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When you are using flexible dosing your pre meal insulin dose is determined by the carbs eaten and your BGL, so doses regularly change. To help work out the dose you can use tools like dosing cards (see below example), or a meter or app with a bolus calculator feature built in (one bolus calculator linked at end of this page).
There are several glucose meters and phone apps available which allow you to program different ICRs and ISFs at different times of the day to help you calculate your insulin dose.
Remember that ICRs and ISFs regulary will change as children grow. So it is important to regularly review your settings no matter what tool you are using.
NOTE - the pre meal target blood glucose level is 4 – 7mmol/l so if your BGLs show a pattern outside this range, it suggests your settings need to change.
MyLife app can be used in a similar way to the dosing cards with the carb ratio and correction factor adjusted in the app. You can have different settings for different meal times
When you add your BGL and carbohydrate into the app the recommended dose is shown.
An added benefit of the app is it can also be an electronic log book (Cloud based through Glooko) that records the entered data, including your BGLs. If this interests you, please speak with your diabetes team before setting up the app. There are some important steps prior to downloading the app that must be completed if you want to share your data with your diabetes team
The doses of insulin are adjusted based on what the insulin to carbohydrate ratio and set correction factor
Adjusting the settings at the top of the spreadsheet then adjusts the amounts required for the BGL and the number of carbohydrate serves that will be eaten at the meal.
The BGL is shown down the left hand side and the carbohydrate serves are labeled across the top (in blue). The insulin dose is written in black and any correction required, is written in red. To work out the pre meal dose needed, you add the insulin for carbohydrates (black) to the correction (red). If required, different cards can be made for different meals
The example below is a dosing card for all meals with an ICR of 1.3 units for 15 grams of carbohydrate, a CF of 4 mmol/L with a target BGL of 6 mmol/L. The dose of insulin if eating 3 serves of carbohydrate for lunch with a BGL of 11 mmol/L is 5 units of rapid acting insulin.
This is an online bolus calculator to use if you have had education. This calculator is different to using a dosing card or app on the phone.
To use this calculator you need to know what your carbohydrate ratio and your insulin sensitivity is, and like all the apps and cards, don't use it unless you have had suitable training.
Flexible bolus calculator