The Effect of Using the Insulin Pump Bolus Calculator Compared to Standard Insulin Dosage Calculations in Patients with Type 1 Diabetes Mellitus – Systematic Review

Abstract

Background:

Modern insulin pumps use bolus calculators to determine the appropriate insulin dose to facilitate achievement of glycaemic targets.

Objective:

To summarize the data on insulin pump bolus calculators compared to standard insulin dosage calculations and the impact on glycaemic profile.

Methods:

The MEDLINE, EMBASE and Cochrane Library databases were searched until October 2012 for related randomized controlled trials (RCTs) and observational studies performed in type 1 diabetes. A meta-analysis of RCTs was conducted.

Results:

We included 6 trials comprising 354 subjects. Combined data of 2 RCTs showed significantly smaller number of correction boluses in the experimental group (MD  − 2.31; 95% CI:  − 3.59 to  − 1.03; p=0.0004) and a trend toward fewer hypoglycaemic episodes per week (MD  − 0.47; from  − 0.95 to 0.02; 95% CI; p=0.06) in the experimental group compared to control subjects. Other authors reported significant reduction in daily post-prandial blood glucose values in the experimental group compared to controls. The authors observed only one adverse event. More frequent self-monitoring of blood glucose in the experimental group was reported in 3 trials. There were no differences in HbA1c within the groups. Patients were satisfied with the treatment with bolus calculator, according to the treatment satisfaction scale.

Conclusions:

Insulin pump bolus calculators are effective and safe in prandial insulin calculation with a positive impact on glucose profile.

Key words

type 1 diabetes - bolus calculator - insulin advisor - insulin calculation - insulin pump

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