Endocrine Abstracts

Objective: Calculation of accurate insulin boluses is one of the major problems related to intensive insulin regimens. A bolus calculator (BC) incorporated into the insulin pump estimates the dose of insulin to be administered at the meal and makes calculation easier and more precise.

The aim of the present study was to assess the efficacy of a BC on glycaemic control of patients with DM1 on CSII.

Material and methods: We enrolled 20 DM1 patients >18 y and treated for >12 months with CSII (Minimed 722, Medtronic). They received an infrared-linked glucometer (Contour Bayer), being glycemic values directly transmitted to the pump to be used by the BC, with possibility to download all the recorded data.

Data evaluated baseline and after 3 months using the BC were: HbA1c, daily insulin dose (Basal and bolus), number of bolus/day and acute complications. Glycemic lability was evaluated using MAGE and SD from SMBG information, and quality of life (DQOL). A satisfaction questionnaire was also evaluated.

Results: After 3 months, significant changes were observed (P<0.05) in weight (71.8±8 vs 72.9 kg) and metabolic control (HbA1c 7.7±1.1 vs 7.5±1%), with no differences found in parameters related to glycemic lability. Patients were satisfied with the BC and found this option easy to use and accurate.

Conclusions: In a group of patients treated with CSII, the addition of a BC achieved an improvement in glycemic control with decrease of HbA1c levels and weight, confirming the patients a high level of satisfaction.