Building Competency in Diabetes Education THE ESSENTIALS

BASAL-BOLUS INSULIN THERAPY | 12-64

MONITORING BG OPTIONS FOR BBI

Identifying blood glucose patterns

There are meters available that help identify blood glucose patterns.

• One offers specific alerts on the meter to notify users of patterns over the past five days and offers various possibilities to resolve the issue.

• Others use colour coding and users would need to reflect and identify patterns themselves if and when meters are uploaded to the data management software.

• One meter can create reports to include % time spent in hyper, target and hypo.

• There have been revolutionary changes in the monitoring field in the last decade. With the improvements made in the sensors for CGM use, BBI users are strongly encouraged to use rtCGM or isCGM to assist in their pattern management (107). Please refer to chapter 7 for further discussion (107).

Can an insulin calculator improve glycemic control with BBI?

• Blood glucose meters available today offer a range of tools to facilitate pattern management. One such meter has a “rapid-acting calculator” or “bolus advisor”. . The meter can be ‘programmed’ with the person’s VIDS (variable insulin dose scale). In “easy mode”, the meter is programmed with a person’s baseline dose for meals, correction target in mmol/L (target blood sugar) and correction factor. It will make insulin dose calculations based on the person’s blood sugar and if it is a meal or correction bolus. In the ‘advanced’ mode, the carbohydrate to insulin ratios are entered along with the correction target in mmol/L (target blood sugar), correction factor and duration of insulin action. This mode has the ability to inform users of remaining active insulin and helps to prevent insulin stacking. Insulin stacking refers to taking correction boluses at intervals that are too close together without considering the insulin action or accounting for the amount of remaining active insulin from the previous bolus. Insulin stacking often leads to hypoglycemia (129).

• There is also an App available: Diabetes: M that people who are carbohydrate counting can