Insulin Pump Therapy

Insulin Pump – Bolus Insulin

Bolus dose

This is the dose of insulin you give over and above your basal rate. This can be given to: -

Cover meals
Cover carbohydrate counting (CHO) drinks and snacks
Correct a high blood glucose

Meal bolus

The aim is for your blood glucose to be virtually the same before a meal and 2-4 hours after.

If your bolus is too large, your blood glucose will be at least 2mmol/L lower 4 hours after a meal than before a meal and you may have a hypo.

If you bolus is too small, your blood glucose will be 2mmol/L higher when you test 4 hours after a meal.

Personal insulin to carbohydrate counting ratio

It is important that each person works out their own insulin to CHO ratio. This may vary from 1 unit for 5g CHO to 1 unit for 20g CHO in a small child. The average is 1:10 or 1:8 in older children.

At the time of starting the pump your diabetes team will advise the dose. To find your own personal correct bolus dose follow the follow tips.

Test your bolus when you have your basal rate correct.

Don't test your boluses: -

During illness
After strenuous exercise
After a serious hypo
After a meal when it is difficult to count CHO

Start the test when

Your blood sugar is in the normal range
You have had no boluses or eaten for 4 hours
Take a blood glucose
Eat a meal/snack and give the dose you think
Test 2 hours afterwards and the blood glucose should be close to where you started

Record your results

Some people find it a good idea to do this for each of their favourite meals and keep a record in the kitchen or in your blue file of the amount of insulin required for favourite meals.

Disclaimer

This website is designed for use by the Leeds Paediatric Diabetes Team and children and parents referred to their service. Every effort has been made to make sure there are no errors on the website. If you think there are any inaccuracies could you please e-mail us so that we can check. kate.barker@leedsth.nhs.uk