Before patient use, a healthcare professional must prescribe the ACCU-CHEK Aviva Expert system and provide the patient-specific target blood glucose, insulin-to-carbohydrate ratio
, and insulin sensitivity parameters to be programmed into the ACCU-CHEK Bolus Advisor.
We have shown that the consumption of an increasing carbohydrate load leads to an exponential increase in postprandial glucose exposure when using a linear algorithm to determine the insulin-to-carbohydrate ratio
after subcutaneous insulin injection, and increases the risk for delayed postprandial hyper- and hypoglycaemia.
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
The Deltec Cozmo(R) Insulin Pump was the first smart insulin pump to have the ability to calculate insulin needs based on grams of carbohydrate consumed, a personalized insulin-to-carbohydrate ratio
, and a personalized setting for effective insulin duration.
The second group, the "Carbohydrate Counting" group, was provided an insulin-to-carbohydrate ratio
to use for each meal and adjusted their Apidra(R) dose based on amount of carbohydrate consumed.
Without this Bolus Wizard, patients using insulin must consider their current and target blood glucose levels, current carbohydrate intake, insulin sensitivity factor, and insulin-to-carbohydrate ratio
when mentally calculating an insulin dosage.