Endocrinology Book

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Insulin Dosing in Type 1 Diabetes

Aka: Insulin Dosing in Type 1 Diabetes, Insulin Dosing in Type I Diabetes
  1. See Also
    1. Carbohydrate Counting
    2. Insulin Dosing
    3. See Insulin Dosing in Type II Diabetes
    4. Insulin Adjustment with Carbohydrate Counting
  2. Dose: Initial Dosing with basal/Bolus Insulin
    1. Calculate total daily Insulin (TDI) dose
      1. Ketones moderate or less: 0.5 units/kg/day
      2. Ketones large: 0.7 units/kg/day
    2. Divide total Insulin into basal and bolus dosing
      1. Basal Insulin (long-acting): 50% of total Insulin
        1. Insulin Glargine (Lantus) once daily (any time) or
        2. NPH Insulin twice daily
      2. Bolus Insulin (rapid acting): 50% of total Insulin
        1. Rapid acting Insulins: Lispro, Aspart
          1. Regular Insulin may be used instead due to cost
        2. Divide out equally before meals
        3. Adjust later for carb count variations at meals
    3. Example: 60 kg adult with moderate ketones
      1. Total Insulin dose: 30 units
      2. Divide Insulin
        1. Insulin Glargine (Lantus): 15 units at bedtime
        2. InsulinLispro: 15 units total divided over meals
          1. Before breakfast: 5 units
          2. Before lunch: 5 units
          3. Before dinner: 5 units
  3. Dose: Conversion from mixed Insulin (70/30 or 75/25)
    1. Calculate total Insulin units
    2. Reduce total Insulin depending of Hemoglobin A1C
      1. Hemoglobin A1C >9%: Decrease total Insulin by 10%
      2. Hemoglobin A1C <9%: Decrease total Insulin by 20%
    3. Divide total Insulin into basal and bolus dosing
      1. Basal Insulin (long-acting): 50% of total Insulin
        1. Insulin Glargine (Lantus) once daily or
        2. NPH Insulin twice daily
      2. Bolus Insulin (rapid acting): 50% of total Insulin
        1. Rapid acting Insulins: Lispro, Aspart
        2. Divide out equally before meals
        3. Adjust later for carb count variations at meals
  4. Management: Adjustments
    1. See Insulin Dosing for adjustment regimen

Insulin (C0021641)

Definition (NCI) A short-acting form of insulin. Regular insulin is obtained from animal or recombinant sources. The onset of action of regular insulin occurs at 30-90 minutes after injection; its effect lasts for 6 to 8 hours. Endogenous human insulin, a pancreatic hormone composed of two polypeptide chains, is important for the normal metabolism of carbohydrates, proteins and fats; it has anabolic effects on many types of tissues. (NCI04)
Definition (NCI) Insulin (51 aa, ~6 kDa) is encoded by the human INS gene. This protein is involved in the direct regulation of glucose metabolism.
Definition (CSP) protein hormone secreted by beta cells of the pancreas; insulin plays a major role in the regulation of glucose metabolism, generally promoting the cellular utilization of glucose and is also an important regulator of protein and lipid metabolism; insulin is used as a drug to control insulin-dependent diabetes mellitus.
Definition (MSH) A 51-amino acid pancreatic hormone that plays a major role in the regulation of glucose metabolism, directly by suppressing endogenous glucose production (GLYCOGENOLYSIS; GLUCONEOGENESIS) and indirectly by suppressing GLUCAGON secretion and LIPOLYSIS. Native insulin is a globular protein comprised of a zinc-coordinated hexamer. Each insulin monomer containing two chains, A (21 residues) and B (30 residues), linked by two disulfide bonds. Insulin is used as a drug to control insulin-dependent diabetes mellitus (DIABETES MELLITUS, TYPE 1).
Concepts Pharmacologic Substance (T121) , Amino Acid, Peptide, or Protein (T116) , Hormone (T125)
MSH D007328
SnomedCT 325014006, 67866001, 39487003, 412222002
LNC LP70329-5, LP16325-0, LP14676-8, LP32542-0, MTHU002108, MTHU019392, LA15805-7
English Insulin, insulin, Regular Insulin, Soluble insulin, Insulin Regular, insulin preparations, insulin preparations (medication), insulin regular, Insulin [Chemical/Ingredient], insulin products, insulin preparation, insulin product, regular insulin, insulins, Insulin, Soluble, Soluble Insulin, Soluble insulin (substance), Insulin regular, Insulin, Regular, Insulin product, Insulin (substance), Insulin preparation, Insulin product (product), Regular insulin product, Unmodified insulin product, Insulin preparation, NOS, Regular insulin preparation, Unmodified insulin preparation, Insulin preparation (substance), Regular insulin (substance), Regular insulin, INSULIN
Swedish Insulin
Finnish Insuliini
French Insuline ordinaire, Insuline soluble, Insuline
Russian INSULIN, ИНСУЛИН
Spanish producto con insulina (producto), preparado insulínico, insulina (producto), producto con insulina, insulina (sustancia), insulina, preparado de insulina (producto), preparado de insulina (sustancia), preparado de insulina cristalina de cinc, preparado de insulina cristalina de zinc, preparado de insulina no modificada, preparado de insulina, insulina regular (sustancia), insulina regular, Insulina
Italian Insulina regolare, Insulina
Croatian INZULIN
Polish Insulina
Japanese インスリン, インスリン亜鉛水性懸濁液, インシュリン
Czech inzulin, insulin
Norwegian Insulin, Oppløselig insulin
German Insulin
Portuguese Insulina
Sources
Derived from the NIH UMLS (Unified Medical Language System)


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