Insulin Adjustments
Glucose values for this time of day should be first to target when glucose levels are elevated at many time periods during the day
What is fasting glucose level?
Type of insulin that is generally titrated only once weekly
What is icodec (700units/mL)?
Bolus titrations are, perhaps, more efficient when glucose levels are within target at these time intervals?
What is fasting and preprandial glucose levels?
Formula which is a starting point for determining ICR when someone wishes to move from fixed bolus doses to bolus doses based on ICR.
What is # grams carbohydrates divided by # units of insulin?
When correction boluses are administered more often than every 2-4 hours, individuals may experience the effect of this
What is insulin stacking?
When addressing concerns with both hyperglycemia and hypoglycemia, ______ should be dealt with first
What is hypoglycemia?
Type of insulin that can either be adjusted by 2 units every 3-4 days or by 4 units weekly?
What is degludec (either concentration of 100-200 units/mL)?
Bolus insulin doses can be calculated using one of these two methods?
What is fixed dose bolus and insulin to carbohydrate ratio?
This formula is commonly known as ...
ICR = 500/TDD
What is "500 rule"?
Insulin Sensitivity Factor is described as the glucose lowering effect of 1 unit of insulin over this amount of hours
What is 2-4 hours?
When working with individuals dealing with this concern, an appropriate strategy would be to determine the cause and lower the appropriate insulin by 10-20%
What is hypoglycemia?
More frequent titration of longer acting insulins can lead to these concerns
What is hypoglycemia?
This method of titration may be used when using fixed dose boluses?
If using short acting insulin (as opposed to rapid acting insulin), the 500 rule calculation would change to this
What is 450/TDD?
This formula is used to calculate the ISF of a person using rapid insulin
What is 100/TDD?
Caution: this may be different in pregnancy!!
What is 1?
Basal insulin is titrated to reach the target of this glucose level and at this time of day?
What is fasting glucose level between 4 and 7 mmol/L?
Bolus insulin should be titrated to reach these targets
What is 2 hour postprandial value of between 5 and 10 mmol/L AND/OR fasting and preprandial value of between 4 and 7 mmol/L?
Case study:
Patient Minnie Mouse is using an ICR of 1:10 for all meals and having issues with hypoglycemia after meals.
Recommend a safe, new ICR
What is 1:11 or 1:12?
This formula is used to calculate the ISF of a person using short acting insulin
What is 83/TDD?
Method of patient-led insulin adjustment that is associated with improved glucose values
What is self-titration?
Titration of intermediate acting insulins and longer acting insulins (with lower concentrations) can generally be titrated at this rate
What is 1 unit daily OR 1-2 units every 2-3 days OR 20% every 2-3 days?
Case study:
Tabby Cat takes 10 units of rapid insulin at lunch (using fixed dose) and postprandial glucose values are above target.
Tabby Cat can be safely recommended to increase her dose to this range of insulin?
What is 11-12 units rapid insulin?
Total number units of insulin taken in one day (regardless of type of insulin) is commonly known as this
What is Total Daily Dose [TDD]?
Insulin dose that is administered in addition to regular bolus dose when glucose levels are above target levels prior to meal
What is correction dose?