How do I start my insulin weight?
(See Glucose Management Algorithm).
- Step 1: Start Basal insulin. Start basal insulin 10 units or 0.1-0.2 units/kg daily or divided BID.
- Step 2: Add Bolus insulin before largest meal. Start bolus insulin 4 units or 0.1 units/kg or 10% of basal insulin dose before largest.
- Step 3: Add Bolus insulin before other meals.
How many units of insulin should I take per body weight?
Use the patient’s weight, body habitus or diabetic status. 0.4 units/kg/day for a patient at normal weight; 0.5 units/kg/day for overweight patients; and. 0.6 units/kg/day or more for patients who are obese, on high-dose steroids or insulin-resistant.
How do you start NPH insulin?
Step 1 – start with long-acting insulin or bedtime NPH
- Initial dose: 10 units/day or 0.1 – 0.2 units/kg/day.
- Adjust dose: increase dose by 10 – 15% or 2 – 4 units once or twice weekly to achieve fasting blood sugar goal (see adjusting basal insulin and NPH dosing for more)
When do you start insulin guidelines?
The American Diabetes Association (ADA) recommends initiation of basal insulin at 10 units/day or 0.1–0.2 units/kg/day, adjusted by 10–15% or 2–4 units once or twice weekly to reach a target fasting plasma glucose (FPG) in patients whose A1C remains uncontrolled after >3 months of triple combination therapy, whose A1C …
When should insulin be initiated?
Insulin should be initiated when A1C is ≥7.0% after 2–3 months of dual oral therapy. The preferred regimen for insulin initiation in type 2 diabetes is once-daily basal insulin. In addition to timely initiation, rapid titration of the dose is indispensable for successful insulin therapy.
Do you draw up NPH or regular insulin first?
Always draw up regular (clear) insulin before NPH (cloudy). Put the needle in the bottle of regular (clear) insulin. Turn the bottle and syringe upside down. The bottle will be on top.
How do you start a Humulin 70 30?
HUMULIN 70/30 is injected under the skin (subcutaneously) of your stomach area (abdomen), buttocks, upper legs or upper arms. Wipe the skin with an alcohol swab. Let the injection site dry before you inject your dose.
When should insulin be started in type 2 diabetes?
The American College of Endocrinology and the American Association of Clinical Endocrinologists recommend initiation of insulin therapy in patients with type 2 diabetes and an initial A1C level greater than 9 percent, or if the diabetes is uncontrolled despite optimal oral glycemic therapy.
What blood sugar is too low to give insulin?
Hypoglycemia needs immediate treatment. For many people, a fasting blood sugar of 70 milligrams per deciliter (mg/dL), or 3.9 millimoles per liter (mmol/L), or below should serve as an alert for hypoglycemia.
How do you calculate insulin ratio?
Practice using an insulin-to-carb ratio
- Divide your total grams of carbohydrate by your ratio of 10. So 55 ÷ 10 = 5.5.
- Your breakfast dose will be 5.5 units of rapid-acting insulin.
How many units are in 1 mL of insulin?
Insulin is measured in International Units (units); most insulin is U-100, which means that 100 units of insulin are equal to 1 mL.
Why is regular insulin drawn first?
When preparing to administer two types of insulin in the same syringe, the nurse draws up the regular insulin first and then the NPH insulin. The regular insulin is drawn into the syringe first to prevent contamination of the regular insulin with the NPH insulin.
How many units of insulin do I need for my weight?
TOTAL DAILY INSULIN DOSE = 160 lb ÷ 4 = 40 units of insulin/day. Example 2: If you are measuring your body weight in kilograms: Assume your weight is 70Kg ; In this example: TOTAL DAILY INSULIN DOSE = 0.55 x 70 Kg = 38.5 units of insulin/day. If your body is very resistant to insulin, you may require a higher dose.
How do you titrate insulin for type 2 diabetes?
Regimen 2: Begin prandial insulin before each meal with a 50% basal/50% prandial ratio to achieve a TDD of 0.3–0.5 units/kg, starting at 50% of the TDD in three divided doses before meals. FIGURE 2. AACE-recommended approach to initiating and titrating insulin in type 2 diabetes.
What is your insulin dose regimen?
Your insulin dose regimen provides formulas that allow you to calculate how much bolus insulin to take at meals and snacks, or to correct high blood sugars. Approximately 40-50% of the total daily insulin dose is to replace insulin overnight, when you are fasting and between meals.
How do you calculate basal insulin dose?
Basal/background Insulin Dose = 40-50% of Total Daily Insulin Dose . Example. Assume you weigh 160 pounds; Your total daily insulin dose (TDI) = 160 lbs ÷ 4 = 40 units. In this example: Basal/background insulin dose = 50% of TDI (40 units) = 20 units