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Chapter 18 My Information
18
This chapter provides tables and forms to record various information needed for
programming your pump. Consult your healthcare team for correct information for your
personal treatment plan.
Insulin to Carb Ratios (I:C)
Daily Time Slot
My I:C ratio
4am – 10am
10am – 4pm
4pm – 10pm
10pm – 4am
BG Targets
Time of Day
My BG target
Fasting (morning)
Before meal
After meal
Before bedtime
Insulin Sensitivity Factor (ISF)
Time of Day
My ISF
Daytime
Bedtime
Temp Basal Rate Decrease for Activity
Activity Type
% Decrease
Set Temp
in advance of
activity (yes or no)
Minutes
to set in
advance
Light (gardening, walking, shopping)
Moderate (leisurely biking, golf {no cart})
Strenuous (basketball, jogging, swimming)
Sustained (ice skating, rowing, hiking)
My duration for Insulin on Board is:
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