Insulin Dosage

Distribution for intensive insulin management is often 50% basal insulin dose and 50% bolus insulin dose. The basal insulin dose should be split-60% of the insulin should be given in the am and 40% in the pm. Basal insulin is administered via continuous infusion or use of long acting insulin, while bolus dosing is done with short acting insulin with food ingestion.

General rule for bolus doses: The total daily dose of bolus insulin should be about half of the total daily dose of insulin. For example, the total daily dose of 45 units should include 20 to 22 units of bolus insulin.

Adjusting Insulin

Insulin should only be adjusted by people with diabetes if they have been instructed in some system using blood glucose patterns. It is important to know target blood glucose and keep accurate blood glucose test records and look for repeating patterns. Also, determine which insulin to adjust based on your blood glucose patterns.

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General rules for adjusting regular human insulin or rapid-acting human insulin analog.

• Pre-breakfast readings: dinner or bedtime basal insulin.
• Pre-lunch readings: breakfast regular or rapid-acting bolus.
• Pre-dinner readings: lunch regular or rapid-acting bolus and/or breakfast basal.
• Bedtime readings: dinner regular or rapid-acting bolus.
• 3 am readings: dinner or bedtime basal

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