TRAINING TIPS

Bolusing Made as Easy as 1-2-3

By Lyndsay Gregerson, RD, CDCES
Principal Clinical Territory Manager, Wisconsin South

When it comes to managing patients on intensive insulin therapy, one size (method) certainly does not fit all. There are numerous factors that impact patient adherence to mealtime insulin coverage. Differences in patient preference, knowledge base, habits, and available resources means that different patients may benefit from different bolus methods. While some patients may feel most comfortable with simplified bolus routines such as fixed doses or meal estimation, those consuming an unpredictable diet (both in timing and amount of carbohydrate) who also experience significant glucose variability, may find carbohydrate counting most optimal.   

Three bolus methods can be offered to both patients on multiple daily injections (MDI) using the InPen™ Smart* Insulin Pen, and those using the MiniMed™ 630G insulin pump. With approximately 90% of people living with diabetes having type 2 diabetes, these therapy options, along with adaptable bolus methods can encourage taking the right amount of insulin at the right time.

The InPen™ Smart Insulin Pen can be programmed in 3 different meal therapy modes: Carb counting, meal estimation, and fixed doses. In addition, the InPen™ tracks active insulin, has dose reminders, automatically logs doses and creates shareable reports. With two-thirds of people needing help calculating their insulin dose(1-3), the InPen™ offers valuable bolus assistance and record keeping that can help support your patients on MDI. The InPen™ can also be a favorable tool to help optimize ongoing education and dose adjustments by having the historical data available in an easy to access report.

InPenTM App Setting Screens

InPen app settings screen.Patients utilizing the MiniMedTM 630G insulin pump have several options for delivering a meal bolus. Some of these are similar to the InPenTM options:

  1. Carb counting (using grams or exchanges) using the Bolus Wizard™ feature.
  2. Fixed Gram/exchanges per meal using the Bolus Wizard™ feature—allows the patient to use a predetermined amount of grams of carbs or exchanges to enter based on meal size (i.e. small, medium, large carb meal).
  3. Fixed doses using Manual Bolus or Preset Bolus features. Allows the patient to deliver a set bolus amount with meals (starting with the same dose that was used with MDI). 

The InPen™ and MiniMed™ 630G system offer unique features to meet patients where they are in their diabetes journey. Both choices not only offer personalized options to help patients take the right amount of insulin at the right time but also provide you with insight on how and when they are bolusing through their downloadable reports.

For further support to your patients use these various bolus options, please contact your local Clinical Medtronic Diabetes representative. 

*

Smart insulin pens connect to a mobile app to provide dosing calculations, reminders and CGM system integration.

1

Garg SK, Bookout TR, McFann KK, et al. Improved glycemic control in intensively treated adult subjects with type 1 diabetes using insulin guidance software. Diabetes Technology and Therapeutics. 2008; 10(5):369-375.

2

Zaugg, Stephanie D., et al. “Diabetes numeracy and blood glucose control: association with type of diabetes and source of care.” Clinical diabetes: a publication of the American Diabetes Association 32.4 (2014): 152-157.

3

Cavanaugh, Kerri, et al. “Association of numeracy and diabetes control.” Annals of Internal Medicine. 148.10 (2008): 737-746.