucose ranges regular throughout the day and night time.
An insulin pump is a computerised, programmable system that has a cartridge stuffed with rapid-acting insulin in it. This rapid-acting insulin works each as a basal insulin, by delivering the insulin little by little, drop by drop within the background, primarily based on sure settings, and as your bolus doses primarily based in your private profile and carbohydrates you enter right into a ‘bolus calculating wizard’.
The pump is worn day and night time and would solely be disconnected when you will have a bathe, bathtub, go swimming or in the event you play contact sports activities.
Individuals with diabetes who’re on a basal-bolus insulin routine, (this may additionally embody folks with sort 2 diabetes), must calculate their rapid-acting insulin a number of instances per day, earlier than every fundamental meal.
This can be a difficult and demanding activity that may depart loads of room for error as you’ll need to think about numerous various factors. These embody:
- Your present blood glucose degree and glucose traits
- Your meals consumption
- Any train, each deliberate and incidental
- Any insulin left on board from earlier injections
- Your insulin motion time
Calculating bolus insulin injections precisely will assist optimise Time in Vary (TIR) while decreasing your danger of hypoglycaemia, or low blood glucose ranges. Miscalculating rapid-acting insulin doses can result in both hypo- or hyperglycaemia (excessive blood glucose ranges) and may improve your danger of growing diabetes-related issues within the long-term.
In case you are on a number of every day injections you need to use your telephone as an insulin bolus calculator.
Bolus calculators have been obtainable as stand-alone units or built-in in insulin pumps for fairly a while. Now they’re additionally obtainable within the type of software program functions that may be downloaded onto sensible units.
Bolus calculator cell phone apps may end up in substantial enhancements in HbA1c and TIR as they might help you calculate how a lot rapid-acting insulin it’s essential to take earlier than a meal primarily based on some pre-set and personalised parameters.
The pre-set parameters usually embody:
- A Blood Glucose Goal which is able to permit the calculator to appropriate excessive or low blood glucose ranges to this pre-set worth or glucose vary. Excessive glucose ranges will end in extra insulin being really useful, whereas a low glucose degree will end in a discount within the prompt dose.
- The Insulin Sensitivity Issue (ISF), which is typically additionally known as the Correction Issue, is the measure of how a lot one extra unit of rapid-acting insulin is anticipated to drop your glucose degree by.
- The Insulin to Carbohydrate Ratio (ICR) tells you what number of grams of carbohydrates are lined by one unit of rapid-acting insulin.
- Any Insulin left On Board (IOB) may be included within the calculation by deducting the IOB from the correction bolus. This can assist cut back the chance of hypoglycaemia.
- The Period of Insulin Motion (DIA) is used within the IOB calculation. It describes how lengthy injected rapid-acting insulin stays lively in your physique. The DIA is usually wherever from three to 5 hours.
Bolus calculators needs to be thought-about ‘medical units’. In Australia the Therapeutic Items Administration (TGA) regulates tips for medical units. Nonetheless, most diabetes app producers make claims which might be at the moment not backed by applicable scientific proof.
Apps can vary in performance from being merely a reminder system, to offering modest data, social networking or scientific statistics, throughout to the extra advanced evaluation of glucose patterns to analyse insulin dose suggestions and blood glucose predictions. Some apps permit for knowledge sharing with well being care professionals.
Some generally really useful (and at the moment TGA accepted) apps for insulin dose calculations in Australia are:
All three of those apps can be found on Google Play and within the App Retailer.
As all the time, we suggest that you just speak to your diabetes well being skilled about which app they suggest you utilize, in your distinctive state of affairs. Your diabetes well being skilled might help you arrange your personalised parameters within the app.
Carolien Koreneff, CDE-RN, FADEA
