how much insulin to take

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Using U-500 Insulin | Clinical DiabetesDiabetes Teaching Center at the University of California, San FranciscoLanguagesSearchCalculating Insulin Dose You will need to calculate some of your insulin doses. You'll also need to know some basic things about insulin. For example, 40-50% of the total daily insulin dose is to replace insulin at night. Your provider will prescribe an insulin dose regimen; however, you still need to calculate some of your insulin doses. Your insulin dose regimen provides formulas that allow you to calculate how much insulin bowls you take in meals and snacks, or correct high blood sugars. In this section you will find: First, some basic things to know about insulin: Bolus – Carbohydrate Coverage The dose of bolt for food coverage is prescribed as an insulin to the ratio of carbohydrates. The insulin-carbohydrate ratio represents how many grams of carbohydrates are covered or eliminated by 1 insulin unit. In general, a fast-acting insulin unit will be disposed of 12-15 grams of carbohydrates. This range can vary from 6-30 grams or more carbohydrates depending on an individual's sensitivity to insulin. Insulin sensitivity can vary from time to day, from person to person, and is affected by physical activity and stress. Bolus – High Blood Sugar Correction (also known as insulin sensitivity factor) The dose of bolt for high blood sugar correction is defined as how much a fast-acting insulin unit will drop sugar in the blood. Generally, to correct a high blood sugar, an insulin unit is needed to drop glucose in the blood at 50 mg/dl. This drop of blood sugar can vary from 30-100 mg/dL or more, depending on the individual insulin sensitivities, and other circumstances. Examples:Read some examples and therapeutic principles on how to calculate the dose of carbohydrate coverage, doses of high blood sugar correction and the total dose of insulin. Example #1: Carbohydrate Coverage in a Food First, you should calculate the insulin dose of carbohydrate coverage using this formula: CHO insulin dose = Total CHO in the food ÷ grams of CHO arranged by 1 insulin unit (CHO grams arranged by 1 insulin unit is the lower number or denominator of the Insulin ratio). For example #1, assume: To get the insulin dose of the CHO, plug the numbers in the formula: insulin dose of PAHO = total PAHO levels in food (60 g) ÷ grams of PAHO arranged by 1 insulin unit (10) = 6 units You will need 6 units of fast insulin to cover the carbohydrate. Example #2: blood sugar correction doseNext, you have to calculate the dose of high blood sugar correction. High blood sugar correction dose = Difference between real blood sugar and target blood sugar* ÷ correction factor.* Real blood sugar minus target blood sugarFor example #2, assume: Now, calculate the difference between your real blood sugar and target blood sugar:220 minus 120 mg/dl = 100 mg/dl To get the insulin dose of high blood sugar correction, plug the numbers in this formula: Correctional dose = Difference between real and target blood glucose (100mg/dl) = 2 units of fast action insulin Therefore, you will need 2 additional units of quick-acting insulin to "cut" blood sugar to a target of 120 mg/dl. Example #3: Total dose of food time Finally, to get the total dose of insulin of food time, add the insulin dose of PAHO along with the insulin dose of blood sugar correction: CHO Insulin dose + High blood sugar correction dose = Total insulin dose For example #3, assume:Now, add the two doses together to calculate the total dose of insulin. Carbohydrate coverage dose (6 units) + high sugar correction dose (2 units) = 8 units total dose of food! The total insulin dose of lunch is 8 units of fast insulin. Example #4: Formulas commonly used to create insulin dose recommendations This example illustrates a method for calculating the dose of substance/basal and bolt and the estimated daily dose of insulin when you need full insulin replacement. Note that this can be too much insulin if you are recently diagnosed or still doing a lot of insulin on your own. And it can be very little if you are very resistant to insulin action. Talk to your provider about the best dose of insulin for you as this is a general formula and may not meet your individual needs. The initial calculation of the basal/back and screw doses requires estimating your daily total dose of insulin: Total daily insulin requirements: The general calculation for the daily insulin requirement of the body is: Total daily insulin requirement (in insulin units) = Pound weight 4Alternatively, if you measure your body weight in kilograms: Total insulin requirement If your body is insulin sensitive, it may require a lower dose of insulin. Baseline/background and Bolus Insulin dose Afterwards, you must set the basal/background dose, the dose of carbohydrate coverage (insulin for carbohydrate ratio) and the high dose of blood sugar correction (correction factor). Basal/background insulin dose: Basal/background Insulin dose = 40-50% of the total daily insulin dose Example: In this example:Basal/background insulin dose = 50% TDI (40 units) = 20 long-acting insulin units (such as glargine or detemir) or quick-acting insulin if you are using a insulin pump (subcutaneous infusion device). The ratio of carbohydrate coverage:500 ÷ Total daily insulin dose = 1 insulin unit covers so many grams of carbohydrates This can be calculated using the "500" Rule: Bolus Carbohydrates Calculation In this example :Carbohydrates coverage ratio = 500 ÷ TDI(40 units) = 1unit insulin/ 12 g CHOThis example above assumes that you have a constant response to insulin throughout the day. In fact, the individual sensitivity of insulin varies. Someone who is resistant in the morning, but sensitive at noon, will have to adjust the insulin-carbohydrate ratio at different moments of food. In such a case, the insulin dose of the fund would still be approximately 20 units; however, the insulin-carbohydrate breakfast ratio could be breakfast 1:8 grams, lunch 1:15 grams and dinner 1:12 grams. Insulin to carbohydrates may vary during the day. Insulin to carbohydrates may vary during the day. Blood sugar correction factor: Correction factor = 1800 ÷Total of the daily insulin dose = 1 insulin unit will reduce blood sugar as many mg/dl This can be calculated using the "1800" Rule. Example: In this example: Correction factor = 1800 ÷ TDI (40 units) = 1 insulin unit will reduce the blood sugar level by 45 mg/dlWhile the calculation is 1 unit will lower the blood sugar 45 mg/dl, so it is easier than most people round or round the number so that the suggested correction factor can be 1 insulin mg/dl. Please note that the estimated insulin regimen is an initial "best guess" and the dose may need to be modified to keep your blood sugar in the target. In addition, there are many variations in insulin therapy. You will need to meet your specific insulin requirements and dose regimen with your health care provider and diabetes equipment. Self-assessment Quiz are available for covered topics on this website. To know how much you've learned about Type 1 Diabetes Treatment, take ours when you've completed this section. The test is a multiple option. Please choose the best answer to each question. At the end of the test, your score will appear. If your score is over 70% correct, you're doing very well. If your score is below 70%, you can return to this section and review the information. Types of Diabetes ©2007-2021 Collective work Martha Nolte Kennedy, Regents of the University of California. All rights reserved.

Top navigation MenuAccountMoreExplore Health.com Explore Health conditions A-Z News Diet and nutrition Fitness Beauty Mind " Body " Lifestyle Profile menuAcuentaMore How much does insulin need? Getty Images If you have and your doctor thinks it may be a good time to start, there are two important factors to consider: How much insulin do you need to take? When do you need to take it? And they're both very personal. "You can't paint everyone with type 2 diabetes with the same brush," says Mark Feinglos, MD, chief of division of endocrinology, metabolism and nutrition at Duke University School of Medicine, Durham, N.C. "You need to adapt the regime to the needs of an individual. "A person with type 2 diabetes can start in half of an insulin unit per kilogram of body weight a day, especially if you don't know much about the nature of your diabetes. However, it is not unusual to need more like a unit, says Dr. Feinglos. (One unit per kilogram would be 68 units per day for someone weighing 150 pounds, which is approximately 68 kilograms.) Much depends on your specific health situation. People with type 2 diabetes suffer from insulin resistance, in which the body loses its ability to use the hormone properly. At the beginning of the disease, insulin-producing cells in the pancreas respond to insulin resistance by getting even more out of the hormone. Over time, however, insulin production decreases. Taking insulin can help you overcome body insulin resistance, although many factors can affect your dose. If your body is still insulin-sensitive, but the pancreas is no longer making much insulin, for example, Dr. Feinglos says you would require less insulin than someone who is really insulin resistant." But the most important issue is not necessarily how much you need to take," he adds. "Beyond, it's time for you to take. Time is all. "Next Page: [ Pagebreak One shot a day or more? If you wake up with high blood sugar in the morning, you will most likely need at least one shot of once a day combined with oral medications, says Dr. Feinglos. Oral medication can reduce insulin resistance, and a long-acting insulin injection (usually taken at bedtime) can mimic the low level of insulin done by the pancreas. (And the shots may not be how you imagine them, painful and complicated. You can use pen-like injectors that have short and thin needles and that allow you to mark the amount of insulin you require, instead of pulling it out of a jar using a syringe.) A shot a day or more? If your blood sugar tends to bite after meals despite using medications and seeing what you eat, you may need to take a quick-acting insulin dose before each meal. "There is controversy about how much better you can do with other shots," says John Buse, MD, PhD, director of the Diabetes Care Center at the University of North Carolina Medical School, Chapel Hill. "I don't see much improvement in overall glucose control in many patients with rapid action insulin taken in meals. And it promotes weight gain and low blood sugar. Is the burden worth the benefit? "A prolonged action formulation once a day is usually the best way to start, according to Dr. Buse. A standard initial dose could be 10 units. The dose is then increased until blood sugar levels are reduced to normal range. "If a person still has a substantial insulin secretion left in his pancreas, a daily shot is probably more than enough to overcome it," says Robert Rizza, MD, a professor of medicine and an executive dean of research at the Mayo Clinic in Rochester, Minn. "But if you're really running out of insulin and you can't store it between meals, then you may need to take both long and short action injections. "Next Page: [Pulse of page]Take insulin with meals If you end up taking insulin at meals, doctors agree that it is particularly important to match food intake with insulin, while physical activity is also accounted for. (Exercise naturally decreases blood sugar, so if you're working, you may need to keep it in mind.) Taking insulin with meals"Some people recommend that insulin coincide with carbohydrate counts," says Dr. Buse. "Others suggest eating a portion of carbohydrates in each meal for a particular dose of insulin." Even more crucial, according to Dr. Feinglos, is moderating food intake before insulin is started. "If you don't first control the calories, and start giving insulin," he warns, "then all a patient will do is gain weight and get more resistant insulin and finish needing larger insulin doses. "It can be a vicious cycle. "The relationship between food and exercise with medicine is so critical in diabetes," he adds. "If you keep spilling medicine into the problem, it doesn't really solve it. "It can be a vicious cycle. However, a patient can do everything right — eat well, work and take his medicine routinely — but still requires more insulin over time due to the progressive nature of the disease. Adjustments can reach through higher doses, higher frequency of injections, or both. In a positive note, with improved diet and exercise, some patients may reduce their consumption, even to the point of leaving insulin injections aside. "There are multiple ways to get to the same point," says Dr. Rizza. "The lower line is to keep sugar in the normal blood. "Participation options Log in Magazines & More informationConnectOther Meredith Sites View image

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