CONTINUOUS GLUCOSE MONITORING-DIRECTED ADJUSTMENTS IN BASAL INSULIN RATE AND INSULIN BOLUS DOSING FORMULAS

摘要

A method for individualized management of diabetes in insulin-dependent patients provides a period of evaluation as the patient adheres to a structured pattern of eating, sleeping, and physical activity. Glucose is monitored with a continuous glucose monitoring system, insulin doses are metered, carbohydrate consumption is quantified, and glucose, carbohydrate, and insulin data are collected and analyzed. Insulin dosage is adjusted in three steps: (1) an insulin dosage is estimated from conventional formulas, (2) adjustments are made according to the patient's clinical specifics, and (3) further insulin dose adjustments are made according to glucose data obtained during the evaluation period. By the end of the evaluation period, substantially normal glucose values are achieved, and quantitative relationships from data are calculated that are then applied to determine insulin dosages for an ensuing period of therapy. By this method, diabetic patients achieve a near normal glycemic profile, and without significant occurrence of hypoglycemic episodes.