Some insulin pumps these days have a feature that allows a child to input the number of carbs eaten, and the pump calculates the carb-to-insulin ratio based on what time of day it is. Most kids have at least three different numbers to divide the number of carbs by, and some have as many as nine different carb-to-insulin ratios – for example, if today’s snack is during soccer practice, it gets divided by one number, but if tomorrow’s snack is during study hall, it gets divided by another number. Anyway, having so many numbers to remember can be a source of error in computing the correct dose. Some pumps can be pre-programmed with all the carb-to-insulin ratios used each day, and so when the number of carbs is put in, the pump figures out the dose automatically and asks for the user’s approval. Our daughter, who does not have a pump, calculated her dose on a piece of paper using long division the other night, while her friend with a pump was done in seconds. The contrast couldn’t have been clearer.
Some pumps also keep track of the last dose given, so that “insulin stacking” is not a problem. This is when one insulin dose is given right after another, without regard to the effect that the first dose is having on the blood stream. The pump will prevent the user from giving too many doses too quickly without compensating for the prior insulin.
So why can’t the microchip that does all this be put on the end of an insulin pen? Eli Lilly has a new insulin pen called the “Memoir” which has a digital screen at the end of it. When I saw this pen displayed at the ADA convention, I thought perhaps some smart scientist had transferred the dose-calculating microchip to the pen, but no luck. This pen tells you what today’s date is, what time it is, and what your last dozen doses were, but that’s it – it doesn’t prevent you from insulin stacking, it doesn’t let you input carbs and it doesn’t calculate the dose for you.
I’m all in favor of kids having to count their own carbs – it’s good for them to know what they’re eating and how much – but anything we can do to reduce human error in calculating the insulin dose is a good thing. Let’s call it the SmartPen – and let’s hope someone invents it soon!
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Published On: June 21, 2006