3614-BD Insulin Adjust Workbook

PUTTING IT ALL TOGETHER
You have learned a lot of information
about making changes to your bolus
insulin doses. Now it is time to put
these facts to work for you. This
section will help you practice using
your new knowledge in your
everyday routine.
Getting Started:
A Five-Step Plan
1. Define your target blood glucose
level.
2. Calculate your insulin sensitivity
factor (ISF).
3. Try starting a carb:insulin ratio of 10
or 15 grams of carb:1 unit of insulin.
4. Count the number of carbohydrates
you will be eating.
5. Reduce, if necessary for exercise.
Tom’s Calculations:
PRACTICE PROBLEMS:
Tom’s Night Out
Let’s look at how Tom uses the 5-step plan
above to calculate his insulin adjustment.
Tom has a fun evening planned. He is
going out to an Italian restaurant for dinner
with some friends after a game of singles
tennis. When he tests his blood glucose
before dinner, he finds it is 190 mg/dl.
Here is his information for the five steps.
• Blood Glucose Goals: 90-130 mg/dl
• Target blood glucose level is 100 mg/dl
• The initial ISF is 1 unit for every
30 mg/dl of blood glucose. Tom’s
total insulin dose is 50 units/day.
Using the rule of 1500, 1500/50 = 30
• The initial carb:insulin ratio is 10:1,
1 unit of Regular insulin for every
10 grams of carb. Using the rule
of 500, 500/50 = 10
• Tom is planning on eating about
90 grams of carbohydrates
• See below for step 5
Insulin needed for carbohydrates 9 units (90 divided by 10)
Insulin needed to correct for high blood glucose (190-100=90) divided by 30 (ISF)=3
Total insulin for food and carb 9 + 3 = 12 units
Reduction for high intensity exercise (Step 5) 3 units
TOTAL amount of pre-dinner insulin 9 units
31