of intensive diabetes management,
the physician must first determine the total daily dose of insulin that the
patient will require. Because many patients need less insulin when beginning
CSII, the prepump total daily dose is usually reduced by 10-25%.
To calculate the hourly
basal
rate,
50% of the pump starting dose is divided by 24 hours.
The remaining 50% of the pump starting
dose is given as "bolus" insulin.
Most people consume the majority
of their carbohydrates at breakfast. Lunch is usually lowest in carbohydrates
and is consumed at a time when insulin sensitivity is highest. Dinner is usually
the largest meal of the day and also contains a large quantity of carbohydrates.
This protocol for determining
appropriate basal rates and bolus doses is presented for illustrative purposes
only. Proper consultation with the physician or other healthcare professional
should be used to determine the basal rates and bolus amounts which are appropriate
for individual pump users.
From the
Endocrinology and Diabetic Clinics at the Naval Medical Center Portsmouth
Undated webpage
http://www-nmcp.med.navy.mil/Endo/starting.asp
