Building Competency in Diabetes Education THE ESSENTIALS

BASAL-BOLUS INSULIN THERAPY | 12-50

CSII Example:

TDD = 40 units Reduce by 25%: 40 x 0.25 = 10 units 40 – 10 = 30 units New TDD = 30 units To determine 50% TDD as basal Basal: 30 x 0.5 = 15 units

15 ÷ 24 hours = 0.625 units/hour

12AM @ 0.625 u/h 3 AM @ 0.625 u/h 9 AM @ 0.625 u/h

Determine meal bolus start ing doses Typically, 50 to 60% of the TDD is divided and given for meal bolus doses (10,727480). Example: With a TDD of 38 units: 38 x 0.5 = 19 units 38 x 0.6 = 23 units Therefore, either 19 or 23 units remain to be divided among meals, according to the individual’s meal plan. Other methods divide the meal bolus by three for equal doses per meal. However, bolus doses will need to be tailored to the patient’s meal size, carbohydrate intake and pattern of eating (10,72,7480).

Example: With a TDD of 38 units using 50% of TDD 38 x 0.5 = 19 units

19 units remain to be divided among meals, according to the individual’s meal plan. 19/3= 6.3 units, which may be rounded down to 6 units with breakfast, lunch and dinner.