Bolus calculator settings in well-controlled type 1 diabetes patients (glycated hemoglobin < 7%) treated with insulin pumps.

Corresponding Author: Tomasz Klupa, M.D., Ph.D., Department of Metabolic Diseases, Jagiellonian University, 15 Kopernika St., 31-501 Kraków, Poland; email address [email protected] Two regimens of insulin therapy are used to achieve the goal of near normoglycemia: multiple daily injections (MDI) and continuous subcutaneous insulin infusion (CSII).1 Due to the apparent improvement in quality of life and metabolic control and the greater personal independence (compared with MDI), CSII is becoming an increasingly popular method of insulin delivery for people with type 1 diabetes mellitus (T1DM).1–3 However, one of the major problems related to the use of CSII, or intensive insulin regimens in general, is the accurate calculation of insulin boluses. These calculations should take into account multiple factors, such as current and target blood glucose levels, carbohydrate intake, insulin-to-carbohydrate ratio (ICR), and insulin sensitivity.3 Using the ICR to calculate meal bolus and insulin sensitivity factor (ISF) to correct hyperglycemia are accepted methods of optimization of metabolic control.3–5 These rules are also used to program the bolus calculator (BC), which is an insulin pump function.3–6 The BC uses preprogrammed settings to generate a recommendation of bolus dose.3 There is an agreement that these settings should be individualized for each person; however, some general rules as starting points do exist.4–6 The aim of this analysis was to evaluate BC settings used by CSII-treated T1DM patients, exclusively with good metabolic control [glycated hemoglobin (HbA1c) < 7.0%].