Open AccessDiurnal variation of carbohydrate insulin ratio in adult type 1 diabetic patients treated with continuous subcutaneous insulin infusion
Author(s) -
Nakamura Tomoaki,
Hirota Yushi,
Hashimoto Naoko,
Matsuda Tomokazu,
Takabe Michinori,
Sakaguchi Kazuhiko,
Ogawa Wataru,
Seino Susumu
Publication year - 2014
Publication title -
journal of diabetes investigation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.089
H-Index - 50
eISSN - 2040-1124
pISSN - 2040-1116
DOI - 10.1111/jdi.12132
Subject(s) - medicine , insulin , meal , basal insulin , endocrinology , diabetes mellitus , carbohydrate , basal (medicine) , type 2 diabetes
To estimate the carbohydrate‐to‐insulin ratio ( CIR ), a formula dividing a constant, usually 300–500, by the total daily dose ( TDD ) of insulin, is widely utilized. An appropriate CIR varies for each meal of the day, however. Here, we investigate diurnal variation of CIR in hospitalized Japanese type 1 diabetic patients treated with continuous subcutaneous insulin infusion. After optimization of the insulin dose, TDD and total basal insulin dose ( TBD ) were 34.9 ± 10.2 and 9.3 ± 2.8 units, respectively, with a percentage of TBD to TDD of 27.3 ± 6.0%. The products of CIR and TDD at breakfast, lunch and dinner were 311 ± 63, 530 ± 161, and 396 ± 63, respectively, suggesting that in the formula estimating CIR using TDD , the constant should vary for each meal of the day, and that 300, 500, and 400 are appropriate for breakfast, lunch, and dinner, respectively.