The New Paradigm 722 Insulin Pump Can Achieve Good Glycemic Control with Carbohydrate Counting Alone: A Case Report of Type 1 Diabetes Mellitus

Abstract

The Medtronic Minimed Paradigm 722 device allows the determination of the active insulin duration for two to eight hour periods, and suggests the appropriate dose of bolus insulin injection after a meal. We intended to validate the dose of post-meal bolus insulin automatically calculated by the Bolus Wizard Calculator of the Paradigm 722. The subject was a female in her 50's with type 1 diabetes mellitus. She had been introduced to the Paradigm 722 insulin pump therapy during several weeks of hospitalization. The pump settings were three hours of active insulin, a specific carbohydrate-to-insulin ratio (11, 15, 13) g/U and 60 mg/dl/U of insulin sensitivity factor (ISF). We compared the bolus dose of insulin automatically suggested by the Bolus Wizard Calculator and that manually calculated using the ISF, with a targeted blood glucose level of 150 mg/dl at two hours post-meal for one week before leaving hospital. The automatically calculated bolus insulin dose was more suitable than the manually calculated dose seven out of the 14 times it was calculated. The automatic correction program for the bolus insulin for post-meal hyperglycemia included with the Paradigm 722 was equivalent to the conventional manual calculation method, and achieves good glycemic control with just carbohydrate counting.