title: Determining starting basal rates of insulin infusion for insulin pump users: a comparison between methods.
abstract: OBJECTIVE
  We aimed to assess the accuracy and safety of presently available methods of estimating starting basal insulin rates for patients with type 1 and 2 diabetes, and to compare them against an empirically derived standard basal rate and a newly developed regression formula.
  
  
  METHODS
  Data on 61 patients with type 1 diabetes on continuous subcutaneous insulin infusion (CSII) therapy and 34 patients with type 2 diabetes on CSII were reviewed. Patient data were first analyzed for correlations between initial patient parameters and final basal rates. Starting basal rates were then retrospectively calculated for these patients according to the weight-based method (WB-M), the total daily dose (TDD) of insulin method (TDD-M), a flat empiric value, and a new formula developed by regression analysis of clinical data. These 4 methods were subsequently compared in their accuracy and potential risk of hypoglycemia.
  
  
  RESULTS
  For type 1 diabetes, patient weight and TDD of long-acting insulin correlated with final basal rates. Both the regression formula and the TDD-M appeared safer than the WB-M and empirical estimates. For type 2 diabetes, only patient TDD of long-acting insulin correlated with final basal rates. The regression formula was significantly more accurate for patients with type 2 diabetes overall, but the TDD-M estimate was marginally safer.
  
  
  CONCLUSIONS
  The pre-existing TDD-M was found to be the safest presently recommended estimate of initial basal rates for pump initiation in both type 1 and 2 diabetes. The best-fit regression was found to have potential use for type 2 CSII initiation.
authors.affiliation: Department of Biochemistry , University of British Columbia , Vancouver, British Columbia , Canada.
authors.forename: Nelson
authors.initials: N
authors.lastname: Chow
authors.affiliation: Department of Zoology , University of British Columbia , Vancouver, British Columbia , Canada.
authors.forename: Daniel
authors.initials: D
authors.lastname: Shearer
authors.affiliation: Dartmouth College , Hanover, New Hampshire , USA.
authors.forename: Hamish G
authors.initials: HG
authors.lastname: Tildesley
authors.affiliation: Endocrine Research Society , Vancouver, British Columbia , Canada.
authors.forename: Jessica
authors.initials: J
authors.lastname: Aydin Plaa
authors.affiliation: Endocrine Research Society , Vancouver, British Columbia , Canada.
authors.forename: Betty
authors.initials: B
authors.lastname: Pottinger
authors.affiliation: Faculty of Medicine , University of British Columbia , Vancouver, British Columbia , Canada.
authors.forename: Monika
authors.initials: M
authors.lastname: Pawlowska
authors.affiliation: Department of Endocrinology and Metabolism , St. Paul's Hospital , Vancouver, British Columbia , Canada.
authors.forename: Adam
authors.initials: A
authors.lastname: White
authors.affiliation: Faculty of Medicine , University of British Columbia , Vancouver, British Columbia , Canada.
authors.forename: Anne
authors.initials: A
authors.lastname: Priestman
authors.affiliation: Faculty of Medicine , University of Calgary , Calgary, Alberta , Canada.
authors.forename: Stuart A
authors.initials: SA
authors.lastname: Ross
authors.affiliation: Department of Endocrinology and Metabolism , St. Paul's Hospital , Vancouver, British Columbia , Canada.
authors.forename: Hugh D
authors.initials: HD
authors.lastname: Tildesley
keywords: Basal; Insulin Dose Management; Insulin Pump; Insulin Treatment in Type 2 Diabetes