3614-BD Insulin Adjust Workbook

Making Changes Using
Pattern Management
You can learn to adjust your insulin
dose by looking at your pre-meal blood
glucose levels over three or more days to
see if you notice any special pattern. In
the following example and throughout
the workbook, assume that the blood
glucose goals recommended by the
American Diabetes Association are in use
(pre-meal plasma values of 90-130 mg/dl,
blood glucose 2 hours after meals less
than 180 mg/dl.) 2 and a target of
100 mg/dl.
How to Evaluate Your Blood
Glucose Record:
• Record your blood glucose levels in
column format (as below) to more
easily identify a pattern. Many of the
data management software programs
will do this for you automatically
when you download the data.
• Look at the readings by group
according to the time of day.
• Select the blood glucose readings
by group that are out of your goal
range.
Day # Breakfast Lunch Dinner Bedtime 3 AM
Day 1
Day 2
Day 3
Three-day Blood Glucose Record:
Pre-meal Goals 90-130 mg/dl Post-meal Goals < 180 mg/dl
Pre Post Pre Post Pre Post
Guidelines for Pattern Management
Any time you see a consistent pattern of
either high or low blood glucose levels
over a period of three days, you could
adjust your insulin by:
• Increasing the appropriate insulin or
decrease the food eaten if the blood
glucose levels are too high.
• Decreasing the appropriate insulin or
increasing the food eaten if the blood
glucose levels are too low.
Most of the time the appropriate meal
to change or insulin to adjust is the rapid
or short-acting insulin taken the meal
before the “out of goal values” appeared.
2 American Diabetes Association, Standards of Medical Care for Patients With Diabetes Mellitus. American
Diabetes Association: Clinical Practice Recommendations, Diabetes Care. 27:Supl:10, 2005.
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