Pediatric Diabetes Smart Insulin Pens

What are the benefits of Diabetes Smart Insulin Pens?

Smart Insulin Pens have the following advantages over traditional disposable insulin pens:

1. Smartphone app – a free app that sends helpful notifications when you pair your pen to your smartphone
2. Dosing assistant – a dosing assistant to help take the guesswork out of dosing
3. Reporting – a report on your child’s insulin therapy created by your smart pen and app

Smartphone app

When paired, the smart insulin pen and the app work together to simplify diabetes management by:

• Calculating recommended insulin doses
• Logging doses with date and time stamps automatically
• Reminding you about doses and to check your blood glucose levels
• Alerting you about the temperature of your insulin, should it be getting too hot

Dosing assistant

Similar to an insulin pump, for smart insulin pens to calculate the correct doses you must enter the following settings for your child:

• Insulin to carbohydrate ratio (ICR) with meals and snacks (ex. 1 unit per 10g CHO)

  • The insulin to carbohydrate ratio (ICR) is a ratio one uses to determine the number of units of insulin to take for each meal based on the number of carbs consumed. For example, a child who needs 6 units of rapid-acting insulin when they consume 60g CHO would be described as being on a “1:10” ICR.

  • ICR’s can change from meal to meal and from day to day depending on activity levels and many other factors. Your care team can help you understand your child’s ICR’s.

• Blood glucose target (mg/dL)
  • The blood glucose target is the desired glucose level that a person with diabetes is trying to maintain. Although you might say to yourself “my target is a range,” for calculation purposes, this has to be a specific number. Your care team can help you decide on a suggested target for your child, often somewhere between 120-140mg/dL.
• Insulin sensitivity factor (mg/dL/unit)

  • Insulin sensitivity factor is best thought of as the drop in glucose level (in mg/dL) that your child can expect from 1 unit of insulin, and is used together with the blood glucose target to determine how much extra insulin to take at mealtime to bring high glucose readings back down to target.

    Example:Imaginary settings for a child:
    ICR: 1:10 (1 unit of rapid acting insulin for 10g CHO)
    Target glucose: 150 mg/dL
    Insulin sensitivity factor: 50 mg/dL

    Current readings and meal plan:
    Glucose 175 mg/dL
    CHO to be consumed: 70g

    In the above scenario, the Smart Insulin Pen dosing assistant would advise 7.5 units of insulin.

    Calculation: 70g/10 = 7 units for CHO
    (175-150)/50 = 0.5 units for correction
    Total = 7.5 units

• Insulin on board (IOB) (hours)
  • Insulin on board (IOB) is one final adjustment factor that allows the dosing assistant to also include the time of your last shot, and how long insulin usually lasts in your child’s body, into its dosing calculation. If your IOB is 4 hours and your child eats 3 hours after their last dose, the calculated dose for the current meal would be adjusted down by a small amount because he/she is still within the 4 hour window of their last shot, and thus some of the last shot is presumed to still be active in their body.

Remember to always discuss these settings with your doctor before using a smart insulin pen. Inaccurate settings can lead to unexpected risks.

Reporting

After each dose, the app logs carbohydrates, glucose levels and insulin doses. Then it sends the big picture of your diabetes care in a report that you can share with your child’s doctor, school nurse or your family.