Switching Insulins 1
When making a switch with these types of insulin, dose adjustments are usually not required
What is once daily basal insulin?
Icodec doses are rounded the nearest (give #) units
This type of antihyperglycemic medication should not be used in combination with insulin
In general, when intensifying insulin regime, this insulin type of insulin is adjusted first
What is basal insulin?
Patients with symptomatic hyperglycemia may present with these symptoms.
What is polyuria, polydipsia, polyphyagia (3 P's), blurred vision, fatigue and recurring infections?
When switching from twice daily basal insulin to a once daily basal insulin, the number of units administered should be decreased by this amount (percentage)
What is 20 percent?
This formula can be used when switching from once weekly insulin to daily insulin
What is total weekly dose divided by 7?
Patients diagnosed with T2DM are sometimes initially managed with insulin. Once acute hyperglycemia has resolved, patients who are stable on less than (give number) units of daily insulin can likely taper insulin and be managed with non-insulin therapies
What is 25-35 units?
If insulin regime is to be switched from less intensive regime to BBI therapy in one visit, the TDD should be decreased by this amount (percentage)
What is 10-20%?
The addition of non-insulin antihyperglycemic therapies may help to reduce (side effect), which is more common with insulin use.
What is weight gain?
When switching from once daily long acting insulin to a twice daily intermediate acting insulin, doses can be split be either of these ratios
What is 50/50 OR 2/3 in the morning and 1/3 at dinner/HS?
If switching from weekly insulin to daily basal insulin, the first dose should generally be administered (give #) weeks after the last dose of weekly insulin
What is 2?
When adding bolus insulin, these types of medication are typically weaned or discontinued?
What are sulfonylureas, meglitinides and DPP-4i?
When switching to BBI therapy, basal requirements are generally 40-60% of TDD. Leaning towards 40% may be helpful for patients experiencing this.
What is fear of or actual hypoglycemic events?
Antihyperglycemic medications with the suffix "tide" belong to this medication class
What is GLP-1 RA?
This formula is used to calculate dose when starting icodec (700 units/mL)
What is current basal daily dose x 7?
Switching between these two types of bolus insulins generally do not require dose adjustments
What is rapid acting insulin and short acting insulin?
These types of non-insulin antihyperglycemics are known for having cardiorenal benefits
What are SGLT2i and GLP-1 RA?
When switching to BBI therapy, basal requirements are generally 40-60% of TDD. Leaning towards 50-60% may be helpful for patients experiencing this.
What is consistent or significant hyperglycemia?
Tabby Cat would like to switch from a less intensive insulin regime to BBI therapy in one visit.
Current doses are Humulin R 20 units in AM and at HS, Humalog 4 units at breakfast
A safe recommendation for her new TDD includes
20+20+4=44 units [TDD]
TDD/10-20% = 35-40 units [new TDD]
What is 35-40 units?
When starting icodec (700 units/mL), a one time increased dose is used as the first dose. If using this one time dose, it is generally (give number) x the calculated weekly dose
What is 1.5?
If switching between rapid and bolus insulins, teaching should be provided around this important topic
What is timing of injections?
If adding SGLT2i or GLP-1 RA to insulin therapy, basal insulin dose should be decreased by this amount (give percentage)
What is 20%?
When switching to BBI therapy, bolus requirements can be calculated by either of these two methods
What is TDD - basal dose then divide this dose between meals OR ICR?
Recommend a safe starting dose
20+20=40 units
40/20% = 32 units
What is 32 units?