Building Competency in Diabetes Education THE ESSENTIALS

BASAL-BOLUS INSULIN THERAPY | 12-97

• An insulin:carbohydrate ratio may be used, but this results in a decimal value and, thus, requires the use of a calculator to determine insulin adjustment. This approach is difficult for many to understand and use. Example:

How much additional insulin is required to cover the additional carbohydrate eaten at the birthday lunch? Note: When using the ratio, it is best to round down to the nearest whole number, as this will result in a lower dose of insulin being taken and, thus, decreases risk of low BG. For both the examples below, the total dose of insulin would be 10 units. There are two different approaches. i) Carbohydrate difference: 30 g carbohydrate 8 g/u = 3.75 units insulin Therefore, 3 units of insulin would be taken, in addition to the usual 7 units of insulin, for a total insulin dose of 10 units. ii) Total carbohydrate: 82 g carbohydrate 8 g/u = 10.25 units of insulin (total insulin dose)

Other considerations Hypoglycemia

Improved glycemic control with intensive diabetes therapy increases the risk of hypoglycemia (21). The negative social and emotional impact of hypoglycemia may make people reluctant to