Abbreviations

  1. FPG = Fasting plasma glucose
  2. TDD = Total Daily dose of insulin
  3. ICR = Insulin to carb ratio
  4. ISF = Insulin sensitivity factor
  5. BIDose = Basal insulin dose

Outpatient Type 2 Diabetes Insulin use formulae

Formula 1 - Which Insulin to Use for Type 2 Diabetes in OPD ?

X=FPGHbA1cX<20−Prefer premixed InsulinX≥20−Prefer Basal insulin

Formula 2.1 - Weight based basal insulin dose

Basal insulin dose=Weight in kg×0.2

Formula 2.2 - Holman-Turner formula

Basal insulin dose=FPG−5010

Formula 3 - Bolus dose calculation for Basal-plus therapy

Bolus insulin dose=Post-meal glucose36

Outpatient Type 1 Diabetes management formulae

Formula 4- Total Insulin dose

TDD=0.52×weight in kg

Formula 5- Basal dose

Basal dose=0.47×TDDBasal dose=0.24×Weight in kg

Formula 6.2 - Bolus dose based on Carb counting

Bolus dose=Carb to be consumedICRICR alternate=(6.2×weight in kg)TDD over 24 hours

Formula 6.3 - Correctional insulin dose

Correctional insulin=(Current glucose−premeal target glucose)ISFISF=1700TDD

Algorithm 1 - Adjusting insulin dosing in type 1 diabetes

Insulin Calculation Process

Inpatient ICU Insulin management

Formula 7 - Insulin infusion dosing

Rate of infusion=blood glucose100

Formula 8 - Shifting from Infusion to Basal-bolus insulin

Total subcutaneous insulin=0.8×(Total insulin in last 6 hrs×4)Basal dose=0.5×Total subcutaneous insulinBolus dose before each meal=(0.5×Total subcutaneous insulin dose)3

Inpatient Non-ICU Insulin management

Formula 9 - Basal insulin dose calculation- Lakhani- Kumar formula

BIDose/kg=0.064+0.030×HBA1c

(BIDose = Basal insulin dose)

References:

  1. Strange P. Treat-to-target insulin titration algorithms when initiating long or intermediate acting insulin in type 2 diabetes. Journal of Diabetes Science and Technology. 2007 Jul;1(4):540-8.
  2. Davidson PC, Hebblewhite HR, Steed RD, Bode BW. Analysis of guidelines for basal-bolus insulin dosing: basal insulin, correction factor, and carbohydrate-to-insulin ratio. Endocrine Practice. 2008 Dec 1;14(9):1095-101.
  3. Lakhani, O.J., Kumar, S., Tripathi, S., Desai, M.A. and Seth, C., 2018. Correlation between basal insulin glargine dose required in achieving target fasting blood glucose and various clinical and laboratory parameters in hospitalized noncritical patients. Indian Journal of Endocrinology and Metabolism, 22(4), p.469.