Diabetes Technology Update

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Diabetes Technology Update

• Carolyn Losure MS, RD, CDE, CD-N

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Continuous Subcutaneous Insulin Infusion
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Why Pump Therapy?

• Insulin Pump Therapy is the most physiologic
  method of insulin delivery. It mimics normal
  pancreatic function more closely than injections.
• Basal insulin delivery is the continuous infusion
  of insulin similar to the daily secretion by the
  pancreas.
• Bolus delivery is insulin delivery on demand.
  There are two types Meal Bolus and Correction
  Bolus.

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Why Pump Therapy?

• Insulin Pump Therapy is the most physiological
  method of insulin delivery and more closely
  mimics the normal pancreas than injections.
• Basal insulin delivery is the continuous infusion
  of insulin similar to the daily secretion by the
  pancreas.
• Bolus delivery is insulin delivery on demand.
  There are two types Meal Bolus and Correction
  Bolus.

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Customizeable Basal Rates
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What do RDs need to know about Bolus Calculators
in Pumps?

• Calculates insulin bolus doses and the amount of
  insulin active in the body
• Calculations are based on preset customized
  settings for
• Blood Glucose Targets
• Individualized Carbohydrate ratios
• Insulin sensitivity factors
• Active insulin time

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Carbohydrate Ratio/ Meal Bolus

• Method 1 450 Rule
• 450/Pump TDD Ratio
• Example
• 450 / 45 units 10
• 1 unit covers 10 grams of
• carbohydrate

• Weight Based Calculations
• Weight (lbs) x 2.8 / Pump TDD
• 165 lbs x 2.8 / 45 10.2
• 1 unit covers 10 grams of carbohydrate

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Insulin Sensitivity Factor1700 Rule

• 1700 / Pump TDD ISF
• 1700/45 37.7
• Or 1 unit rapid acting insulin decreases the
  patients blood glucose about 38 mg/dl

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Bolus Calculation Formula

• Current BG Target BG / ISF Correction
  Dose
• Example BG 265 mg/dl
• Target BG 100 mg/dl
• ISF 38
• 265-100 165
• 165/38 4.3 unit correction dose

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Checking a CarbInsulin Ratio
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Another Technology AdvancementTherapy Management
Software

• Effect of Carelink, an internet-based insulin
  pump monitoring system, on glycemic control in
  rural and urban children with type 1 diabetes
  mellitus.
• Erin A Corriveaua,
• Peter J Dursoa,
• Ellen D Kaufmanb,
• Betty J Skipperc,
• Louise A Laskaratosb and
• Kimberly B Heintzmanb

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Personal Continuous Glucose Monitoring Devices
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Professional Continuous Glucose Monitoring Devices
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Does A1C Tell the Entire Story?
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HbA1c versus Glycemic Variability
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288 data points per day
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Interstitial Glucose Reflects Plasma Glucose
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Clinical Evidence for CGM
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Sensor Converts Glucose to Electronic Signals
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Sensors and Meters measure in different places
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Minimal carbohydrate consumption during the day
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Postprandial hypoglycemia and nocturnal
hyperglycemia
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Dual Wave Bolus Option
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Therapy Management Dashboard
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Absolute Latest Technology in Connected Care
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• Questions?