title: A Review of Insulin-Dosing Formulas for Continuous Subcutaneous Insulin Infusion (CSII) for Adults with Type 1 Diabetes.
abstract: Dosing guidelines for patients with type 1 diabetes using continuous subcutaneous insulin infusion (CSII), which are historically based on clinical experience and retrospective studies of patients consuming an American diet, recommend that basal insulin should represent approximately 50 % of the total daily dose (TDD). Recent prospective studies in the USA and Japan conclude that the more appropriate proportion is closer to 30-40 % of TDD. In addition, currently used formulas for calculating the carbohydrate-to-insulin ratio (CIR) and correction factor (CF) may lead to underdosing of bolus insulin by as much as 12.8-50 % for a hypothetical patient. The discrepancies between traditional formulas and data from newer studies can be accounted for by the more rigorous design of the newer studies (e.g., prospective design, controlled diets, meal omission, and frequent glucose monitoring). International differences in diet composition may also be important to consider when developing dosing recommendations for CSII.
authors.affiliation: Diabetes Care Center, 1260 S. Main Street, Salinas, CA, 93901, USA. aking@diabetescarecenter.com.
authors.forename: Allen B
authors.initials: AB
authors.lastname: King
authors.affiliation: Diabetes Therapeutics and Research Center, Institute for Advanced Enzyme Research, Tokushima University, 3-18-15, Kuramoto-cho, Tokushima, 770-8503, Japan.
authors.forename: Akio
authors.initials: A
authors.lastname: Kuroda
authors.affiliation: Diabetes Therapeutics and Research Center, Institute for Advanced Enzyme Research, Tokushima University, 3-18-15, Kuramoto-cho, Tokushima, 770-8503, Japan.
authors.forename: Munehide
authors.initials: M
authors.lastname: Matsuhisa
authors.affiliation: Novo Nordisk, Inc., 100 College Rd W, Princeton, NJ, 08540-6604, USA.
authors.forename: Todd
authors.initials: T
authors.lastname: Hobbs
mesh_terms: D000328:Adult; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy*; D004032:Diet; D004305:Dose-Response Relationship, Drug; D006801:Humans; D055104:Infusions, Subcutaneous; D007328:Insulin / Q000008:administration & dosage* / Q000627:therapeutic use*; D007332:Insulin Infusion Systems; D017410:Practice Guidelines as Topic
chemical_list: D007328:Insulin
keywords: Continuous subcutaneous insulin infusion; Dosing formulas; Insulin pump; Insulin-dosing guidelines; Type 1 diabetes