Building Competency in Diabetes Education THE ESSENTIALS

TREATMENT MODALITIES: PHARMACOLOGICAL THERAPIES | 6-97

Modified insulin regimen: 3 injections/day Figure 8. Modified insulin regimen: 3 injections/day

• Insulin type and timing:

o Premixed insulin analogue or premixed insulin before breakfast. o Rapid-acting insulin analogue (short-acting) before dinner. o Long-acting basal insulin analogue (intermediate insulin) in the evening (10:00 to 11:00 PM). • Dosage: o The premixed insulin dose at breakfast remains unchanged. o The premixed dose at dinner is split: one-third rapid/short-acting insulin taken at dinner and two-thirds long-acting basal analogue/intermediate taken at bedtime. • Benefits : o Nocturnal hypoglycemia can be minimized by splitting the dinner dose of premixed insulin. o Prandial insulin at dinner: Allows for increased flexibility to adjust dose based on