Table 7 Adjustment of insulin therapy
Rapid-acting insulin | Long-lasting basal insulin | ||
|---|---|---|---|
3 methods for adjusting rapid-acting insulin | Â | ||
Retrospective ( sliding scale ) - the simplest- given dose according to pre-prandial blood glucose | Anticipatory | Functional | Only when pre-prandial glucose >1.20 g/L or when the patient loses weight |
- insulin dose according to postprandial glycaemia observed at the same time on preceding days. | - insulin dose based on counting carbohydrates - complex | - usually 2 detemir injections | |
- or a single glargine injection in the evening at a total dose of 0.3 to 0.5 U/kg/day. | |||
- more complex to use but | - poorly suited to transient insulin therapy | - Any increase in pre-prandial glycaemia (particularly in the morning) >1.50 g/L necessitates an increase of 2 to 4 units in the dose of slow-acting insulin relative to the previous day. | |
- more appropriate if steroids use | Â | Â | |