Table 3 Calculation of the basal-bolus insulin regimen dose

Basal Insulin

Establish the Total Daily Dose (TDD) of insulin (0.2–0.6 UI/kg/day)

Basal dose = 50% of TDD or 0.1–0.3 UI/kg/day

Types of Basal Insulin:

• NPH: 2–3 doses per day (For Type 1 diabetes, LADA, or pancreatectomized patients, prefer 3 times a day)

• Glargine U100: 1 or 2 doses per day

• Degludec and Glargine U300: 1 dose per day (These can be used, but attention should be given to their longer half-life and the 3–4 day period required to reach steady state, which may complicate management in hospitalizations or short-term follow-ups)

Bolus Insulin

Bolus dose = 50% of TDD

• If on oral or intermittent enteral diet:

1/3 of the bolus dose per meal (50% TDD/3 before breakfast, lunch, and dinner)

• If on continuous enteral/parenteral diet:

¼ of the bolus dose every 6 h

• If fasting:

Do not use

Types of Insulin for Bolus:

• Rapid-acting or ultra-rapid analogs: (Lispro, Glulisine, Aspart, Fast-Acting Aspart)

Should be administered up to 15 min before meals

• Short-acting insulin: Regular human insulin:

Should be administered 30 min before meals