Diabetes practices and regimens can vary between countries, hospitals / clinics, & specialists.  Therefore what may be encouraged in one setting may not be so recommended in another.  This insulin tutorial is not meant to provide a didactic (regimented / fixed) plan for using insulin.  Rather the tutorial intends to show some ways of doing things, and provide some explanations as to why things may be done in a certain way.  Furthermore it is hoped that this tutorial may encourage people to think a bit more about what insulin regimens are possible, & how they might be improved and / or tailored for an individual.  In all this remember that people's mileage may vary - so what works for one person may not be appropriate for someone else.  Therefore, as with all medical information on the Web, it is important that you consult your doctor or diabetes specialist before considering acting on any of the information discussed in this tutorial.

Insulin Tutorial 2-2
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How do I change the insulin dose?

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.

  1 - 10 units: ±1 unit

11 - 20 units: ±2 units

21 - 30 units: ±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':

The dose of regular insulin can be increased or decreased by 20%

  1 - 10 units: ±2 units

11 - 20 units: ±4 units
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.

Diabetes Insulin Tutorial
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The information presented at this site is for general use only and is not intended to provide personal medical advice or substitute for the advice of your doctor or diabetes specialist. If you have any questions about any of the information presented here, concerns about individual health matters or the management of your diabetes, please consult your doctor or diabetes specialist
The material in this on-line Diabetes / Insulin Tutorial has been drawn from a number of different sources.
However the original Web-based version can be found at the AIDA Website at: http://www.2aida.org/tutorial.

AIDA diabetes software simulator program of glucose-insulin interaction