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Advanced Pump Functions: Bolus Calculator, Bolus Types, and Temporary Basal Rates

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Research into Childhood-Onset Diabetes

Abstract

Over the past decade, technology has considerably changed insulin therapy in children and adolescents. A major improvement in insulin delivery has been achieved with the introduction of insulin pumps (CSII) and continuous glucose monitoring systems (CGM). The possibility to use advanced functions within these technological tools (different bolus types, bolus calculator, temporary basal rates) allows the patient to potentially achieve improved glucose control as well as lifestyle flexibility and quality of life.

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References

  1. Danne T, Bangstad HJ, Deeb L et al (2014) Insulin treatment in children and adolescents with diabetes. Pediatr Diabetes 15(Suppl 20):115–134

    Article  CAS  PubMed  Google Scholar 

  2. Berghaeuser MA, Kapellen T, Heidtmann B, Haberland H, Klinkert C, Holl RW (2008) Continuous subcutaneous insulin infusion in toddlers starting at diagnosis of type 1 diabetes mellitus. A multicenter analysis of 104 patients from 63 centres in Germany and Austria. Pediatr Diabetes 9:590–595

    Article  CAS  PubMed  Google Scholar 

  3. Maniatis AK, Klingensmith GJ, Slover RH, Mowry CJ, Chase HP (2001) Continuous subcutaneous insulin infusion therapy for children and adolescents: an option for routine diabetes care. Pediatrics 107:351–356

    Article  CAS  PubMed  Google Scholar 

  4. Misso ML, Egberts KJ, Page M, O’Connor D, Shaw J (2010) Continuous subcutaneous insulin infusion (CSII) versus multiple insulin injections for type 1 diabetes mellitus. Cochrane Database Syst Rev:Jan 20;(1):CD005103

    Google Scholar 

  5. Doyle EA, Weinzimer SA, Steffen AT, Ahern JA, Vincent M, Tamborlane WV (2004) A randomized, prospective trial comparing the efficacy of continuous subcutaneous insulin infusion with multiple daily injections using insulin glargine. Diabetes Care 27:1554–1558

    Article  CAS  PubMed  Google Scholar 

  6. Bruttomesso D, Laviola L, Lepore G et al (2015) Continuous subcutaneous insulin infusion in Italy: third national survey. Diabetes Technol Ther 17:96–104

    Article  PubMed  Google Scholar 

  7. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. The Diabetes Control and Complications Trial Research Group (1993) N Engl J Med 329:977–986

    Google Scholar 

  8. Fullerton B, Jeitler K, Seitz M, Horvath K, Berghold A, Siebenhofer A (2014) Intensive glucose control versus conventional glucose control for type 1 diabetes mellitus. Cochrane Database Syst Rev (2):CD009122

    Google Scholar 

  9. Delahanty LM, Halford BN (1993) The role of diet behaviors in achieving improved glycemic control in intensively treated patients in the Diabetes Control and Complications Trial. Diabetes Care 16:1453–1458

    Article  CAS  PubMed  Google Scholar 

  10. Gillespie SJ, Kulkarni KD, Daly AE (1998) Using carbohydrate counting in diabetes clinical practice. J Am Diet Assoc 98:897–905

    Article  CAS  PubMed  Google Scholar 

  11. Training in flexible, intensive insulin management to enable dietary freedom in people with type 1 diabetes: dose adjustment for normal eating (DAFNE) randomised controlled trial (2002) BMJ 325:746

    Google Scholar 

  12. Schmidt S, Norgaard K (2014) Bolus calculators. J Diabetes Sci Technol 8:1035–1041

    Article  PubMed  PubMed Central  Google Scholar 

  13. Thomas DE, Elliott EJ (2010) The use of low-glycaemic index diets in diabetes control. Br J Nutr 104:797–802

    Article  CAS  PubMed  Google Scholar 

  14. Davidson PC, Hebblewhite HR, Steed RD, Bode BW (2008) Analysis of guidelines for basal-bolus insulin dosing: basal insulin, correction factor, and carbohydrate-to-insulin ratio. Endocr Pract 14:1095–1101

    Article  PubMed  Google Scholar 

  15. Walsh J, Roberts R, Bailey T (2010) Guidelines for insulin dosing in continuous subcutaneous insulin infusion using new formulas from a retrospective study of individuals with optimal glucose levels. J Diabetes Sci Technol 4:1174–1181

    Article  PubMed  PubMed Central  Google Scholar 

  16. Walsh J, Roberts R, Heinemann L (2014) Confusion regarding duration of insulin action: a potential source for major insulin dose errors by bolus calculators. J Diabetes Sci Technol 8:170–178

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Vigersky RA (2015) The benefits, limitations, and cost-effectiveness of advanced technologies in the management of patients with diabetes mellitus. J Diabetes Sci Technol 9:320–330

    Article  PubMed  PubMed Central  Google Scholar 

  18. Barnard K, Parkin C, Young A, Ashraf M (2012) Use of an automated bolus calculator reduces fear of hypoglycemia and improves confidence in dosage accuracy in patients with type 1 diabetes mellitus treated with multiple daily insulin injections. J Diabetes Sci Technol 6:144–149

    Article  PubMed  PubMed Central  Google Scholar 

  19. Enander R, Gundevall C, Stromgren A, Chaplin J, Hanas R (2012) Carbohydrate counting with a bolus calculator improves post-prandial blood glucose levels in children and adolescents with type 1 diabetes using insulin pumps. Pediatr Diabetes 13:545–551

    Article  CAS  PubMed  Google Scholar 

  20. Ziegler R, Tubili C, Chico A et al (2013) ProAct study: new features of insulin pumps improve diabetes management and glycemic control in patients after transition of continuous subcutaneous insulin infusion systems. Diabetes Technol Ther 15:738–743

    Article  CAS  PubMed  Google Scholar 

  21. Pinelli L, Rabbone I, Salardi S et al (2008) Insulin pump therapy in children and adolescents with type 1 diabetes: the Italian viewpoint. Acta Biomed 79:57–64

    PubMed  Google Scholar 

  22. Wolpert HA, Atakov-Castillo A, Smith SA, Steil GM (2013) Dietary fat acutely increases glucose concentrations and insulin requirements in patients with type 1 diabetes: implications for carbohydrate-based bolus dose calculation and intensive diabetes management. Diabetes Care 36:810–816

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  23. Lodefalk M, Aman J, Bang P (2008) Effects of fat supplementation on glycaemic response and gastric emptying in adolescents with type 1 diabetes. Diabet Med 25:1030–1035

    Article  CAS  PubMed  Google Scholar 

  24. Pankowska E, Blazik M, Groele L (2012) Does the fat-protein meal increase postprandial glucose level in type 1 diabetes patients on insulin pump: the conclusion of a randomized study. Diabetes Technol Ther 14:16–22

    Article  CAS  PubMed  Google Scholar 

  25. Smart CE, Evans M, O’Connell SM et al (2013) Both dietary protein and fat increase postprandial glucose excursions in children with type 1 diabetes, and the effect is additive. Diabetes Care 36:3897–3902

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  26. Blazik M, Pankowska E (2012) The effect of bolus and food calculator Diabetics on glucose variability in children with type 1 diabetes treated with insulin pump: the results of RCT. Pediatr Diabetes 13:534–539

    Article  CAS  PubMed  Google Scholar 

  27. Zisser H, Robinson L, Bevier W et al (2008) Bolus calculator: a review of four “smart” insulin pumps. Diabetes Technol Ther 10:441–444

    Article  CAS  PubMed  Google Scholar 

  28. Zisser H, Wagner R, Pleus S et al (2010) Clinical performance of three bolus calculators in subjects with type 1 diabetes mellitus: a head-to-head-to-head comparison. Diabetes Technol Ther 12:955–961

    Article  PubMed  Google Scholar 

  29. Rossi MC, Nicolucci A, Pellegrini F et al (2009) Interactive diary for diabetes: a useful and easy-to-use new telemedicine system to support the decision-making process in type 1 diabetes. Diabetes Technol Ther 11:19–24

    Article  CAS  PubMed  Google Scholar 

  30. Cukierman-Yaffe T, Konvalina N, Cohen O (2011) Key elements for successful intensive insulin pump therapy in individuals with type 1 diabetes. Diabetes Res Clin Pract 92:69–73

    Article  PubMed  Google Scholar 

  31. Klupa T, Benbenek-Klupa T, Malecki M, Szalecki M, Sieradzki J (2008) Clinical usefulness of a bolus calculator in maintaining normoglycaemia in active professional patients with type 1 diabetes treated with continuous subcutaneous insulin infusion. J Int Med Res 36:1112–1116

    Article  CAS  PubMed  Google Scholar 

  32. Shashaj B, Busetto E, Sulli N (2008) Benefits of a bolus calculator in pre- and postprandial glycaemic control and meal flexibility of paediatric patients using continuous subcutaneous insulin infusion (CSII). Diabet Med 25:1036–1042

    Article  CAS  PubMed  Google Scholar 

  33. Ziegler R, Cavan DA, Cranston I et al (2013) Use of an insulin bolus advisor improves glycemic control in multiple daily insulin injection (MDI) therapy patients with suboptimal glycemic control: first results from the ABACUS trial. Diabetes Care 36:3613–3619

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  34. Ramotowska A, Golicki D, Dzygalo K, Szypowska A (2013) The effect of using the insulin pump bolus calculator compared to standard insulin dosage calculations in patients with type 1 diabetes mellitus – systematic review. Exp Clin Endocrinol Diabetes 121:248–254

    Article  CAS  PubMed  Google Scholar 

  35. Ramotowska A, Szypowska A (2014) Bolus calculator and wirelessly communicated blood glucose measurement effectively reduce hypoglycaemia in type 1 diabetic children – randomized controlled trial. Diabetes Metab Res Rev 30:146–153

    Article  PubMed  Google Scholar 

  36. Scaramuzza A, Cherubini V, Tumini S et al (2014) Recommendations for self-monitoring in pediatric diabetes: a consensus statement by the ISPED. Acta Diabetol 51:173–184

    Article  CAS  PubMed  Google Scholar 

  37. Heinemann L (2009) Insulin pump therapy: what is the evidence for using different types of boluses for coverage of prandial insulin requirements? J Diabetes Sci Technol 3:1490–1500

    Article  PubMed  PubMed Central  Google Scholar 

  38. Lopez P, Smart C, Morbey C, McElduff P, Paterson M, King BR (2014) Extended insulin boluses cannot control postprandial glycemia as well as a standard bolus in children and adults using insulin pump therapy. BMJ Open Diab Res Care 2:e000050

    Article  PubMed  PubMed Central  Google Scholar 

  39. Standards of medical care in diabetes – 2015: summary of revisions (2015) Diabetes Care 38(Suppl):S4

    Google Scholar 

  40. Smart CE, Annan F, Bruno LP, Higgins LA, Acerini CL (2014) Nutritional management in children and adolescents with diabetes. Pediatr Diabetes 15(Suppl 20):135–153

    Article  CAS  PubMed  Google Scholar 

  41. Chase HP, Saib SZ, MacKenzie T, Hansen MM, Garg SK (2002) Post-prandial glucose excursions following four methods of bolus insulin administration in subjects with type 1 diabetes. Diabet Med 19:317–321

    Article  CAS  PubMed  Google Scholar 

  42. Wilkinson J, McFann K, Chase HP (2010) Factors affecting improved glycaemic control in youth using insulin pumps. Diabet Med 27:1174–1177

    Article  CAS  PubMed  Google Scholar 

  43. Robertson K, Riddell MC, Guinhouya BC, Adolfsson P, Hanas R (2014) Exercise in children and adolescents with diabetes. Pediatr Diabetes 15(Suppl 20):203–223

    Article  PubMed  Google Scholar 

  44. Taplin CE, Cobry E, Messer L, McFann K, Chase HP, Fiallo-Scharer R (2010) Preventing post-exercise nocturnal hypoglycemia in children with type 1 diabetes. J Pediatr 157:784–788.e1

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  45. Younk LM, Mikeladze M, Tate D, Davis SN (2011) Exercise-related hypoglycemia in diabetes mellitus. Expert Rev Endocrinol Metab 6:93–108

    Article  PubMed  PubMed Central  Google Scholar 

  46. Zaharieva DP, Riddell MC (2015) Prevention of exercise-associated dysglycemia: a case study-based approach. Diabetes Spectr 28:55–62

    Article  PubMed  PubMed Central  Google Scholar 

  47. Brink S, Joel D, Laffel L et al (2014) Sick day management in children and adolescents with diabetes. Pediatr Diabetes 15(Suppl 20):193–202

    Article  PubMed  Google Scholar 

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Correspondence to Riccardo Bonfanti .

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Bonfanti, R. et al. (2017). Advanced Pump Functions: Bolus Calculator, Bolus Types, and Temporary Basal Rates. In: Scaramuzza, A., de Beaufort, C., Hanas, R. (eds) Research into Childhood-Onset Diabetes. Springer, Cham. https://doi.org/10.1007/978-3-319-40242-0_15

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  • DOI: https://doi.org/10.1007/978-3-319-40242-0_15

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