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    Home > Active Ingredient News > Endocrine System > How to adjust the dose of insulin? When to adjust? As a clinician, do you really understand? (two)

    How to adjust the dose of insulin? When to adjust? As a clinician, do you really understand? (two)

    • Last Update: 2021-09-12
    • Source: Internet
    • Author: User
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    In the previous article, we learned the dose calculation of the "three short and one long" insulin intensive program .


    In the previous article, we learned the dose calculation of the "three short and one long" insulin intensive program .


    1.


    Day 1 times 0.


    30U treatment of hypoglycemia for more than 3 months, the total daily dose of 1:1 is allocated to the morning and dinner before the injection of metformin and α-glycosidase inhibitor thiazolidinedione drugs

    When the dosage is fully adjusted and the oral hypoglycemic agent is reasonably combined, HbA1c or postprandial blood glucose still does not meet the standard, or hypoglycemia occurs repeatedly during the dosage adjustment process , indicating that the two-time daily premixed insulin regimen cannot meet the treatment needs and still needs Continue to adjust the plan


    HbA1c or postprandial blood glucose is still not up to standard, or hypoglycemia occurs repeatedly in the process of adjusting the dose

    (1) Consider adjusting to a premixed insulin analogue twice a day


    Premixed insulin analogue twice daily and other dosage converter 1:1 partitioned early, before dinner

    (2) It can be adjusted to premix insulin analogs 3 times a day


    Pre-mixed insulin analogues are converted to the same dose before breakfast and dinner 3 times a day, and 2~6 U of pre-breakfast dose is added before lunch to divide into breakfast and lunch

    (3) The daily dose can be converted into the daily dose of the basal-meal insulin regimen.


    Basal- 40%-50% of prandial insulin is used as the basal insulin dose, the remaining amount is used as prandial insulin, and the three meals are equally distributed

    (4) Switch to insulin pump therapy


    Insulin pump daily total amount of insulin=pre-pump insulin dosage×(80%~100%), daily basic infusion=full day total insulin×(40%~60%)(average 50%), before meal The high-dose is generally 50% of the initial full-day insulin dosage, distributed according to 1/3, 1/3, and 1/3 of the three meals


    Indications: Patients with frequent insulin injections, high blood sugar fluctuations, frequent occurrence of hypoglycemia and hyperglycemia, irregular life, frequent business trips


    For T2DM patients who have not been treated with insulin before, the initial total daily amount (IU) = weight (kg) × (0.


    The initial daily total (IU) = body weight (kg) × (0.


    The total daily amount of insulin = the amount of insulin before the pump × (80% to 100%)


    30 principle <1.


    50 principle <2.


    Original source:

    Li Yanbing,Ma Jianhua,Mu Yiming.
    Clinical expert guidance on short-term insulin intensive treatment of type 2 diabetes[J].
    Drug Evaluation,2017,14(09):5-12+26.





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