Related Experiment Video
Updated: Jun 17, 2026
Improving IV Insulin Administration in a Community Hospital
Published on: June 11, 2012
A new model to estimate bolus insulin need
Edward H Mathews1, Ruaan Pelzer
1Faculty of Engineering, North-West University, Pretoria, Republic of South Africa.
Background:
Patients with type 1 diabetes usually use the carbohydrate (CHO) counting method to establish their bolus insulin need. However, most still struggle with blood glucose control. We believe that for good control their insulin requirements should strive to mimic the insulin secretion of those without diabetes. The objective here is to develop, from first principles, a better model than the CHO counting model for calculating the bolus insulin need of subjects without diabetes. Such a model may also provide better blood glucose control for patients with type 1 diabetes. This will be investigated in a future article.
Methods:
Equations for metabolism of CHO and for insulin response were derived from first principles. Clinical trials were used to verify these models. The final results--namely, the new bolus insulin requirement equations--were verified using clinical trials by other researchers (Wolever and co-workers). Their methods used are described in their articles given in the list of references.
Results:
The postprandial insulin secretion relationships resulted in an average Pearson R(2) of 0.807 (for the new method) versus the old method's R(2) of 0.562 (CHO counting).
Conclusions:
The newly derived equation provides a better approximation than the CHO counting method of insulin secretion due to metabolized blood glucose energy from ingested carbohydrates for those without diabetes. We believe that insulin dosage requirements for a patient with type 1 diabetes should mimic the insulin secretion of those without diabetes. If this is true, it means that the new equation should also estimate bolus insulin need for a patient with type 1 diabetes more accurately than before. This will be investigated in a future article.
Related Concept Videos
00:56One-Compartment Open Model for IV Bolus Administration: Estimation of Clearance
In the one-compartment open model for intravenous (IV) bolus administration, clearance is estimated by dividing the elimination rate by the plasma drug concentration. This equation leverages the elimination rate constant and the apparent...
01:19One-Compartment Open Model for IV Bolus Administration: General Considerations
The drug's presence in the body is defined by an equation representing the difference between the rates of drug entry and exit. Key parameters—elimination rate constant, half-life,...
01:18Two-Compartment Open Model: IV Bolus Administration
The disparity between drug input and the sum of drug transfer rates between...
01:09One-Compartment Open Model for IV Bolus Administration: Estimation of Elimination Rate Constant, Half-Life and Volume of Distribution
01:16Insulin: Dosing Regimen and Adverse Effects
The basal dose constitutes about 40%-50% of the total daily dose, with the rest as premeal insulin. The mealtime insulin dose should mirror...
00:59Nonlinear Pharmacokinetics: Drug Elimination for IV Bolus Injection
Following the administration of a single intravenous (IV) bolus injection, we can determine the concentration of the drug in the plasma at any given time. This calculation is achieved using a specific equation that integrates the values of Vmax and KM.
We can also...