MiniMed faxed me a one page flyer which highlights the results from the following study in an easy
to read format. Unfortunately, I cannot reproduce the flyer here, but if anyone wants me to fax it
to them, please email me your fax number. I have also requested the full text of the article and if
it is provided in electronic format, I will be happy to email it to anyone that wants it. Although
the study was done using a bolus calculator on a PDA, the conclusion is that a bolus calculator
integrated into an insulin pump would provide the same benefit.
A bolus calculator is an effective means of controlling postprandial glycemia in patients on insulin
pump therapy.
Diabetes Technol Ther 2003;5(3):365-9 (ISSN: 1520-9156)
Gross TM; Kayne D; King A; Rother C; Juth S
Medtronic MiniMed, Northridge, California 91325, USA. [email hidden].
Accurate bolus insulin doses require calculations based on (1) current blood glucose, (2) target
blood glucose, (3) carbohydrate-to-insulin ratios, (4) total grams of carbohydrate in meals, and (5)
insulin sensitivity factors. Patients may often forego these calculations for insulin doses based on
empirical estimates. A bolus calculator (Medtronic MiniMed) uses these five parameters to generate a
recommended bolus insulin dose. This study provides the evidence that a hand-held bolus calculator
is effective in controlling postprandial blood glucose. Subjects (n = 49) with Type 1 diabetes and
experienced with continuous subcutaneous insulin infusion therapy were randomized to begin one of
two bolus dosing methods. After 7 days, subjects crossed over to the alternate method. Prior to
entering the Bolus Calculator period, physicians established patients' bolus parameters and
programmed them into a personal digital assistant (PDA). Subjects used the PDA to obtain recommended
pre-meal insulin bolus doses. During the Standard Bolus period, significantly more correction
boluses were administered to curtail postprandial hyperglycemia (p = 0.008) and more supplemental
carbohydrate was consumed to raise low blood glucose (p = 0.046). Similar values were observed
between the two bolus dosing methods in average deviation of 2-h postprandial blood glucose.
Subjects reported that the bolus calculator was easy to use and that they were confident in the
bolus doses suggested by the device. These results confirm that bolus insulin doses computed by a
bolus calculator, compared with standard bolus techniques, achieve target postprandial blood glucose
but with fewer correction boluses and supplemental carbohydrate. A bolus calculator, which can be
integrated into insulin pump software, may help patients to more accurately meet prandial insulin
dosage requirements, improve postprandial glycemic excursions, and achieve optimal glycemic control.
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Antonio Age 37, Type 1 for 10 years On MiniMed insulin pump