OUTREACH & ENGAGEMENT COMMITTEE
November is National Diabetes Awareness Month (NDAM). Please take some time to check out our T1D topics. We encourage you to share this information on your social media to help educate and raise awareness about Type 1 Diabetes.
An insulin pump is a small, computerized device that is programmed to deliver insulin into the fatty tissue under the skin. The insulin pump is durable and lasts for years, but the insulin supply and certain pump components (reservoir, tubing and infusion set) are changed every few days.
T1D Terminology - Insulin Pump Lingo
Pumping insulin has its own language. Here's some common lingo T1Ds on pump therapy use...
Active Insulin - refers to bolus insulin (defined below) that has been delivered to your body via your pump, but that your body has not yet used up. In other words, it's the insulin that is currently 'active' in your body working to manage / steady blood sugars.
Basal Rate - a small amount of insulin that is programmed to be automatically delivered by the pump every few minutes in a cycle of 24 hours, referred to as a basal rate pattern. Basal rates are sometimes called 'background insulin'. Basal insulin replaces the insulin that your body should be producing naturally, but isn't. Using an insulin pump, you can program and regularly tweak different patterns to meet different needs; like a weekend or shift work, an exercise class, hormonal fluctuations, or travel.
Bolus Insulin - a dose of insulin released by the pump to cover an expected rise in blood glucose from eating or to lower a high blood glucose down to target range, otherwise known as a 'correction'. The pump is programmed with the bolus settings, based on the needs of the individual as determined by a medical team of specialists.
Correction Factor - the amount of insulin needed to bring a high blood glucose level back down to target range. A correction bolus factor, or 'Sensitivity Factor' is equal to how much 1 unit of insulin will lower your blood glucose. This factor is used to calculate a correction bolus amount when your blood sugar is high and is calcualated as follows:
(BG level) – (BG target) = X.X, then
X.X ÷ (correction bolus factor) = correction bolus amount.
Dual / Combo Bolus - delivers only a portion of the required insulin immediately and the balance of the total required dose is delivered as an extended/square wave. A dual bolus provides insulin coverage for foods that contain both high fat or high protein with simple carbohydrates. This allows variation of three key components:
the proportion of the immediate dosage vs the amount given via prolonged delivery,
the overall time duration of the delivery, and
the insulin to carbohydrate ratio.
Infusion Set - connects the insulin pump delivery device to your body. It works the same way an IV line you might get at a hospital does. A needle is housed inside a flexible cannula - a tiny, plastic tube that sits in the fatty tissue just under the surface of the skin. The needle helps to quickly poke the cannula through the skin and is then immediately removed, leaving only the soft, flexible tubing in place.
Insulin on Board (IOB) - a feature of the pump's programming that keeps track of how long a bolus of insulin has been working. Using the IOB feature, a pumper can adjust the next insulin bolus preventing an overlapping insulin effect, also known as 'stacking', from multiple boluses, thus preventing excessive correction resulting in low blood sugar (hypoglycemia). The IOB for a certain amount of time - usually 4 hours, depending upon the dose of rapid-acting insulin. Individuals with especially high bolus doses (over 15-20 units per bolus), may require a longer IOB of 5-6 hours.
Insulin-to-Carbohydrate Ratio (Carb Ratio) - helps you estimate what size bolus you should take when eating carbohydrates. Depending on each T1Ds specific and individual requirements, this setting tells the pump how many units of insulin is required to help the body process a certain number of grams of carbohydrate. If 1 unit of insulin disposes of 10 grams of carbohydrates, the ITC ration would be 1:10. Your healthcare professional will determine your insulin to carbohydrate ratio.
Insulin Sensitivity Factor (ISF) - refers to how many points (mmol/L) blood sugars will drop in response to 1 unit of insulin (also known as a high blood sugar correction factor). This setting is programmed into the pump and can be set at different amounts for different times of the day.
Interstitial Fluid - the fluid between the cells in the human body that makes up approximately 16% of your total body weight.
Reservoir - the plastic container that holds insulin and fits inside the pump. The reservoir is connected to the infusion set by long, flexible tubing that helps the pump deliver the insulin to the body.
Temp Basal - when the basal delivery rate is temporarily increased or decreased for a specific period of time. This feature is NOT automatic and must be manually programmed in the moment by choosing how much less basal insulin is desired - usually as a % of your normal basal rate - and for how long. This pump feature is most commonly used for exercise and illness, as insulin needs may change during these periods. Learning how to adjust the basal rate can help to prevent low (hypoglycemia) and high (hyperglycemia) blood sugars.
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Past NDAM postings:
T1D Stickers and Accessories | Driving with T1D | Pump Lingo | Dawn Phenomenon | Blood Sugar Management Get Diabetes Right | Foot Care | Sleep: the lost frontier | Glycemic Index | Medication Management