MCP๋กœ ์—ฐ๊ฒฐ โ†’

๊ณ„์‚ฐ ์ž…๋ ฅ

๊ณต์‹

๊ด‘๊ณ 

๊ฒฐ๊ณผ

์ถ”์ • ๋ณผ๋ฃจ์Šค ์šฉ๋Ÿ‰
7.6
๋‹จ์œ„์˜ ์†ํšจ์„ฑ ์ธ์А๋ฆฐ
ํƒ„์ˆ˜ํ™”๋ฌผ ์šฉ๋Ÿ‰ 6 units
๊ต์ • ์šฉ๋Ÿ‰ 1.6 units

์ด ๊ฒฐ๊ณผ๋Š” ๊ต์œก์šฉ ์ถ”์ •์น˜์ผ ๋ฟ์ž…๋‹ˆ๋‹ค. ํ•ญ์ƒ ๋ณธ์ธ์—๊ฒŒ ์ฒ˜๋ฐฉ๋œ ์šฉ๋Ÿ‰ ๊ณ„ํš์„ ๋”ฐ๋ฅด๊ณ , ์ธ์А๋ฆฐ ์šฉ๋Ÿ‰์„ ๋ณ€๊ฒฝํ•˜๊ธฐ ์ „์— ๋ฐ˜๋“œ์‹œ ๋‹ด๋‹น ์˜๋ฃŒ์ง„๊ณผ ์ƒ๋‹ดํ•˜์„ธ์š”.

์ด ๊ณ„์‚ฐ๊ธฐ๋Š” ๋ฌด์—‡์„ ํ•˜๋‚˜์š”

์ด ๋„๊ตฌ๋Š” ๋‘ ๊ฐ€์ง€ ์š”์†Œ๋ฅผ ํ•ฉ์ณ ์‹์‚ฌ ์‹œ(๋ณผ๋ฃจ์Šค) ์ธ์А๋ฆฐ ์šฉ๋Ÿ‰์„ ์ถ”์ •ํ•ฉ๋‹ˆ๋‹ค. ํ•˜๋‚˜๋Š” ๊ณง ์„ญ์ทจํ•  ํƒ„์ˆ˜ํ™”๋ฌผ์„ ์ฒ˜๋ฆฌํ•˜๋Š” ๋ฐ ํ•„์š”ํ•œ ์ธ์А๋ฆฐ์ด๊ณ , ๋‹ค๋ฅธ ํ•˜๋‚˜๋Š” ๋†’์•„์ง„ ํ˜ˆ๋‹น์„ ๋ชฉํ‘œ์น˜๋กœ ๋˜๋Œ๋ฆฌ๊ธฐ ์œ„ํ•œ ๊ต์ • ์šฉ๋Ÿ‰์ž…๋‹ˆ๋‹ค. ๊ต์œก ๋ชฉ์ ์œผ๋กœ ๋งŒ๋“ค์–ด์กŒ์œผ๋ฉฐ ์ผ๋ฐ˜์ ์ธ ๋‹จ์œ„(ํƒ„์ˆ˜ํ™”๋ฌผ์€ ๊ทธ๋žจ, ํ˜ˆ๋‹น์€ mg/dL)๋ฅผ ์‚ฌ์šฉํ•ฉ๋‹ˆ๋‹ค. ์˜ํ•™์  ์ง„๋ฃŒ๋‚˜ ์˜๋ฃŒ์ง„์ด ์ฒ˜๋ฐฉํ•œ ์šฉ๋Ÿ‰ ๊ณ„ํš์„ ๋Œ€์‹ ํ•  ์ˆ˜๋Š” ์—†์Šต๋‹ˆ๋‹ค.

์‚ฌ์šฉ ๋ฐฉ๋ฒ•

์‹์‚ฌ์— ํฌํ•จ๋œ ํƒ„์ˆ˜ํ™”๋ฌผ ์–‘(g), ์ธ์А๋ฆฐ-ํƒ„์ˆ˜ํ™”๋ฌผ ๋น„์œจ(ICR โ€” ์ธ์А๋ฆฐ 1๋‹จ์œ„๊ฐ€ ์ฒ˜๋ฆฌํ•˜๋Š” ํƒ„์ˆ˜ํ™”๋ฌผ ๊ทธ๋žจ ์ˆ˜), ํ˜„์žฌ ํ˜ˆ๋‹น๊ณผ ๋ชฉํ‘œ ํ˜ˆ๋‹น, ๊ทธ๋ฆฌ๊ณ  ์ธ์А๋ฆฐ ๋ฏผ๊ฐ๋„ ๊ณ„์ˆ˜(ISF โ€” ์ธ์А๋ฆฐ 1๋‹จ์œ„๊ฐ€ ํ˜ˆ๋‹น์„ ๋ช‡ mg/dL ๋‚ฎ์ถ”๋Š”์ง€)๋ฅผ ์ž…๋ ฅํ•˜์„ธ์š”. ๊ณ„์‚ฐ๊ธฐ๋Š” ์ถ”์ • ๋ณผ๋ฃจ์Šค ์ด๋Ÿ‰๊ณผ ํ•จ๊ป˜ ํƒ„์ˆ˜ํ™”๋ฌผ ์šฉ๋Ÿ‰๊ณผ ๊ต์ • ์šฉ๋Ÿ‰์„ ๊ฐ๊ฐ ๋ณด์—ฌ์ค๋‹ˆ๋‹ค.

๊ณต์‹ ์„ค๋ช…

๋ณผ๋ฃจ์Šค๋Š” ๋‘ ๋ถ€๋ถ„์˜ ํ•ฉ์ž…๋‹ˆ๋‹ค.

ํƒ„์ˆ˜ํ™”๋ฌผ ์šฉ๋Ÿ‰ = ํƒ„์ˆ˜ํ™”๋ฌผ รท ICR, ๊ทธ๋ฆฌ๊ณ  ๊ต์ • ์šฉ๋Ÿ‰ = (ํ˜„์žฌ ํ˜ˆ๋‹น โˆ’ ๋ชฉํ‘œ ํ˜ˆ๋‹น) รท ISF์ž…๋‹ˆ๋‹ค. ํ•ฉ๊ณ„๋Š” ๋‹ค์Œ๊ณผ ๊ฐ™์ด ๋ฉ๋‹ˆ๋‹ค.

$$\text{๋‹จ์œ„} = \dfrac{\text{ํƒ„์ˆ˜ํ™”๋ฌผ}}{\text{ICR}} + \dfrac{\text{ํ˜„์žฌ ํ˜ˆ๋‹น} - \text{๋ชฉํ‘œ ํ˜ˆ๋‹น}}{\text{ISF}}$$

ํ˜ˆ๋‹น์ด ๋ชฉํ‘œ์น˜๋ณด๋‹ค ๋‚ฎ์œผ๋ฉด ๊ต์ • ํ•ญ์ด ์Œ์ˆ˜๊ฐ€ ๋˜์–ด ๋ณผ๋ฃจ์Šค๊ฐ€ ์ค„์–ด๋“ญ๋‹ˆ๋‹ค. ๊ฒฐ๊ณผ๊ฐ’์€ 0์—์„œ ๋ฉˆ์ถ”๋„๋ก ์ฒ˜๋ฆฌ๋˜์–ด ์Œ์ˆ˜ ์šฉ๋Ÿ‰์„ ์ œ์•ˆํ•˜์ง€ ์•Š์Šต๋‹ˆ๋‹ค.

๊ด‘๊ณ 
Diagram showing a mealtime insulin bolus as the sum of a carb-coverage dose and a correction dose
A mealtime bolus combines a carb-coverage dose (carbs รท ICR) and a correction dose ((current โˆ’ target BG) รท ISF).

๊ณ„์‚ฐ ์˜ˆ์‹œ

ํƒ„์ˆ˜ํ™”๋ฌผ 60g์„ ์„ญ์ทจํ•˜๊ณ  ICR์ด 10g/๋‹จ์œ„, ํ˜„์žฌ ํ˜ˆ๋‹น์ด 180 mg/dL, ๋ชฉํ‘œ๊ฐ€ 100 mg/dL, ISF๊ฐ€ 50 mg/dL/๋‹จ์œ„๋ผ๊ณ  ๊ฐ€์ •ํ•ด ๋ด…์‹œ๋‹ค. ํƒ„์ˆ˜ํ™”๋ฌผ ์šฉ๋Ÿ‰ \(= 60 \div 10 = 6\)๋‹จ์œ„. ๊ต์ • ์šฉ๋Ÿ‰ \(= (180 - 100) \div 50 = 1.6\)๋‹จ์œ„. ์ดํ•ฉ:

$$6 + 1.6 = \mathbf{7.6}\ \textbf{๋‹จ์œ„}$$
Number line of blood glucose showing current level above target and the gap that the correction dose covers
The correction portion of the bolus lowers blood glucose from the current level toward the target.

์ž์ฃผ ๋ฌป๋Š” ์งˆ๋ฌธ

ํƒ„์ˆ˜ํ™”๋ฌผ ๋น„์œจ(ICR)์ด๋ž€ ๋ฌด์—‡์ธ๊ฐ€์š”? ์†ํšจ์„ฑ ์ธ์А๋ฆฐ 1๋‹จ์œ„๊ฐ€ ์ฒ˜๋ฆฌํ•˜๋Š” ํƒ„์ˆ˜ํ™”๋ฌผ์˜ ๊ทธ๋žจ ์ˆ˜์ž…๋‹ˆ๋‹ค. ๋น„์œจ์ด 1:10์ด๋ฉด 10g๋‹น 1๋‹จ์œ„๋ผ๋Š” ๋œป์ž…๋‹ˆ๋‹ค.

ISF๋ž€ ๋ฌด์—‡์ธ๊ฐ€์š”? ์ธ์А๋ฆฐ ๋ฏผ๊ฐ๋„(๊ต์ •) ๊ณ„์ˆ˜๋กœ, ์ธ์А๋ฆฐ 1๋‹จ์œ„๊ฐ€ ํ˜ˆ๋‹น์„ ์–ผ๋งˆ๋‚˜ ๋‚ฎ์ถ”๋Š”์ง€๋ฅผ ๋‚˜ํƒ€๋ƒ…๋‹ˆ๋‹ค. ์˜ˆ๋ฅผ ๋“ค์–ด 1๋‹จ์œ„๋‹น 50 mg/dL ๊ฐ™์€ ์‹์ž…๋‹ˆ๋‹ค.

์ด ๊ฒฐ๊ณผ๋งŒ ๋ฏฟ๊ณ  ์šฉ๋Ÿ‰์„ ์ •ํ•ด๋„ ๋˜๋‚˜์š”? ์•ˆ ๋ฉ๋‹ˆ๋‹ค. ์ด๊ฒƒ์€ ๊ต์œก์šฉ ์ถ”์ •์น˜์ผ ๋ฟ์ž…๋‹ˆ๋‹ค. ์ฒด๋‚ด ์ž”์—ฌ ์ธ์А๋ฆฐ(IOB), ์šด๋™, ์งˆ๋ณ‘ ๋“ฑ ์—ฌ๋Ÿฌ ์š”์ธ์ด ์˜ํ–ฅ์„ ๋ฏธ์นฉ๋‹ˆ๋‹ค. ๋ฐ˜๋“œ์‹œ ๋‹ด๋‹น ์˜๋ฃŒ์ง„์˜ ์ง€์นจ์„ ๋”ฐ๋ฅด์„ธ์š”.

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