When you have kind 1 diabetes you can be taking insulin both by way of a number of day by day injections (sometimes called a basal-bolus regime or MDI), or by way of a steady subcutaneous insulin infusion (CSII), additionally known as an insulin pump.
On MDI you’ll take round three injections per day of rapid-acting insulin earlier than fundamental meals and one or two injections of long-acting insulin that may 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, based mostly on sure settings, and as your bolus doses based mostly 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’ve gotten a bathe, bathtub, go swimming or should you play contact sports activities.
Individuals with diabetes who’re on a basal-bolus insulin routine, (this could additionally embody individuals with kind 2 diabetes), have to calculate their rapid-acting insulin a number of occasions per day, earlier than every fundamental meal.
It is a difficult and demanding activity that may go away numerous room for error as you will have 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 threat of hypoglycaemia, or low blood glucose ranges. Miscalculating rapid-acting insulin doses can result in both hypo- or hyperglycaemia (excessive blood glucose ranges) and might enhance your threat of growing diabetes-related problems within the long-term.
If you’re on a number of day by day injections you need to use your cellphone 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 purposes that may be downloaded onto good units.
Bolus calculator cell phone apps can lead to substantial enhancements in HbA1c and TIR as they might help you calculate how a lot rapid-acting insulin it is advisable to take earlier than a meal based mostly on some pre-set and personalised parameters.
The pre-set parameters typically embody:
- A Blood Glucose Goal which can enable the calculator to right excessive or low blood glucose ranges to this pre-set worth or glucose vary. Excessive glucose ranges will end in further insulin being really useful, whereas a low glucose degree will end in a discount within the advised dose.
- The Insulin Sensitivity Issue (ISF), which is typically additionally known as the Correction Issue, is the measure of how a lot one further unit of rapid-acting insulin is predicted to drop your glucose degree by.
- The Insulin to Carbohydrate Ratio (ICR) tells you what number of grams of carbohydrates are coated by one unit of rapid-acting insulin.
- Any Insulin left On Board (IOB) might be included within the calculation by deducting the IOB from the correction bolus. This may assist scale back the chance of hypoglycaemia.
- The Length of Insulin Motion (DIA) is used within the IOB calculation. It describes how lengthy injected rapid-acting insulin stays energetic in your physique. The DIA is mostly wherever from three to 5 hours.
Bolus calculators needs to be thought of ‘medical units’. In Australia the Therapeutic Items Administration (TGA) regulates pointers 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 info, social networking or medical statistics, during to the extra complicated evaluation of glucose patterns to analyse insulin dose suggestions and blood glucose predictions. Some apps enable for information sharing with well being care professionals.
Some generally really useful (and at the moment TGA accredited) 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 advocate that you just discuss to your diabetes well being skilled about which app they advocate 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