When it comes to managing diabetes, an insulin pump provides precise control. Whether you're newly diagnosed or you've been on insulin for a while, the idea of using an insulin pump is likely an encouraging one. Transitioning to a pump also means that you need to calculate both your basal and bolus rates based on your overall insulin needs. You may be able to get some support to calculate this from your pump training specialist or your diabetic educator, but the more that you understand from the beginning, the more likely you are to get it right the first time.
Measuring Your Total Insulin Requirement
Your total insulin requirement refers to the total number of insulin units your body requires every day. If you've never used a pump before, there are a few ways to calculate this number.
- Body Weight – to calculate your daily insulin requirement based on your body weight, multiply your weight in kilograms by 0.5. So, if you weigh 75 kilograms, you would multiply 75 by 0.5 to arrive at a total insulin requirement of 37.5 units of insulin per day.
- Current Insulin Consumption – if you're already taking insulin, you can evaluate your current daily consumption to identify your basal requirement. This should include both the long-acting and short-acting insulin types that you need. For example, if you're taking 20 units of long-acting insulin every day and an average of 18 units of fast-acting insulin at mealtimes, your total daily insulin requirement would be approximately 38 units.
Calculating Your Basal Rate
The basal rate for your pump is the amount of insulin that the pump administers to you progressively throughout the day. Your basal rate should be equal to a little less than half of the total daily requirement. This serves as your background blood sugar management dosage. For example, forty-five percent of a daily insulin requirement of 38 units equals 17.1 units of basal insulin. This will be divided evenly over 24 hours unless you find that you need to increase your dosage at specific times, such as in the early morning hours.
Determining Your Bolus Rate
Your bolus rate indicates how many units of insulin you need per gram of carbohydrates that you consume. To calculate this when you're starting a pump, your doctor will start with an estimate. Most doctors will use the quotient of 450 divided by your total daily insulin to base your bolus rate. For example, if you have a total daily insulin need of 38 units, your bolus rate will start at 1 unit per 11.8 grams of carbohydrates. You can adjust this as necessary if you find that your post-meal numbers are still too high.
For patients who have used multiple daily insulin injections, transitioning to a pump can bring a sense of freedom and tighter control over your blood sugar levels. If you're newly diagnosed, starting treatment with a pump will allow you to maintain your blood sugar numbers with ease. Use these tips with a rapid-acting insulin and your diabetes educator's support to make your pump transition successful.