Insulin

A 60-kg patient with newly diagnosed type 1 diabetes is being started on insulin.
What is their Total Daily Dose (TDD)?

Answer explanation

✅ Answer:
0.5 units/kg × 60 = 30 units/day
🧠 Use 0.5 units/kg/day for T1DM

Using the TDD from Q1 (30 units/day), how would you split this for basal and bolus?

___%

Answer explanation

✅ Answer:
Basal = 15 units (50%)
Bolus = 15 units (50%) → divide 5 units per meal
🧠 Split 50/50 for basal and mealtime insulin

A patient is on NPH 20 units BID (total 40 units/day). You’re switching them to glargine.
What glargine dose should you prescribe?

Answer explanation

✅ Answer:
Use 80% of TDD → 40 × 0.8 = 32 units daily
🧠 For BID NPH → glargine, use 80% of TDD

A patient on NPH 18 units once daily is switching to glargine.
What dose of glargine should you use?

Answer explanation

✅ Answer:
1:1 conversion = 18 units daily
🧠 Only reduce dose if switching from BID NPH

A patient is on insulin lispro with TDD = 40 units.
📍How many grams of carbohydrates are covered by 1 unit?

Answer explanation

✅ Answer:
500 ÷ 40 = 12.5 grams/unit
🧠 500 Rule = for rapid-acting insulin

Same patient switches to regular insulin.
What is their carb ratio now?

Answer explanation

✅ Answer:
450 ÷ 40 = 11.25 grams/unit
🧠 450 Rule = for regular insulin

A patient on insulin lispro has TDD = 36 units.
What is the correction factor?

Answer explanation

✅ Answer:
1800 ÷ 36 = 50
🧠 1 unit of insulin lowers BG by 50 mg/dL

Same patient switches to regular insulin.
New correction factor?

Answer explanation

✅ Answer:
1500 ÷ 36 = 41.7
🧠 Use 1500 Rule for regular insulin

BG now = 240 mg/dL. Target BG = 100 mg/dL. Correction factor = 50
How many units should be added as a correction dose?

Answer explanation

✅ Answer:
(240 – 100) ÷ 50 = 2.8 → round to 3 units
🧠 Always round sensibly — clinical practice may round up or down depending on context

Patient will eat 75g carbs. Carb ratio = 1:15. BG = 230, correction factor = 50, target = 100
What is the total pre-meal dose?

___ units

Answer explanation

✅ Answer:
Carb: 75 ÷ 15 = 5 units
Correction: (230 – 100) ÷ 50 = 2.6 → round to 3 units
Total = 5 + 3 = 8 units lispro ✅
🧠 Combine carb coverage + correction