Advanced carb counting involving equations which help in better understanding of insulin-to-carbohydrate ratio and insulin dose adjustment are also included in this review.
Insulin-to-carbohydrate ratio (ICR) and sensitivity factor (SF)
Advanced insulin users can calculate an "insulin-to-carbohydrate ratio
" (ICR) to estimate the amount of insulin they need to accommodate the amount of carbohydrates they ingest per meal.
The FIDs are then added up and put into the patient's pump, which is programmed to create an insulin-to-FID ratio, just as it does an insulin-to-carbohydrate ratio
After data collection, the provider can estimate the patient's insulin-to-carbohydrate ratio. For example, if a patient consumes 500 grams of carbohydrate and uses 25 units of insulin daily, then 1 unit of insulin would be required for every 20 grams of carbohydrate consumed.
Once the appropriate insulin-to-carbohydrate ratio is calculated, the patient can use specific functions of the insulin pump to promote glycemic control further.
This system used an algorithm based on the current glucose level and its gradient, the remaining effect of already-infused insulin, the amount of carbohydrate intake, and patient-specific factors such as basal insulin requirement and insulin-to-carbohydrate ratio
. Overnight values approached the target of 120 mg/dL, with half the variability seen in patients without the controller.
This system utilized an empirical glucose-control algorithm based on a calculation of the current glucose concentration and its gradient, the remaining effect of already-infused insulin, the amount of carbohydrate intake, and patient-specific factors such as basal insulin requirement and insulin-to-carbohydrate ratio
. As with the adolescents, overnight values approached the target of 120 mg/dL, with only half the variability that occurred among the patients without the controller.
We have shown that the glucose excursion after ingesting up to 4C (60g carbohydrate) can be limited by preprandial subcutaneous insulin using fixed insulin-to-carbohydrate ratios
and that the slope of the curve is more linear in this range.