Building Competency in Diabetes Education THE ESSENTIALS

BASAL-BOLUS INSULIN THERAPY | 12-53

Figure 7. Sample VIDS Your goal BG levels are:

before meals and 2 hours after meals. A baseline dose is effective when your BG is in your goal range , you eat the goal carbohydrate and your activity is “usual.”

Pre-meal short/rapid insulin

BG (mmol/L) <3.9 Treat low

Basal insulin

Breakfast

Lunch

Dinner

Bed

Snack

–1

–1

–1

Basal dose 24 units

4.0–5.9

8

7

8

Snack

6.0–7.9

8

7

8

<7, Snack

8.0–9.9

+1

+1

+1

10.0–11.9

+2

+2

+2

12.0–13.9

+3

+3

+3

14.0–15.9*

+4

+4

+4

1

16.0–17.9*

+5

+5

+5

2

*If BG >14.0, test for ketones see sick-day guidelines.

18.0–19.9*

+6

+6

+6

3

4

>20.0*

+7

+7

+7

Goal CHO

60 g

50 g

65 g

CHO:INS ratio BG = blood glucose; CHO = carbohydrate; INS = insulin © Leadership Sinai Centre for Diabetes

Principles of VIDS development 1. Hyperglycemia leads to increased insulin requirements. • More insulin is needed if preprandial BG is elevated to cover the same amount of food and activity.