Insulin Flashcards
What is the recommended starting basal dose and when to give it ?
10 units at bedtime
What is the recommended starting basal starting dose for lean patients <50 kg
0.1-0.2kg/unit
What is the recommended titration for basal insulin ?
1 unit/day
What is Tresiba’s titration ?
2-4 units / week
To titrate safety, what does the person have to do ?
Perform SMBG to check FBG at least once a day
Basal insulin should not be increased if ?
2 episodes of hypoglycemia in 1 week
OR
Any episode of nocturnal hypoglycemia
If fasting hypoglycemia occurs, what should be done ?
Reduce bedtime basal insulin
Can metformin and secretagogues be kept when starting basal insulin ?
Yes, usually unless there’s hypoglycemia during the day
Are metformin and secretagogues kept when starting basal + bolus insulin ?
No. Only metformin is kept
How do you calculate total daily dose of basal + bolus insulin ?
0.5 units/kg
Ex: weight = 100kg
0.5/100kg = 50 units of total daily insulin
What would the distribution be for basal and bolus insulin be from TDI ?
40% basal
60% bolus
What is the calculation of TDI for starting basal + bolus dose of type 1 ?
1 unit/kg
When is basal plus strategy used ?
When intensification of insulin is needed. Starts with adding bolus insulin once a day to either main meal or breakfast
What is the starting dose of basal plus strategy ?
2-4 units or 10% of basal insulin
What should titration be of basal plus ?
1 unit/day
What are 4 main side effects of insulin ?
Hypoglycemia, weight gain (due to decreased glycosuria and basal metabolic rate), allergic reaction, and lipohypertrophy
