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Terms in this set (31)

Calculate daily dose (0.5 unit of insulin per kilogram per day).

Give 50% as basal insulin. Perform dose titration to FBG values.

Give 50% as bolus insulin. Split into three mealtime doses.

Example: 80-kg patient starting multiday injection therapy:
0.5 unit/kg = 40 units of insulin/day; half as basal, half as bolus, with the following:(1)Glargine or detemir 20 units every day
(2)Aspart or glulisine, lispro 6 units prebreakfast(3)Aspart or glulisine, lispro 7 units prelunch(4)Aspart or glulisine, lispro 7 units predinner

(5)Titrate insulin doses to BG values.

(d)Correctional insulin dosing - Meant to correct for premeal glycemic excursions.

Premeal algorithm is as follows:(1)Rapid-acting insulin (the rule of 1800): 1800/current total daily insulin dose = mg/dL change/1 unit (e.g., 40 units/day: 1800/40 = 45 mg/dL [insulin sensitivity]).

Titrate according to the following algorithm:Glucose reading Change to be made to insulin dose< 80 mg/dL
Subtract 1 unit80-125 mg/dL

Usual premeal dose(fixed or based on carbohydrate intake)126-170 mg/dLAdd 1 unit171-215 mg/dLAdd 2 units216-260 mg/dLAdd 3 units

Regular insulin (the rule of 1500): 1500/current total daily insulin dose = mg/dL change/1 unit (e.g., 50 units/day: 1500/50 = 30 mg/dL [insulin sensitivity]). Titrate according to the following algorithm

Establishing an insulin/carbohydrate ratioInsulin/carbohydrate ratio (the rule of 500) - This requires extensive patient education on counting carbohydrates and may be used to estimate the early use of rapid-acting insulins at mealtime to prospectively cover what is to be ingested. 500/daily insulin dose = insulin/carbohydrate ratio. (e.g., 50 units/day: 500/50 = 10. Insulin/carbohydrate ratio = 1 unit for 10 g of carbohydrates.)