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Insulin Pump Basal Rate Calculator

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Seek Advice From Your Care Team

How to Program a Single Basal Rate with the MiniMed 530G Insulin Pump

In order to learn your way around your pump and to set your basal rates, you will first need hands-on instructions from your Care Team. They will demonstrate how you can perform your basal rate calculations.

They will show you how to set your basal rate into the settings on your pump. After you demonstrate the steps to your Care Team, they will know whether you are ready to adjust your own pump settings.

Fly solo with insulin pump settings only when you are ready

Then and only then, should you adjust your basal settings on your insulin pump without supervision from your Care Team. While pumps are different, calculations are the same. You need to demonstrate that you can do the math, and work the pump. This is not something you will learn to do just by reading.

Your pump representative is of valuable resource. Often they are nurses, or Certified Diabetes Educators , who specialize in insulin pump knowledge.

For the new pumper

For those of you, who are just starting insulin pump therapy, always seek the advice of your Care Team when changing any of your pump settings. It is not a good idea to be careless with the insulin dose. It could lead to a dangerously low blood sugar or a dangerously high blood sugar, which can put you into ketoacidosis.

How To Successfully Test Your Basal Rate

12/3/2014 by Ilka Gdanietz

Are you looking for basal rate information and testing instructions? Perfect! You’re in the right place!

Why is basal rate testing so important? Because the foundation of our diabetes management is basal insulin.

If our basal insulin isn’t adjusted properly, nothing else works properly. When basal rates are off, it’s like walking through quicksand doing a lot of work without much progress, or sinking even deeper into trouble.

Example #: Formulas Commonly Used To Create Insulin Dose Recommendations

This example illustrates a method for calculating of your background/basal and bolus doses and estimated daily insulin dose when you need full insulin replacement. Bear in mind, this may be too much insulin if you are newly diagnosed or still making a lot of insulin on your own. And it may be too little if you are very resistant to the action of insulin. Talk to your provider about the best insulin dose for you as this is a general formula and may not meet your individual needs.

The initial calculation of the basal/background and bolus doses requires estimating your total daily insulin dose:

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Personalised Convenience To Meet Your Patients Needs

  • Basal Rate: This is a programmed insulin rate consisting of small amounts of insulin delivered continuously, mimicking the basal insulin produced by a healthy pancreas. You can determine the programmed rate, based on your patients needs. This basal rate delivery can also be customised according to specific daily needs and can be suspended or altered for a definite time frame – this is not possible with long acting insulin injections.
  • Bolus Dose: This is the insulin which is delivered around mealtimes or used to correct high blood glucose levels. The MiniMedTM 640G has a bolus calculator that helps your patients calculate their bolus amount based on settings that are pre-determined by you.

How We Deal With The Overnight Rise In Blood Glucose Depends On Which Of The Above Scenarios Actually Occurred:

Programming a Basal Rate Pattern on a MiniMed Paradigm ...
  • If blood glucose rose steadily overnight as in A: it makes sense to increase the basal rates throughout the night.
  • If blood glucose remained steady for part of the night and then increased towards morning as in B: you may choose to increase the basal rate for the second half of the night.
  • If blood glucose dropped and then rose as a result, as in C: then a in the basal rate for the first half of the night may actually result in lower waking blood glucose readings.

If you would like assistance with sorting out the possibilities, please consult your childs diabetes health care team.

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Determining Basal Insulin Infusion Rates

The present scientific and industry consensus on insulin pump initiation supports the use of two formulas as guidelines for a patient’s basal insulin infusion rate., In accordance with the judgment of a healthcare professional, these estimates aid in establishing an initial basal rate that is titrated further over the course of pump therapy.

The current formulas for estimating basal rates in adult patients with type 1 diabetes, in units per hour, using weight or TDD of insulin are as follows:For the purposes of this study, an empirically derived standard basal rate of 0.8âU/h was also included in type 1 comparisons. This was based on the observation that many of these patientsâ titrated basal rates appeared to converge on this single value.

For patients with type 1 diabetes, only those with a final HbA1c â¤7.5% were considered, with a mean HbA1c of 6.9%±0.1%. Owing to sample size restrictions, all patients with type 2 diabetes were included irrespective of their final HbA1c, with a mean HbA1c of 8.1%±0.5%. The underlying assumption of this restriction is that an HbA1c near therapeutic goals reflects a more ideal final basal rate.

Conditions For Basal Testing

In order to get valid results from a basal test its preferable for your child to get as close as possible to the following circumstances:

  • not eat/drink during the test period and for 4 hours before the test period begins. This means that only water and diet drinks are allowed.

If you are using Method 1, and your child finished lunch at 1:00pm, you can assess the 5:00-7:00 time period by delaying supper until 7:00pm providing only 0 calorie, 0 carb food and drink from 1-7 pm.

If you are using Method 2, and your child finished lunch at 1:00pm, you can assess the 5:00-9:00 time period by providing only 0 calorie, 0 carb food and drink from 1-9 pm.Sound impossible for your child? You may want to give it a try before dismissing the idea. I was amazed at what some home-made popsicles and snowcones, in the presence of a plethora of fun distractions, could do to help the time pass for my 4-year-old son. ~Michelle

  • eat a healthy meal/snack before the test period, avoiding fatty foods and restaurant/takeout food. Ensure the carb-content of the meal is known.
  • avoid caffeine during the test.
  • consume only water and diet drinks during the pre-test and test period.
  • not bolus for 4 hours before the test.
  • not exercise during the test period.
  • not have had any lows in the last 12 hours.
  • not be sick.
  • not be at the beginning of or just prior to her menstrual cycle.
  • not disconnect or suspend the pump during the pre-test or during the testing period.

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Example #: Carbohydrate Coverage At A Meal

First, you have to calculate the carbohydrate coverage insulin dose using this formula:

CHO insulin dose = Total grams of CHO in the meal ÷ grams of CHO disposed by 1 unit of insulin .

For Example #1, assume:

  • You are going to eat 60 grams of carbohydrate for lunch
  • Your Insulin: CHO ratio is 1:10

To get the CHO insulin dose, plug the numbers into the formula:

CHO insulin dose =

  • The carbohydrate coverage dose is 6 units of rapid acting insulin.
  • The high blood sugar correction dose is 2 units of rapid acting insulin.

Now, add the two doses together to calculate your total meal dose.

Carbohydrate coverage dose + high sugar correction dose = 8 units total meal dose!

The total lunch insulin dose is 8 units of rapid acting insulin.

Insulin Pump Therapy: A Practical Guide To Optimising Glycaemic Control

How to Program a Multiple Basal Rate with the MiniMed 530G Insulin Pump

Emma G Wilmot MB ChB, BSc , MRCP , PhD

Specialist Registrar

Department of Diabetes, Queen’s Medical Centre, Nottingham, UK

Pratik Choudhary MBBS, MRCP, MD

Senior Lecturer and Consultant Diabetologist

King’s College London, UK

Paul Grant MBBS, BSc, MSc, MRCP

Consultant Diabetologist

Peter Hammond MA, BM BCh, MD, FRCP

Consultant Diabetologist

Emma G Wilmot MB ChB, BSc , MRCP , PhD

Specialist Registrar

Department of Diabetes, Queen’s Medical Centre, Nottingham, UK

Pratik Choudhary MBBS, MRCP, MD

Senior Lecturer and Consultant Diabetologist

King’s College London, UK

Paul Grant MBBS, BSc, MSc, MRCP

Consultant Diabetologist

Peter Hammond MA, BM BCh, MD, FRCP

Consultant Diabetologist

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Determine The Current Tdd

An individuals TDD is the primary determinant of their mean glucose level. Accurate basal doses and CarbF and CorrF settings can be closely estimated from formulas based on an accurate TDD, and will provide more appropriate bolus doses than settings based on easy-to-use numbers. An average TDD is available on a history screen in most insulin pumps but must be reconstructed for those who use an insulin pen, syringe, or written records.

Those using MDI can determine their TDD by adding up averages of typical injection doses in . In the rapid insulin column, averages of carb plus correction boluses taken at each time of day over the last 2 weeks are entered. Averages of the long-acting insulin doses are entered into the long-acting insulin column. These are added together to find the current TDD.

How Does An Insulin Pump Work

The American Diabetes Association states that insulin pumps are small, computerized devices. They deliver insulin in a steady and continuous dose, or basal rate, which the user programs. They also deliver insulin as a surge dose, or bolus, under the users direction.

The insulin enters the body through a thin tube that attaches to a needle, which goes under the skin. People refer to the tube and needle together as an infusion set.

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Adjusting Insulin : Testing & Tweaking Basal Rates

Basal insulin is the background insulin which, if set properly, keeps blood glucose steady in the absence of food and exercise. But how can you tell whether the current basal rates programmed into your child’s insulin pump are working well or not? Here we look at how to assess the current pump basal rates, including the conditions for effective basal testing. Then we outline the process of adjusting them if needed, suggest how much to adjust settings by, and give some practical tips from our own experience with basal testing with our young T1D son.

Guidelines For Success With A Bolus Calculator

How To Make Basal Rate Testing Less Brutal

In the LowGT, we analyzed why pump CarbF settings differed from actual CarbFs . We found that many pumps used numbers such as 5, 10, 15, or 20 g/U for their CarbF settings. These settings did not correspond with actual bolus doses given for carbs, indicating that pump users or the BC itself were compensating for faulty BC settings.

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Benefits Of Insulin Pump Therapy

Insulin Pump Therapy can help your patients reduce diabetes complications

The MiniMed 640G insulin pump provides the following benefits vs. Multiple Daily Injections :

  • Easier dosing: calculating insulin requirements can be a complex task, with many different aspects to be considered. The MiniMed 640G has a built-in Bolus Wizard for accurate dosing. It works by taking into account any insulin already in the body, the current glucose levels, carbohydrate intake and personal insulin settings.
  • Greater flexibility: the MiniMed 640G Insulin Pump can be instantly adjusted to allow for exercise, illness or to deliver small boluses to cover meals and snacks. This is easily done with a touch of a button. There is also a temporary basal rate option to proportionally reduce or increase the basal insulin rate.
  • Personalised convenience: the MiniMed 640G offers the additional convenience of a wirelessly connected blood glucose meter. This meter automatically sends blood glucose values to the pump, allowing more accurate Bolus Wizard calculations and to deliver insulin boluses discreetly.

Assessing Current Basal Rates

Eleanor Roosevelt might as well have been predicting the use of insulin pumps when she said, With freedom comes responsibility. The use of a pump means we are not tied to a single basal rate all day it means we dont have to cope with the midday highs just to avoid the overnight lows it means we can program many different basal rates, in different time periods throughout the day and night. But that freedom and flexibility will not improve blood glucose control if we do not take on the responsibility of assessing and fine-tuning the programmed rates to reflect a childs actual insulin needs at different times of the day.

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Changing Your Basal Rate

DEVICE: MiniMed® 530G , Revel , 522/722, 515/715, 512/712

Important: Your healthcare professional will calculate your basal rates for you.

Did You Know: Basal insulin is the background insulin needed throughout the day to maintain your target glucose values when you are not eating. Your basal insulin accounts for about half of your daily insulin requirements.

Your basal rate settings determine the amount of basal insulin you receive each hour. You can set multiple basal rates to meet your insulin needs throughout the day. Each basal rate consists of a different insulin delivery with distinct start times and stop times. Together, the different insulin rates cover a 24-hour period and are repeated each day.

Note: You cannot make changes to your basal rate settings while a temporary basal is active.

Allowed Range & Default Settings

  • Go to the SET BASAL RATE 1 screen.Main Menu > Basal > Basal Setup > Set/Edit Basal
  • The SET BASAL RATE 1 screen flashes the basal rate in U/H.
  • Enter your first basal rate amount and press ACT.The start time for your first basal rate is midnight and cannot be changed.
  • The SET START TIME 2 screen appears. The dashes under the screen name flash. The first basal rate is now set. If you do not need a second basal rate for the day, press ESC. If you need to set up a second basal rate for the day, follow steps 5 and 6.
  • In the SET START TIME 2 screen, enter the start time for the next rate.
  • Press ACT. The SET BASAL RATE 2 screen appears. Enter the rate.
  • The High Blood Sugar Correction Factor:

    How Many Basal Rates Do I Need in My Pump?

    Correction Factor = 1800 ÷Total Daily Insulin Dose = 1 unit of insulin will reduce the blood sugar so many mg/dl

    This can be calculated using the Rule of 1800.

    Example:

    = 1800 ÷ TDI = 1 unit insulin will drop reduce the blood sugar level by 45 mg/dl

    While the calculation is 1 unit will drop the blood sugar 45 mg/dl, to make it easier most people will round up or round down the number so the suggested correction factor may be 1 unit of rapid acting insulin will drop the blood sugar 40-50 mg/dl.

    Please keep in mind, the estimated insulin regimen is an initial best guess and the dose may need to be modified to keep your blood sugar on target.

    Also, there are many variations of insulin therapy. You will need to work out your specific insulin requirements and dose regimen with your medical provider and diabetes team.

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    Data Collection And Subgrouping

    Retrospective chart data on 61 adult patients with type 1 diabetes and 34 adult patients with type 2 diabetes were collected from a private diabetes clinic. To qualify for inclusion, patients must have utilized insulin pump therapy for greater than 3âmonths, with records of glycated hemoglobin , insulin dosage and weight available from before and after pump initiation. Only patients with type 1 diabetes with an HbA1c â¤7.5% were eligible for consideration. Baseline characteristics of the patients with type 1 and 2 diabetes are summarized in .

    Mean baseline characteristics of the type 1 and 2 diabetes patient groups. Error is calculated and reported in 95% CIs

    What Is A Basal Rate

    When we speak of basal rates of insulin for diabetes, we are referring to insulin that is meant to keep the blood glucose steady for a 24-hour period. For patients with no insulin pump who take injections, basal rate still applies to them.

    If you take injections, you may be taking a basal insulin once a day, or a split dose of NPH that serves as your basal dose that is meant to do essentially the same thing. Basal rate on an insulin pump is sometimes called background or baseline insulin.

    I also recommend advise reading the following material:

    What is the basal rate for an insulin pump?

    When we talk about the basal rate of an insulin pump, we are referring to about 50% of the total daily dose of insulin that a person with diabetes requires, give or take 10%. Instead of taking a basal insulin injection, the pump delivers short-acting insulin as the basal insulin dose throughout the day and night. How much a person eats, and how much activity they are getting, plays into the basal dose calculation.

    In an insulin pump, you use short or rapid-acting insulin. You could use Humalog , Novolog , or Glulisine . There are several pumps that do use regular insulin for the pump, which is used to set bolus and basal rates.

    What is basal rate when taking insulin injections?

    In a person using injections of insulin, the basal dose is the long acting insulin , or intermediate acting insulin given in 2 doses .

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    Is Insulin Pump Therapy Right For Your Patient

    Insulin Pump Therapy is beneficial for use by children, adolescents and adults who:

    • Have poorly controlled HbA1c
    • Want to improve their HbA1c
    • Want a more flexible therapy
    • Have onset or concerns of long-term complications
    • Experience dawn phenomenon
    • Have more than two severe hypoglycaemic events in the last 6 months
    • Have hypoglycaemia unawareness
    • Are pregnant or planning to conceive8
    • Problems with glycaemic variability

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