Building Competency in Diabetes Education THE ESSENTIALS

BASAL-BOLUS INSULIN THERAPY | 12-55

Figure 8. Using the 1800 Rule

Using the 1800 rule in Canada means converting to a “rule of 100” as follows: Convert 1800 (or 1900 mg/dL) to mmol/L: i.e. 1800 mg/dL ~100 mmol/L Divide 100 by the individual’s TDD of insulin to derive the sensitivity or CF for that individual the Canadian CF formula (or insulin sensitivity factor) is therefore 100 mmol/l = # mmol/L CF TDD insulin (units) This means that 1 unit of insulin will lower the BG level by this amount, providing a CF (or insulin sensitivity factor).

Example: TDD = 40 units CF= 100/TDD 100/40 = 2.5 1 unit of rapid-acting insulin will lower BG by 2.5 mmol/L

The CF in this example is 2.5, which may be rounded off to an even number if the person is not using a pump, a ½ unit pen or syringe. In general, round to a more conservative dose of insulin to reduce the risk of hypoglycemia.

• Some individuals do not need a written scale with the correction factor calculated for them. o They simply remember their individual CF and calculate the amount needed at meals: ▪ Current BG level – target BG level divided by CF = amount to give or add to baseline dose.