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When data were graphed, it was obvious that a linear regression with an intercept of 60 and a slope, or multiplier, of 0.02 could resolve the complexity of the orders of White et al. to a single formula for calculation of intravenous insulin requirements: (blood glucose − 60) × 0.02 = insulin dose/h. [3]
In this way, visitors can not only read about insulin dosage adjustment in diabetes, but also interactively simulate examples of what they are learning about. The tutorial is currently arranged in four sections: (1) Insulin-dosage adjustment, (2) Choosing the insulin dose, (3) Timing of meals & diet planning, and (4) Glucose & the kidney. [25]
Basal insulin is provided as a once or twice daily injection of dose of a long-acting insulin. In an MDI regimen, long-acting insulins are preferred for basal use. An older insulin used for this purpose is ultralente, and beef ultralente in particular was considered for decades to be the gold standard of basal insulin.
The device automatically adjusts a patient's basal insulin delivery. [7] It is made up of a continuous glucose monitor, an insulin pump, and a glucose meter for calibration. It automatically functions to modify the level of insulin delivery based on the detection of blood glucose levels by continuous monitor.
The long acting insulin is given once (usually glargine, Lantus) or twice (usually detemir, Levemir) daily to provide a base, or basal insulin level. Rapid acting (RA) insulin is given before meals and snacks. A similar profile can be provided using an insulin pump where rapid acting insulin is given as the basal and premeal bolus insulin.
An insulin pump and wristop controller is one way to arrange for a closely controlled basal insulin rate. The slow-release insulins (e.g., Lantus and Levemir) can provide a similar effect. In healthy individuals, basal rate is monitored by the pancreas, which provides a regular amount of insulin at all times.
Insulin release from pancreas is pulsatile with a period of 3-6 minutes. [1] The insulin concentration in blood increases after meals and gradually returns to basal levels during the next 1–2 hours. However, the basal insulin level is not stable. It oscillates with a regular period of 3-6 min.
Pump and infusion set (catheter) placement Insulin basal bolus profile. Insulin pumps are drug delivery devices used to treat patients with type 1 and type 2 diabetes. The Minimed Paradigm REAL-Time and Continuous Glucose Monitoring (CGM) system, which received FDA clearance in 2006, uses tubing and a reservoir with rapid-acting insulin.
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