September 16, 2003
Daily Care, Insulin Pumps
Question from Holbrook, New York, USA:
There are three pumpers in my family (ages 5, 13 and 35), and while we try not to forget to bolus, it does happen occasionally. Speaking to parents of other kids that pump, I know that this is not a unique experience.
I am wondering why, if you forget to bolus after or before a meal for more than an hour, and you check the blood sugar before administering insulin, it seems many times that the correction dose for that high blood sugar is less than the food bolus amount would have been. This is not always 100% accurate, and there are times when, after a forgotten bolus, the correction bolus is exactly in line with the missed food bolus. (It’s so nice when the math makes sense.) Usually, however, in these instances when we check and give insulin based on the correction bolus, the blood glucose is back on target within two hours, and this to me is a puzzling question. Exercise and activity do not seem to play a factor, and it happens to all of us. Any ideas on this?
Answer:
The new insulin pumps that calculate doses utilize very complicated math formulas that take into account a bolus given previously and still active as well as basal insulin, your own correction factors, and the dose. I would assume that you are describing a situation in which the bolus factor is significant, and therefore the pump estimates a dose that takes this into account a well as the actual blood glucose level of the moment.
SB
