3614-BD Insulin Adjust Workbook

Insulin Adjustment and
Pattern Management –
Adjusting insulin doses based on a
pattern of blood glucose readings over
three days or more is called “Pattern
Management,” or “Pattern Control.”
If your blood glucose is too high or too
low at certain times of the day or night,
an adjustment to your insulin dose may
be needed. In this case it is helpful to
look for patterns in your blood glucose
readings over three days or more. For
example, take a look at Jean’s blood
glucose readings before dinner for the
past three days:
JEAN’S THREE-DAY BLOOD GLUCOSE RECORD
(Goal 90 mg/dl-130 mg/dl)
Breakfast Lunch Dinner Bedtime
98 mg/dl 129 mg/dl 250 mg/dl 150 mg/dl
89 mg/dl 105 mg/dl 225 mg/dl 111 mg/dl
102 mg/dl 88 mg/dl 240 mg/dl 138 mg/dl
You can see that her dinner numbers are all
too high. The problem may be related to
how much carbohydrate (carb) she ate at
lunch, snacking, schedule or basal insulin.
However, it is most likely that her food at
lunch did not match her pre-lunch bolus.
She ate too much carb for her insulin bolus
dose. For more information on Pattern
Control or Pattern Management, see the
BD Publication: Pattern Control.
Insulin Sensitivity Factor
(ISF) and Correction –
• ISF is the amount that one unit of
rapid- or short-acting insulin will
lower your blood glucose reading.
It is used to calculate your correction
or supplemental dose.
• Correction dose is the amount of
insulin you need to correct a high
blood glucose level and bring it into
the range your blood glucose should
fall into most of the time.
Once you know your ISF, you can give
yourself the right dose of insulin to keep
you within your blood glucose goals. The
ISF is different for different people and
your Diabetes Team will help determine
it for you. For instance, if your blood
glucose at lunch is 200 mg/dl and your
goal is 90-130 mg/dl, you will learn to
take a correction dose, an extra amount
of rapid- or short-acting insulin to bring
your high blood glucose down to the
range your blood glucose should be in
most of the time. Correction is usually
required before a meal, so you will need
to add or subtract this dose of insulin to
the amount of insulin needed for your
carbohydrate intake. The correction dose
is extra insulin if your blood glucose is
too high or a lower insulin dose if your
blood glucose is to low.
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