Diabetes Insulin Calculator

Eli Lilly Gets Fda Clearance For Insulin Dose Calculator App

Updated with statement from Eli Lilly Indianapolis-based pharma company Eli Lilly recently recieved FDA 510K clearance for a new mobile app called Go Dose, a diabetes management and insulin dosing app for users of Humalog, Lilly's rapid-acting insulin. The clearance is for prescription use, but includes two versions of the app: Go Dose, for patients, and Go Dose Pro, for healthcare providers. "The Go Dose System, comprised of the Go Dose and Go Dose Pro applications, is for use in home and clinical settings to aid in the review, analysis, and evaluation of historical blood glucose test values to support type 2 diabetes mellitus management," the company writes in the submission document. "The Go Dose System is a mobile application for use with iPad or iPhone mobile devices. The Go Dose System provides recommendations for titrating prandial Humalog dosing one meal at a time using blood glucose values entered by the patient." While there are a number of insulin dosage calculator apps available, not many are FDA-cleared despite clear guidance from the FDA that insulin dosage apps require premarket approval. A 2015 study found 46 such apps on iOS and Android stores and reported that "none of the apps included in this study appear to have completed registration, labeling, or other general controls which are the minimal requirements for products in both regimes". Diabetes management app mySugr offers a bolus calculator to European customers but hasn't introduced it to the US because of the regulatory burden. And Eli Lilly's choice of predicate devices -- desktop and Palm Pilot software -- further suggest very few if any FDA clearances exist for smartphone-based insulin dosage calculators. There is at least one, however: Roche's Accu-Check connect app, which launched in 2015. " Continue reading >>

Prandial Insulin Dosing Using The Carbohydrate Counting Technique In Hospitalized Patients With Type 2 Diabetes

OBJECTIVE To compare a modified fixed meal dosing strategy to flexible meal dosing in hospitalized patients with type 2 diabetes. RESEARCH DESIGN AND METHODS Patients (N = 126) with refractory hyperglycemia or requiring at least 20 units of insulin per day were randomly assigned to fixed meal dosing (including withholding the dose if less than half of the meal tray was consumed) or flexible meal dosing based upon carbohydrate intake. The inpatient diabetes management team made all treatment adjustments. Outcomes included day 3 mean glucose, 72-h glucose trend analysis, hypoglycemia (<3.9 mmol/L), and inpatient diabetes treatment satisfaction. RESULTS The mean glucose on day 3 was 9.5 and 8.8 mmol/L in the fixed and flexible meal groups, respectively (P = 0.26). The frequency of hypoglycemia was 23 and 39% overall in the fixed and flexible meal groups (P = 0.08), with half of events occurring in the morning. There was a wide range of carbohydrate intake (median 51 g/meal, 10–90% range 26–72 g on day 3). The fixed dose group required significantly more prandial insulin overall and more correction insulin over time. There was no difference in composite treatment satisfaction or dosing miscalculations between groups. CONCLUSIONS A fixed meal dosing strategy provided similar glucose control as flexible meal dosing, when managed by an inpatient diabetes treatment team. However, a larger sample size would be needed to definitively evaluate a treatment effect of flexible meal dosing in the hospital. Further study is needed to improve the delivery of bolus insulin in hospitalized patients. Hyperglycemia is common in the hospital (1) and is associated with poor outcomes (2). Subcutaneous insulin is traditionally favored for most general surgical and medical patients outside o Continue reading >>

Weight-based Insulin Dosing Safe At Recommended Doses

Weight-based insulin doses up to 0.6 units per kilogram are associated with a low risk of hypoglycemia, according to a new report…. Dr. Daniel J. Rubin from Temple University School of Medicine in Philadelphia writes that, "Our study provides evidence for the safety of daily insulin doses up to 0.6 units/kg." "I hope this will encourage more physicians to be comfortable using weight-based insulin dosing." Dr. Rubin and colleagues investigated the relationship between insulin dose and hypoglycemia in a retrospective, case-control study of 1,990 diabetic patients admitted to hospital wards. The report appears online June 23 in Diabetes Care. The unadjusted odds of hypoglycemia increased with insulin doses above 0.2 units/kg, and patients who received insulin doses of 0.6 units/kg or more faced increased odds of hypoglycemia. The adjusted odds of hypoglycemia were not higher among patients who received 0.2 to 0.6 units/kg. The adjusted odds of hypoglycemia were 3 times higher among patients who didn’t receive sliding scale insulin than among those who did, and there was a trend toward higher odds among patients who received NPH compared with patients who received glargine or short-acting insulin. Hypoglycemia was not more common among patients given insulin with an oral diabetes medication than among those given insulin alone. "0.6 units/kg seems to be a threshold below which the odds of hypoglycemia are relatively low," the researchers note. "Some patients, however, require more than 0.6 units/kg to treat hyperglycemia and do not experience any hypoglycemia," Dr. Rubin said. "If there is any concern for hypoglycemia, it is reasonable to use doses <0.6 unit/kg. Insulin dosing for individual patients must be done on a case-by-case basis." "Our data are consistent with t Continue reading >>

Interactive Dosing Calculator

Lantus® is a long-acting insulin analog indicated to improve glycemic control in adults and pediatric patients with type 1 diabetes mellitus and in adults with type 2 diabetes mellitus. Lantus® should be administered once a day at the same time every day. Limitations of Use: Lantus® is not recommended for the treatment of diabetic ketoacidosis. Contraindications Lantus® is contraindicated during episodes of hypoglycemia and in patients hypersensitive to insulin glargine or one of its excipients. Warnings and Precautions Insulin pens, needles, or syringes must never be shared between patients. Do NOT reuse needles. Monitor blood glucose in all patients treated with insulin. Modify insulin regimen cautiously and only under medical supervision. Changes in insulin strength, manufacturer, type, or method of administration may result in the need for a change in insulin dose or an adjustment in concomitant oral antidiabetic treatment. Do not dilute or mix Lantus® with any other insulin or solution. If mixed or diluted, the solution may become cloudy, and the onset of action/time to peak effect may be altered in an unpredictable manner. Do not administer Lantus® via an insulin pump or intravenously because severe hypoglycemia can occur. Hypoglycemia is the most common adverse reaction of insulin therapy, including Lantus®, and may be life-threatening. Medication errors, such as accidental mix-ups between basal insulin products and other insulins, particularly rapid-acting insulins, have been reported. Patients should be instructed to always verify the insulin label before each injection. Severe life-threatening, generalized allergy, including anaphylaxis, can occur. Discontinue Lantus®, treat and monitor until symptoms resolve. A reduction in the Lantus® dose may be re Continue reading >>

Insulin Dosing

OTHER HELPFUL PAGES ACRONYMS AND DEFINITIONS ADA - American Diabetes Association Basal Insulin - Long- and Intermediate-acting insulins used to supply constant blood levels of insulin activity Carb- carbohydrate DM1 - Type 1 diabetes DM2 - Type 2 diabetes FDA - U.S. Food and Drug Administration Hypoglycemia - low blood sugar Multidose insulin regimen - Insulin regimens that involve a basal insulin and a premeal insulin given at meals Premeal Insulin - also called “prandial” insulin. Rapid and short-acting insulins given at mealtime for short burst of insulin. Total daily dose of insulin - Sum of premeal and basal insulin given in a day Units/kg/day - units of insulin per kilogram of body weight per day USDA - United States Department of Agriculture 1 kilogram = 2.2 pounds IMPORTANT POINTS ABOUT DOSING INSULIN Overview There are a number of different ways to dose insulin No detailed guidelines for dosing insulin have been issued by professional associations The appropriate method for individual patients will depend on a number of factors including patient education, patient motivation, diabetes control, and resources Low blood sugar (Hypoglycemia) The main concern in most patients when initiating an insulin regimen is the occurrence of low blood sugars Patients need to understand that when they are starting and adjusting insulin, there is an increased risk for low blood sugars A number of things can affect this risk including variations in eating patterns, sensitivity to insulin, and variations in activity level Measures to help prevent low blood sugars Start low and go slow - patients naïve to insulin should start at the lower end of dosing ranges When using a multidose regimen, adjust only one of the regimens every 3 days and alternate between the two (see below f Continue reading >>

New Online Calculator For The Diabetes Math Impaired

Those of us living with diabetes, especially type 1, feel like we're never-ending math story problems. How many units do you take if you want to eat X amount of carbs, at a current blood sugar of Y, with a sensitivity factor of Z that varies due to time of day, amount of sleep, any stress you may be experiencing, or which way the wind is blowing? We are walking D-Math calculators. Technology makes it easier, without a doubt. Insulin pumps automatically calculate boluses for meals and correcti ons, and many keep track of how much active insulin we have working at any given time. Apps can do some D-Math too, but the need to pull out your phone for every bolus is not for everyone. That's why it was exciting to hear about the new Diabetes Calculator for Kids, a new, online program that can do D-calculations for you. It's developed by Nationwide Children's Hospital in Columbus, OH. But don't be deceived by the names: this free resource can actually help any PWD, of any age. After my mom's recent ER and hospital experience that temporarily affected her D-Math ability in a big way, we turned to this online calculator tool to do the calculations for us. And it worked perfectly! The Diabetes Calculator is apparently the first of its kind -- which is somewhat amazing, because it's really nothing fancy beyond a web-based version of a programmable spreadsheet. The online tool can be personalized so that any PWD or caregiver can create an individualized, printable chart that displays the calculated bolus amounts for food or insulin corrections, in five easy steps. You just plug in your personal information including name and birth date, caregiver's name, and whether you want doses rounded to the nearest half or whole unit. Then you enter the carb-to-insulin ratio, sensitivity factor Continue reading >>

Calculating Insulin Dose

You'll need to calculate some of your insulin doses. You'll also need to know some basic things about insulin. For example, 40-50% of the total daily insulin dose is to replace insulin overnight. Your provider will prescribe an insulin dose regimen for you; however, you still need to calculate some of your insulin doses. Your insulin dose regimen provides formulas that allow you to calculate how much bolus insulin to take at meals and snacks, or to correct high blood sugars. In this section, you will find: First, some basic things to know about insulin: Approximately 40-50% of the total daily insulin dose is to replace insulin overnight, when you are fasting and between meals. This is called background or basal insulin replacement. The basal or background insulin dose usually is constant from day to day. The other 50-60% of the total daily insulin dose is for carbohydrate coverage (food) and high blood sugar correction. This is called the bolus insulin replacement. Bolus – Carbohydrate coverage The bolus dose for food coverage is prescribed as an insulin to carbohydrate ratio.The insulin to carbohydrate ratio represents how many grams of carbohydrate are covered or disposed of by 1 unit of insulin. Generally, one unit of rapid-acting insulin will dispose of 12-15 grams of carbohydrate. This range can vary from 4-30 grams or more of carbohydrate depending on an individual’s sensitivity to insulin. Insulin sensitivity can vary according to the time of day, from person to person, and is affected by physical activity and stress. Bolus – High blood sugar correction (also known as insulin sensitivity factor) The bolus dose for high blood sugar correction is defined as how much one unit of rapid-acting insulin will drop the blood sugar. Generally, to correct a high blood Continue reading >>

New Apps Calculate Your Insulin Doses

Trying to calculate your insulin doses for injections, without the help of an insulin pump "wizard"? There's an app for that! (of course) First came basic insulin dose calculators like RapidCalc. But providing more personalized recommendations in a so-called "insulin titration app" was something of a challenge, because these provide real medical treatment decision support and therefore require FDA approval -- as opposed to so many diabetes logging apps that do not. The first regulatory breakthrough for a "mobile prescription therapy aid" that analyzes users' past data trends to deliver personalized recommendations came with WellDoc's BlueStar app in 2013. That was followed in 2015 by the Accu-Chek Connect app, that also calculates and recommends insulin amounts. WellDoc just recently snagged an expanded label for its BlueStar app that allows patients to use it without a doctor's prescription -- adding to the accessibility of this mobile tech tool. The FDA's decision last year to allow a dosing claim for the Dexcom G5 CGM system seems to have helped pave the way for even more smartphone-based decision therapy tools. And now, two new apps have snagged FDA clearance and are almost ready for prime time: Lilly's Go Dose In December, Eli Lilly got FDA clearance on its new mobile app called Go Dose, which can be used for the Lilly-branded Humalog insulin to titrate doses. This is the company's first class II ("moderate-risk") mobile app approved by the FDA. This one is designed for adults with type 2 diabetes, and is focused on meal-time insulin use for Humalog U-100 only. There is a Go Dose version for patients to use at home, and the Go Dose Pro clinical version for use by healthcare professionals. As of now, it's only compatible with iOS devices (iPads and iPhones), but hop Continue reading >>

Smartphone Apps For Calculating Insulin Dose: A Systematic Assessment

Go to: Abstract Medical apps are widely available, increasingly used by patients and clinicians, and are being actively promoted for use in routine care. However, there is little systematic evidence exploring possible risks associated with apps intended for patient use. Because self-medication errors are a recognized source of avoidable harm, apps that affect medication use, such as dose calculators, deserve particular scrutiny. We explored the accuracy and clinical suitability of apps for calculating medication doses, focusing on insulin calculators for patients with diabetes as a representative use for a prevalent long-term condition. We performed a systematic assessment of all English-language rapid/short-acting insulin dose calculators available for iOS and Android. Results Searches identified 46 calculators that performed simple mathematical operations using planned carbohydrate intake and measured blood glucose. While 59% (n = 27/46) of apps included a clinical disclaimer, only 30% (n = 14/46) documented the calculation formula. 91% (n = 42/46) lacked numeric input validation, 59% (n = 27/46) allowed calculation when one or more values were missing, 48% (n = 22/46) used ambiguous terminology, 9% (n = 4/46) did not use adequate numeric precision and 4% (n = 2/46) did not store parameters faithfully. 67% (n = 31/46) of apps carried a risk of inappropriate output dose recommendation that either violated basic clinical assumptions (48%, n = 22/46) or did not match a stated formula (14%, n = 3/21) or correctly update in response to changing user inputs (37%, n = 17/46). Only one app, for iOS, was issue-free according to our criteria. No significant differences were observed in issue prevalence by payment model or platform. Conclusions The majority of insulin dose calcu Continue reading >>

Mealtime Dosage Calculator

The mealtime dosage calculator is intended as an aid in figuring mealtime rapid-acting insulin requirements. It should only be used under the supervision and guidance of your health care team. Mealtime Dosage Calculator Instructions **IMPORTANT!!! Do not use the Mealtime Dosage Calculator without first discussing your exact insulin requirements with the clinician who prescribes your insulin. All values entered into the calculator should be determined with the guidance of your health care team. note: the Mealtime Dosage Calculator will work on most major spreadsheet programs, including Excel. To Use The Mealtime Insulin Dose Calculator: 1. You will need to enter your insulin dosage formulas into the boxes in the top left. Information can only be entered in the YELLOW boxes. First, enter the meal/situation that the chart applies to. For example, “breakfast” or “lunch before exercise” or “all meals”. Second, enter your target blood glucose (your “ideal value”). This should be one exact number in mg/dl, such as “100” or “120”. Third, enter your sensitivity factor. This is the amount that one unit of insulin lowers your blood glucose. Fourth, enter your carb:insulin ratio. This is the grams of carbohydrate “covered” by one unit of insulin. Fifth, enter an exercise factor (if needed). An exercise factor of 1.00 means that you will not be exercising and want to take your usual dose. If you want to lower your doses by 25% in anticipation of exercise, enter “.75”. If you want to lower your doses by 33%, enter “.67”. If you want to take half of your usual doses, enter “.50”. 2. The numbers on the large chart will update to reflect your mealtime insulin doses based on the parameters entered above. Find the grams of carbohydrate in the top ro Continue reading >>

Insulin Correction Dose Calculator -beta

perinatology.com Please enable JavaScript to view all features on this site. Insulin Correction Dose Calculator Select the type of insulin, enter the total daily dose of insulin used, the carbohydrate content of the meal, and press 'calculate' button to estimate the amount of insulin needed to cover the carbohydrate content of the meal. All calculations must be confirmed before use. The suggested results are not a substitute for clinical judgment. Neither Perinatology.com nor any other party involved in the preparation or publication of this site shall be liable for any special, consequential, or exemplary Insulin Type Rapid acting Insulin (Humalog, Novolog) Short acting (Regular) Total Daily Dose of Insulin (TDD) units Carbohydrate Content of meal : grams Current Blood Glucose mg/dL Target Pre-Meal Blood Glucose mg/dL Carbohydrate Ratio = One unit of insulin covers grams of carbohydrate Insulin Sensitivity Factor (ISF) = One unit insulin decreases blood glucose by mg/dL Insulin required to cover carbohydrate in meal units Correction to Dose Of Insulin units Dose Of Insulin for meal units Meal related insulin boluses are calculated according to the carbohydrate content of the meal using the carbohydrate-to-insulin ratio (CIR) The carbohydrate-to-insulin ratio (CIR) is the number of grams of carbohydrate that are covered by 1 unit of insulin. The CIR is calculated by dividing the constant 450 by the Total Daily Dose (TDD). The CIR may be different for different meals of the day. CIR-= 450 / TDD Example: TDD= 50 units insulin CIR= 450 /50 = 9 grams/unit The meal has 90 grams of carbohydrate Meal insulin bolus = carbohydrates/carbohydrate to insulin ratio CIR =90/9= 10 units If the post meal blood sugar is above the targeted blood sugar range for 2 to 3 days then consider Continue reading >>

Insulin Initiation Dose Calculator (type 2 Diabetes)

Tweet This calculator helps people with diabetes to determine the correct initial insulin dose for type 2 diabetes patients. This calculator was invented in the UK Prospective Diabetes Study (Source: N England Journal of Medicine; 357: September 21). How to use the Insulin Initiation Dose Calculator To calculate the number of units required per day, simply input: Your weight Your height Your fasting blood glucose Your gender You will then be presented with the initial dose in IU/day. This tool is meant for indicative purposes only. Please consult your GP or healthcare team to determine your insulin initiation dose. Tweet Type 2 diabetes mellitus is a metabolic disorder that results in hyperglycemia (high blood glucose levels) due to the body: Being ineffective at using the insulin it has produced; also known as insulin resistance and/or Being unable to produce enough insulin Type 2 diabetes is characterised by the body being unable to metabolise glucose (a simple sugar). This leads to high levels of blood glucose which over time may damage the organs of the body. From this, it can be understood that for someone with diabetes something that is food for ordinary people can become a sort of metabolic poison. This is why people with diabetes are advised to avoid sources of dietary sugar. The good news is for very many people with type 2 diabetes this is all they have to do to stay well. If you can keep your blood sugar lower by avoiding dietary sugar, likely you will never need long-term medication. Type 2 diabetes was formerly known as non-insulin-dependent or adult-onset diabetes due to its occurrence mainly in people over 40. However, type 2 diabetes is now becoming more common in young adults, teens and children and accounts for roughly 90% of all diabetes cases worldwi Continue reading >>

Mysugr Bolus Calculator – Get Help With Your Insulin Dose (currently Available In Eu)

back to Overview It's time for lunch. Your blood sugar is 165 mg/dl (9.2 mmol/L). You have a big slice of pizza, a bag of chips, and a cold Diet Coke waiting for you. How much insulin do you take? I can think of a few ways this goes: There’s not much to think about. You always eat the same thing and always take the same amount of insulin. You define the phrase “creature of habit.” You hate thinking about all of this stuff, so you just guess. You love doing a bunch of math before every meal, so calculating your insulin dose is fun and easy. I can relate to the first two. There’s a lot of value in routine, and I’ve also done my share of guesstimating. That last one? Enjoying all of the diabetes math? I’m sorry. That’s just weird. (I’m teasing. Kind of…) But there’s another option, and it makes thinking about your insulin doses easier and more precise. I’m talking about a bolus calculator. If you wear an insulin pump, you’re probably already using one (they’re often built in). You’re welcome to stay and read, but there’s not much new information for you here. However, if you’re using injections (syringes or pens), like most people with diabetes, then stick around. This article should be helpful. So you don’t have (or want) an insulin pump, but I bet you have a smartphone. What does that mean? It means that you should meet mySugr’s Bolus Calculator. It’s a module integrated into the mySugr app that helps with your insulin doses (note: mySugr Bolus Calculator is currently approved for use in Europe). What the heck is a “bolus,” you ask? Great question. A bolus, in our case, is a single dose of insulin given all at once. In other words, it’s your mealtime shot or a shot to fix a high blood sugar. mySugr’s Bolus Calculator examines Continue reading >>

Tips For Calculating A Total Daily Dose Of Insulin

You can use one of several methods to determine a safe, initial dose Published in the August 2007 issue of Today’s Hospitalist. Evidence keeps mounting that high blood sugars lead to worse outcomes in hospitalized patients “and that sliding scale regimens produce both more hyperglycemia and hypoglycemia. But as hospitalists switch from sliding scale to basal and bolus dosing, how do they calculate a safe total daily dose to start with? Experts say that physicians can use any of three different strategies, depending on whether patients have been using insulin as either an outpatient or in the ICU. ~ Deepak Asudani, MD Baystate Medical Center Any one of these approaches will produce a safe, conservative initial dose, but experts warn that none of the strategies by itself is a slam dunk. You still have to bring art to each approach, adjusting doses according to such factors as illness severity and eating status. Related article: Keeping it simple with insulin regimens, July 2013 Here’s a look at how two hospitalists use these strategies in their day-to-day practice. 1. Base total sub-Q dose on insulin infusion rates. When Deepak Asudani, MD, a hospitalist at Baystate Medical Center in Springfield, Mass., transitions patients from IV insulin in the ICU to sub-Q insulin on the wards, he uses the following formula: Take the average hourly insulin infusion rate over the past six hours and multiply that rate by 20. That gives you a number that should equal 80% of the daily infusion dose. “It’s a little correction to prevent any hypoglycemia,” says Dr. Asudani. Because patients’ insulin needs are tapering down a bit as they exit the ICU, he adds, you don’t need to supply the same daily dose. For patients eating substantial amounts of food, you can use that calcul Continue reading >>

Diabetes Calculator For Kids

Everything matters when it comes to your child's care. Thats why Nationwide Children's has developed an online resource for managing your child's diabetes. Our goal is to empower families to successfully manage diabetes at home in order to provide as normal a life as possible for patients with diabetes. Managing your childs diabetes requires the proper balance between insulin dose, food and activity on a daily basis. It is important to keep your childs blood sugars within a target range at all times. This online resource will enable you to calculate the insulin dosage given to your child prior to eating. The Diabetes Calculator for Kids is an electronic tool that calculates rapid acting insulin bolus dosage in 5 easy steps. Each chart is customized based on the child's personal input and information that is generally provided by a doctor or diabetes educator. Please consult your physician with any questions related to your individual diabetes management plan. Add the Diabetes Calculator for Kids to Your Website You can embed the Diabetes Calculator for Kids on your blog or website. Just copy the below code and paste it into your website. Please Note: The Diabetes Calculator for Kids will work on any webpage but it looks best on a webpage with a white background. The area on your webpage where you embed the calculator should be at least 660 pixels wide and 670 pixels in height. The Diabetes Calcultor for Kids is provided by Nationwide Children's Hospital Continue reading >>