Patient should generally have received at least 12 to 24 hours of currently ordered insulin regimen prior to adjustments
Changes in patient status or medications may require adjustment less than 12 hours after initiation of regimen
Adjust basal insulin regimen based on fasting blood glucose
Fasting Blood Glucose (mg/dL) | Basal Insulin Dose Adjustment |
---|---|
<70 | Decrease by 20% |
70-100 | Decrease by 10% |
100-180 | No change |
180-250 | Increase by 10% AND add 50% of correction within previous 24 hrs |
250-350 | Increase by 15% AND add 50% of correction within previous 24 hrs |
>350 | Increase by 20% AND add 50% of correction within previous 24 hrs |
Adjust bolus/pre-prandial insulin regimen based on average pre-prandial blood glucose
Divide new total bolus insulin into 3 even doses (scheduled with meals)
Average Pre-Prandial Blood Glucose (mg/dL) | Total Bolus Insulin Dose Adjustment |
---|---|
<70 | Decrease by 20% |
70-100 | Decrease by 10% |
100-180 | No change |
180-250 | Increase by 10% AND add 50% of correction within previous 24 hrs |
250-350 | Increase by 15% AND add 50% of correction within previous 24 hrs |
>350 | Increase by 20% AND add 50% of correction within previous 24 hrs |
Add total bolus doses and total basal dose
New TDD should NOT exceed 25% increase from previous TDD