Insulin Tutorial 2-2

When you have looked at the results of your urine and blood sugar tests and come to the conclusion that the insulin dose has got to be changed, you must ask yourself the following questions:

1. Should the dose be increased or decreased?

Next you must ask:
2. By how many units must the dose be increased or decreased?

If you are having insulin injections in the evenings and in the mornings you must also ask:
3. Must the increase or decrease be made in the morning or in the evening?

First of all we will try to answer Question No. 2:

The general 'rule' which normally applies is that you can increase or decrease the dose of insulin by about 10% of the dose which you usually inject;

that means
if you inject 10 units, by 1 unit,
if you inject 20 units, by 2 units,
if you inject 30 units, by 3 units,
and so on.

"And if the dose is something in between?" You're quite right, let's try to formulate the rule more precisely:

If you give 10 units or less in each injection, change the dose by 1 unit.

If you give between 11 and 20 units in each injection, change it by 2 units.

If you give between 21 and 30 units in each injection, change it by 3 units.

This 'rule' best applies to long-acting and premixed insulin preparations: in other words to insulin preparations which consist solely or mainly of long-acting insulin.

For regular insulin there is another general 'rule':

There are also different 'rules' governing the frequency of dose changes.

The dose of long-acting insulin should be changed as seldom as possible.

The dose of regular insulin can be altered more frequently. It has to be adjusted to meet the continual change in the metabolic situation.

Let's try to answer Questions Nos. 1 and 3 with the aid of a few examples.

However, please do not adjust your own therapy without discussing this first with your doctor / health-carer.