Approximate Sensitivity Factor (mmol/l): 1.1, 1.4
Average Total Daily Insulin (Basal + Bolus units): 100
Approximate Sensitivity Factor (mg/dl): 15, 20
Approximate Sensitivity Factor (mmol/l): 0.8, 1.1
Average Total Daily Insulin (Basal + Bolus units): 120
Approximate Sensitivity Factor (mg/dl): 13, 17
Approximate Sensitivity Factor (mmol/l): 0.7, 1.0
Average Total Daily Insulin (Basal + Bolus units): 140
Approximate Sensitivity Factor (mg/dl): 11, 15
Approximate Sensitivity Factor (mmol/l): 0.6, 0.8
Average Total Daily Insulin (Basal + Bolus units): 160
Approximate Sensitivity Factor (mg/dl): 10, 12
Approximate Sensitivity Factor (mmol/l): 0.5, 0.7
Average Total Daily Insulin (Basal + Bolus units): 180
Approximate Sensitivity Factor (mg/dl): 9, 11
Approximate Sensitivity Factor (mmol/l): 0.5, 0.6
Average Total Daily Insulin (Basal + Bolus units): 200
Approximate Sensitivity Factor (mg/dl): 8, 10
Approximate Sensitivity Factor (mmol/l): 0.4, 0.6
Medtronic In the Past 20 Minutes
Rising <3 mg/dL/min [0.17 mmol/L]
Rising 2-3 mg/dL/min [0.11-0.17 mmol/L]
Rising 1-2 mg/dL/min [0.06-0.11 mmol/L]
n/a
n/a
n/a
Falling 1-2 mg/dL/min
Falling 2-3 mg/dL/min [0.11-0.17 mmol/L]
Falling 2-3 mg/dL/min [0.11-0.17 mmol/L]
Falling <3 mg/dL/min [0.17 mmol/L]
Dexcom In the Past 15 Minutes
n/a
Rising <3 mg/dL/min [0.17 mmol/L]
Rising 2-3 mg/dL/min [0.11-0.17 mmol/L]
Rising 1-2 mg/dL/min [0.06-0.11 mmol/L]
Changing <1 mg/dL/min [0.06 mmol/L]
Falling 1-2 mg/dL/min [0.06-0.11 mmol/L]
Falling <2 mg/dl/min [0.11-0.16 mmol/l]
Rising <3 mg/dL/min [0.17 mmol/L]
n/a
Libre
n/a
n/a
Rising <2 mg/dl/min [0.11-0.16 mmol/l]
Rising 1-2 mg/dL/min [0.06-0.11 mmol/L]
Changing <1 mg/dL/min [0.06 mmol/L]
Falling 1-2 mg/dL/min [0.06-0.11 mmol/L]
Falling <2 mg/dl/min [0.11-0.16 mmol/l]
n/a
n/a
Eversense In the Past 20 Minutes
n/a
n/a
Rising <2 mg/dl/min [0.11-0.16 mmol/l]
Rising 1-2 mg/dL/min [0.06-0.11 mmol/L]
Changing <1 mg/dL/min [0.06 mmol/L]
Falling 1-2 mg/dL/min [0.06-0.11 mmol/L]
n/a
n/a
Current Trend
Rising Very Fast
Rising Fast
Rising Modestly
Falling Modestly
Falling Fast
Falling Very Fast
CGM Arrow Designation
Medtronic: Dexcom: Libre: (n/a) Eversense: (n/a)
Medtronic: Dexcom: Libre: Eversense
Medtronic: Dexcom: Libre: Eversense
Medtronic: Dexcom: Libre: Eversense
Medtronic: Dexcom: Libre: Eversense
Medtronic: Dexcom: Libre: (n/a) Eversense: (n/a)
Adjust Usual Dose to Offset
Add enough to usual bolus to offset 75 mg/dL [4.2 mmol/L] rise
Add enough to usual bolus to offset 50 mg/dL [2.8 mmol/L] rise
Add enough to usual bolus to offset 25 mg/dL [1.4 mmol/L] rise
Subtract enough from usual bolus to offset 25 mg/dL [1.4 mmol/L] fall
Subtract enough from usual bolus to offset 50 mg/dL [2.8 mmol/L] fall
Subtract enough from usual bolus to offset 75 mg/dL [4.2 mmol/L] fall
Table 7-8. How Different Systems Handle IOB
Device : Accu-Chek/Roche
What It Does with IOB : Calculates the correction bolus required to reach predicted or desirable glucose level given the amount of time since the last bolus was given.
Device : Insulet/OmniPod
What It Does with IOB : Deducts IOB from total meal + correction dose.
Device : Medtronic
What It Does with IOB : Deducts IOB from correction bolus only. Meal portion of the bolus is never reduced by IOB.
Device : Tandem
What It Does with IOB : If the glucose entry is above the target blood sugar, the IOB is deducted from the correction bolus only; the meal portion of the bolus will not be reduced by IOB. If the glucose entry is below the target blood sugar, the meal dose will be reduced by IOB.
Device : Ypsomed
What It Does with IOB : Deducts IOB from total meal + correction bolus. IOB is calculated based on a linear insulin action profile rather than the usual curvilinear action.
Device : InPen
What It Does with IOB : If it has been ≤ 2hrs since last food bolus and BG >180 (10), IOB deducted from correction dose only. If >2hrs and BG is above target, IOB deducted from total food + correction dose. If BG is below target, IOB will be deducted from the food dose.
Table 7-9. IOB Based on Time Since Bolus Was Given
Time Since Bolus Was Given: 0.5 hr
Insulin Used Up: 10%
Insulin Still Working (IOB): 90%
Time Since Bolus Was Given: 1 hr
Insulin Used Up: 30%
Insulin Still Working (IOB): 70%
Time Since Bolus Was Given: 1.5 hrs
Insulin Used Up: 50%
Insulin Still Working (IOB): 50%
Time Since Bolus Was Given: 2 hrs
Insulin Used Up: 65%
Insulin Still Working (IOB): 35%
Time Since Bolus Was Given: 2.5 hrs
Insulin Used Up: 80%
Insulin Still Working (IOB): 20%
Time Since Bolus Was Given: 3 hrs
Insulin Used Up: 90%
Insulin Still Working (IOB): 10%
Time Since Bolus Was Given: 3.5 hrs
Insulin Used Up: 95%
Insulin Still Working (IOB): 5%
Time Since Bolus Was Given: 4 hrs
Insulin Used Up: 100%
Insulin Still Working (IOB): 0%
Table 7-10. Simplified IOB Calculation Based on a Three-Hour Duration of Insulin Action
Time Since Bolus Was Given: 1 hr
Insulin Used Up: 33%
Insulin Still Working (IOB): 67%
Time Since Bolus Was Given: 2 hrs
Insulin Used Up: 67%
Insulin Still Working (IOB): 33%
Time Since Bolus Was Given: 3 hrs
Insulin Used Up: 100%
Insulin Still Working (IOB): 0%
Table 7-11. Simplified IOB Calculation Based on a Four-Hour Duration of Insulin Action
Time Since Bolus Was Given: 1 hr
Insulin Used Up: 25%
Insulin Still Working (IOB): 75%
Time Since Bolus Was Given: 2 hrs
Insulin Used Up: 50%
Insulin Still Working (IOB): 50%
Time Since Bolus Was Given: 3 hrs
Insulin Used Up: 75%
Insulin Still Working (IOB): 25%
Time Since Bolus Was Given: 4 hrs
Insulin Used Up: 100%
Insulin Still Working (IOB): 0%
Table 7-12. Simplified IOB Calculation Based on a Five-Hour Duration of Insulin Action
Time Since Bolus Was Given: 1 hr
Insulin Used Up: 20%
Insulin Still Working (IOB): 80%
Time Since Bolus Was Given: 2 hrs
Insulin Used Up: 40%
Insulin Still Working (IOB): 60%
Time Since Bolus Was Given: 3 hrs
Insulin Used Up: 60%
Insulin Still Working (IOB): 40%
Time Since Bolus Was Given: 4 hrs
Insulin Used Up: 80%
Insulin Still Working (IOB): 20%
Time Since Bolus Was Given: 5 hrs
Insulin Used Up: 100%
Insulin Still Working (IOB): 0%
Time: 8:00 a.m.
Blood Sugar: 238 mg/dl (13.2 mmol/l) Correction bolus given
Time: 8:30
Blood Sugar: 235 (13.1)
Time: 9:00
Blood Sugar: 222 (12.3)
Time: 9:30
Blood Sugar: 174 (9.8)
Time: 10:00
Blood Sugar: 141 (7.8)
Time: 10:30
Blood Sugar: 125 (6.9)
Time: 11:00
Blood Sugar: 118 (6.6)
Time: 11:30
Blood Sugar: 111 (6.2)
Time: 12:00 p.m.
Blood Sugar: 112 (6.2)
Table 7-13. Bolus Multipliers for Physical Activity
Activity Multipliers
: Low Intensity (RPE 8, 11)
Short Duration (15, 30 Minutes): 0.90 (10% reduction)
Moderate Duration (40, 60 Minutes) 0.80 (20% reduction)
Long Duration (<60 Minutes): 0.70 (30% reduction)
Activity Multipliers
: Moderate Intensity (RPE 12, 15)
Short Duration (15, 30 Minutes): 0.75 (25% reduction)
Moderate Duration (40, 60 Minutes) 0.67 (33% reduction)
Long Duration (<60 Minutes): 0.50 (50% reduction)
Activity Multipliers
: High Intensity (RPE 16, 18)
Short Duration (15, 30 Minutes): 0.67 (33% reduction)
Moderate Duration (40, 60 Minutes) 0.50 (50% reduction)
Long Duration (<60 Minutes): 0.33 (67% reduction)
Table 7-14. Rating of Perceived Exertion
Very, very light 8
Very light
Fairly light
Somewhat hard
Hard
Very hard
Very, very hard
Note: Very, very light activities constitute little more than resting and typically do not require any insulin adjustments. Very, very hard activities (maximal intensity) are usually “anaerobic,” meaning they cannot be performed for more than a few minutes and often cause a short-term rise in blood sugar levels.
Table 7-15. Optimal Bolus Timing Based on Glycemic Index of Food
High-GI food
Bolus well before eating
Moderate-GI food
Bolus soon before eating
Low-GI food, prolonged or very large meals
Bolus after eating, or spread out delivery
Table 7-16. Bolus Timing Based on GI and Premeal Blood Sugar
Bolus Timing in Relation to Meal: BG above target
High GI: 35-45 minutes prior
Moderate GI: 20-25 minutes prior
Low GI, Prolonged or Large Meal: 0-10 minutes prior
Bolus Timing in Relation to Meal: BG on target
High GI: 20-30 minutes prior
Moderate GI: 5-10 minutes prior
Low GI, Prolonged or Large Meal: 5-15 minutes after
Bolus Timing in Relation to Meal: BG below target
High GI: 0-15 minutes prior
Moderate GI: 5-10 minutes after
Low GI, Prolonged or Large Meal: 20-30 minutes after
Table 8-1. Protein Content of Protein-Rich Foods
Protein Source: sirloin steak
Serving Size: 4 oz
Protein Content (grams): 34 g protein
Protein Source: chicken breast
Serving Size: 3 oz
Protein Content (grams): 26 g protein
Protein Source: cooked ground turkey
Serving Size: 3 oz
Protein Content (grams): 22 g protein
Protein Source: cooked ground beef
Serving Size: 3 oz
Protein Content (grams): 22 g protein
Protein Source: tuna (drained)
Serving Size: 3 oz
Protein Content (grams): 22 g protein
Protein Source: salmon
Serving Size: 3 oz
Protein Content (grams): 19 g protein
Protein Source: cottage cheese
Serving Size: 4 oz
Protein Content (grams): 14 g protein
Protein Source: tofu
Serving Size: 3 oz
Protein Content (grams): 13 g protein
Protein Source: skim or 1% milk
Serving Size: 8 oz
Protein Content (grams): 9 g protein
Protein Source: lima / kidney beans
Serving Size: half cup
Protein Content (grams): 7 g protein
Protein Source: cheese
Serving Size: 1 oz
Protein Content (grams): 7 g protein
Protein Source: 1 whole egg
Serving Size: large
Protein Content (grams): 6 g protein
Protein Source: low fat yogurt
Serving Size: 4 oz
Protein Content (grams): 5 g protein
Protein Source: Greek yogurt
Serving Size: 8 oz
Protein Content (grams): 20 g protein
Protein Source: nut butter
Serving Size: 2 Tbsp
Protein Content (grams): 8 g protein
Table 8-2. Carbs to Maintain Blood Sugar During Typical Cardiovascular Exercise
Carbohydrate Needed (grams) per Sixty Minutes of Physical Activity
Low Intensity
50 lbs (23 kg): 5-8 g
100 lbs (45 kg): 10-16 g
150 lbs (68 kg): 15-25 g
200 lbs (91 kg): 20-32 g
250 lbs (114kg): 25-40 g
300 lbs. (135 kg): 30-48 g
Moderate Intensity
50 lbs (23 kg): 10-13 g
100 lbs (45 kg): 20-26 g
150 lbs (68 kg): 30-39 g
200 lbs (91 kg): 40-52 g
250 lbs (114kg): 50-65 g
300 lbs. (135 kg): 60-78 g
High Intensity
50 lbs (23 kg): 15-18 g
100 lbs (45 kg): 30-36 g
150 lbs (68 kg): 45-55 g
200 lbs (91 kg): 60-72 g
250 lbs (114kg): 75-90 g
300 lbs. (135 kg): 90-118 g
Table 9-1
Weight in lbs (kg): <60 (<28)
Amount Each Gram of Carb Should Raise Your BG in mg/dl (mmol/l): 6-10 (0.33-0.55)
Weight in lbs (kg): 60-100 (29-47)
Amount Each Gram of Carb Should Raise Your BG in mg/dl (mmol/l): 5 (0.28)
Weight in lbs (kg): 101-160 (48-76)
Amount Each Gram of Carb Should Raise Your BG in mg/dl (mmol/l): 4 (0.22)
Weight in lbs (kg): 161-220 (77-105)
Amount Each Gram of Carb Should Raise Your BG in mg/dl (mmol/l): 3 (0.17)
Weight in lbs (kg): <220 (<105)
Amount Each Gram of Carb Should Raise Your BG in mg/dl (mmol/l): 2 (0.11)
Table 9-2. Proper Treatment for Low Blood Sugar (Based on Body Weight and Blood Sugar Level), with a Target BG of 120 (6.7)
Blood Sugar mg/dl
(mmol/l)
Weight : <60 lbs (<28 kg)
80s (4.4, 5): 4 g
70s (3.9, 4.3): 5 g
60s (3.3, 3.8): 7 g
50s (2.8, 3.2): 8 g
40s (2.2, 2.7) : 10 g
<40 (<2.2): 12 g
Blood Sugar mg/dl
(mmol/l)
Weight : 60-100 (28-47)
80s (4.4, 5): 7 g
70s (3.9, 4.3): 9 g
60s (3.3, 3.8): 11 g
50s (2.8, 3.2): 13 g
40s (2.2, 2.7) : 15 g