CARBOHYDRATE COUNTING–GUIDED INSULIN DOSING Flashcards
(42 cards)
What is the carbohydrate-to-insulin (C:I) ratio?
An estimate of the grams of carbohydrate that will be covered by each unit of insulin
What does a C:I ratio of X:1 signify?
1 unit of insulin should be given for each X grams of carbohydrate to be consumed
How is the initial C:I ratio calculated?
500 divided by total daily dose (TDD) of insulin
What is the optimal postprandial glucose excursion range for individuals?
30–50 mg/dL rise from premeal value to 2-hour postmeal value
What is the first step to determine if the current C:I ratio is correct?
Consume something easily covered at the meal before the test meal
What glucose levels should be avoided before the test meal?
Below 70 mg/dL or above 140 mg/dL
What should be done if glucose before the test meal is in the desired range?
Eat a meal with well-known carbohydrate content and about 20 g of fat
What is the target glucose excursion after the test meal?
About 30 to 50 mg/dL
What should be done if the glucose rise is greater than 50 mg/dL?
Strengthen the C:I ratio
What is a high blood glucose (BG) correction factor (CF)?
An estimate of the glucose drop expected for each unit of insulin given when glucose is elevated
What does a CF of N:1 mean?
1 unit of insulin will drop the glucose N mg/dL
How is the initial CF for a patient calculated?
1650 divided by TDD (some use 1800, 1700, or 1500 divided by TDD)
What are BOB and IOB in insulin management?
BOB indicates how much insulin is still active; IOB is similar but refers to active insulin time
What is the typical duration of insulin action (DIA)?
Often 4 hours, but can vary based on individual experience
What is the formula to calculate BOB?
BOB = (Bolus 2 - Bolus 3) * (elapsed time since bolus) / DIA
Do patients using basal-bolus insulin need to perform these calculations before every meal?
Yes, especially for those using multiple daily injections (MDIs)
How do insulin pumps assist with insulin dosing?
They calculate and display the recommended dose of insulin for carbohydrate content and correction doses
What does a continuous glucose monitoring (CGM) system measure?
Interstitial glucose every 3 to 5 minutes
What additional information does a CGM provide?
Current blood glucose value and trend arrow indicating glucose direction
What adjustment is recommended for glucose rising at a rate of 1 mg/dL/min?
Add 1 unit of insulin to the correction factor (CF) dose
What should be done if glucose is dropping at a rate of 1 mg/dL/min?
Subtract 1 unit of insulin from the CF dose
Fill in the blank: The glucose excursion from premeal value to 2-hour postmeal value should be about _______.
30 to 50 mg/dL
What is carbohydrate counting?
A method for managing carbohydrate intake, particularly for those with diabetes
Who typically teaches carbohydrate counting?
A certified diabetes educator
