The ratio of long-acting and short-acting insulin per day. Rules for administering injections. Intensive insulin regimen

Greetings, readers. Throughout their lives, people have to deal with various diseases: some learn from the stories of friends, some observe the disease in loved ones and relatives, and many personally have to experience the influence of one or another illness. Diabetes mellitus is considered the most common disease nowadays. From the first day after the doctor makes this diagnosis, the patient becomes familiar with the concept of bread units (denoted XE).

Origin of the term "XE"

Treatment of diabetes for each person begins with a personal conversation with a doctor, during which the doctor describes in detail the characteristics of the disease and introduces the patient to his new diet. If therapy with insulin is necessary, the dosing and administration algorithm for the drug is discussed separately. It is based on daily counting of bread units and monitoring blood glucose levels.

To follow the doctor’s recommendations, a person with such a disease needs to calculate daily how many carbohydrate-containing foods can be eaten, not forgetting that some of them increase sugar after 15 minutes, and some carbohydrates help increase blood sugar concentration only after half an hour .

Description of the concept "XE"

For people suffering from type 1 diabetes mellitus and maintaining sugar levels within normal values With the help of the drug insulin, the concept of “XE” was introduced. It is especially important for insulin-dependent diabetics to monitor their diet to avoid a very sharp jump in sugar, either higher (hyperglycemia) or lower (hypoglycemia). Thus, the disease called diabetes, insulin, bread units are interconnected and form the basis of the new lifestyle of diabetics.
XE is a relative value used in medicine to indicate the number of carbohydrates consumed in food.

Carbohydrates in the amount of 12 grams make up one bread unit. It received this name due to measuring a certain volume of bread. Everyone knows that a cut piece of standard bread 1 cm thick weighs 25 grams. Just half of it is equal to approximately 12 grams, which is the desired value. This system for assessing XE in each dish is recognized internationally and can be used for illness in any country.

In some sources, the volume of carbohydrates in one XE is determined to be 10-15 grams. When you are ill, it is important to understand that the main key to successful compensation of glucose levels is not a strictly defined number of carbohydrates, but the ability to correctly calculate the dose and administer the medicine in advance before meals.

Calculation of bread units, insulin doses for diabetes mellitus

Daily use of the XE system for diabetes allows you to determine the required amount of carbohydrates in the menu per unit, with just one glance, without first weighing the dishes. To do this, just focus on the size of the piece, glass, number of vegetables or fruits. In almost all endocrinology departments, a diabetes school has been created, in which patients are taught how to count XE.
Having determined with the attending physician permissible value bread units for consumption per day, it is best for a diabetic to evenly divide the total amount into approximately three equal parts (breakfast, dinner and lunch) and leave an additional supply of 1 XE for a snack in the interval between main meals. Such nutrition is especially important in type 1 diabetes, when the patient uses rapid and long acting. To avoid hypoglycemia due to low blood sugar, it is better to eat 1 or 1.5 XE between main meals. You should not consume more than seven XE in one meal. Obese patients should plan their meals so that no more than 120 grams of carbohydrates are consumed per day.
For example, if daily norm XE is equal to 10, then it is most rational to use them during the day as follows:

1. Breakfast – 2 XE;
2. Second breakfast – 1 XE;
3. Lunch menu – 3 HE;
4. Afternoon snack – 1 XE;
5. Menu for dinner - 3 XE or you can have 2 XE and leave one for the second dinner.

It is preferable to eat cereals for breakfast, which are absorbed much more slowly by the body and do not sharply increase sugar levels.
Type 1 diabetes mellitus requires the mandatory inclusion of XE in the patient’s diet, since each unit requires a certain dose of insulin. One XE can increase blood sugar by approximately 2.77 mmol/l. To compensate for 1 XE, insulin must be administered in a volume of 1-4 units.
Exists standard scheme insulin consumption during the day:

1. In the morning, to compensate for 1 XE, 2 units are needed. insulin;
2. At lunch, the injection schedule for 1 XE is as follows: insulin - 1.5 units;
3. In the evening, the number of units of insulin is equal to the number of XE, that is, 1:1, respectively.

Achieving compensation for diabetes and maintaining normal sugar levels is possible only with constant self-monitoring of glucose.

Calculation of bread units in finished products

“How to count XE?” This question is asked by all patients with diabetes. It is important for them to learn how to independently count the number of bread units in finished products in order to know how much XE is in certain products. To do this, it is enough to know the total mass of the product and how many carbohydrates are in 100 grams. If you divide the indicated number of carbohydrates by 12, you can find out the final value of XE in 100 g. Provided that the purchased product contains, for example, 300 grams, then the resulting XE value must be increased by 3 times.

When visiting restaurants or cafes, calculating XE will be more difficult due to the lack of an exact recipe for preparing dishes indicating the ingredients included. After all, flour, milk, potatoes and much more can be used in finished products. Most foods must be counted in grain units, even fruits, milk and cereals, many of which are recommended to be consumed in minimal quantities. It is better to use your own recipes for dishes that will not be difficult to count carbohydrates.

Table of bread units for insulin-dependent diabetes and type 2 diabetes

For convenience and organization correct menu For diabetics, various ready-made tables of bread units have been developed, which indicate how many grams or milliliters of a particular product are per unit. Using them you can easily determine how much of the product can be consumed and get acquainted with their main list. The table of bread units is quite easy to remember and does not require constant use by patients.

Table of XE in dairy products, bread products and cereals

Table of grain units in vegetables and fruits

XE table in finished products

People diagnosed with type 2 diabetes should take into account HE along with insulin-dependent diabetics, independently monitor their blood sugar, plan their meals and follow all the recommendations of their doctor in order to avoid complications of the disease and achieve the maximum possible compensation for the disease.

pitanielife.ru

Example of insulin dose calculation 1:

Patient with type 1 diabetes mellitus, ill for 5 years, compensation. Weight 70 kg, height 168 cm.
IPD 50% of 42 units = 21 (rounded to 20 units): before breakfast - 12 units, at night 8 units.
ICD 42-20 = 22 units: before breakfast 8-10 units, before lunch 6-8 units, before dinner 6-8 units.

Further dose adjustment of IPD is based on the level of glycemia, ICD is based on glycemia and XE consumption. This calculation is indicative and requires individual correction, carried out under the control of glycemic levels and the consumption of carbohydrates in XE.

It should be noted that when correcting glycemia, it is necessary to take into account the dose of short-acting insulin to reduce elevated levels, based on the following data:
1 unit of short- or ultra-short-acting insulin reduces glycemia by 2.2 mmol/l;
1 XE (South of carbohydrates) increases the glycemic level from 1.7 to 2.7 mmol/l, depending on the glycemic index of foods.

Example of insulin dose calculation 2:

A patient with type 1 diabetes mellitus, ill for 5 years, subcompensation. Weight 70 kg, height 168 cm.
Insulin dose calculation: daily requirement 0.6 units x 70 kg = 42 units of insulin.
IPD 50% of 42 units = 21 (rounded to 20 units): before breakfast -12 units, at night 8 units.
ICD 42 -20 = 22 units: before breakfast 8-10 units, before lunch 6-8 units, before dinner 6-8 units.

Further dose adjustment of IPD is based on the level of glycemia, ICD is based on glycemia and XE consumption. Morning glycemia is 10.6 mmol/l, it is assumed to consume 4 XE. The ICD dose should be 8 units for 4 XE and 2 units for “decrease” (10.6 - 6 = 4.6 mmol/l: 2.2 = 2 units of insulin). That is, the morning dose of ICD should be 10 units.

It can be assumed that correct use The provided treatment recommendations and strict adherence to the desired blood glucose levels will help patients live longer and healthier lives. They should still be convinced of the need to purchase personal glucometers and constant monitoring glycemia and glycated hemoglobin levels.

medkarta.com

The process of calculating the dose of a hormone replacement for a patient with type 1 diabetes

Researchers have developed the basics of a method for calculating the insulin dose of drugs for people suffering from various types diabetes mellitus

If a person suffers from type 1 diabetes, then insulin calculations are carried out only if a whole set of indices is used. A person's body weight determines the number of units of the drug. How to choose an insulin dose for a patient with non-standard weight? If the patient is overweight, the index should be reduced, and if the patient is underweight, the index should be increased. The following indicators emerge from this:

1. 0.5 units/kg body weight for those who have recently been diagnosed with type 1 diabetes.
2. The coefficient should be 0.6 units/kg of the patient’s weight if diabetes mellitus was diagnosed approximately a year ago, but all the patient’s health indicators are relatively stable and positive.
3. The index should be 0.7 units/kg of weight of a person who has type 1 diabetes mellitus, but his health indicators are not stable.
4. If a situation arises where decompensation is observed in type 1 diabetes, the value should be 0.8 units/kg.
5. If a person experiences ketoacidosis, the insulin index for diabetes mellitus should be 0.9 units.
6. If a patient with diabetes is in puberty or a sick woman in the third trimester of pregnancy, then the calculation of insulin is based on one unit/kg of weight.

An overdose occurs after taking more than 1 unit/kg of a person’s weight. Although lethal dose insulin levels will be different for each person. The initial stage is characterized by an indicator of no more than 0.5 units. but then it can be reduced. This period is called the “honeymoon” of the development of the disease. But then insulin administration will need to be increased.

When a long-acting drug is used, it must simulate that the hormone is being produced at sufficient levels. You will need to inject this drug twice a day, and in equal parts from the daily volume of the substance.

How to calculate the dose of fast-acting insulin? It should be used before meals, when the insulin dosage is calculated, the XE index (bread units) is used. To determine how many carbohydrates you consume per day, you need to know the total amount of calories consumed.

These indicators are important in order to determine glucose. The patient needs to consume from 70 to 310 g of carbohydrates per day. This amount of carbohydrates equates to a value from 7 to 31 XE. It is advisable to divide them throughout the day. Use 4-8 XE in the morning, 3-4 XE at lunch, and up to 4 XE in the evening. 4-5 XE are broken up for intermediate meals. The selection of preparators depends on individual indicators. The dosage of insulin is determined according to the situation of various durations actions. Short-acting substances should be administered in no more than 28 units.

Calculations of the dosage of insulin drugs for a patient with type 2 diabetes mellitus

The first stage is normalization of fasting glycemia. If the patient has glycemia, with an empty stomach, more than 7.8 mmol/l is constantly recorded, then it will be necessary to stop using tablets that reduce sugar levels. Instead, you need to use a drug with a long-term effect of approximately 0.2 units/kg per day. Then you need to increase the dose by 4 units every 4 days, or you can do this once every two days. The increase amount is 2 units. If, during glycemic adjustments during this period, after calculations, a volume of insulin is accumulated that is more than 30 units, then it is necessary to divide the volume of the drug into two doses. The evening volume should be slightly less than in the morning.

The second stage is to bring postprandial glycemia (after eating) to normal. When the level of glycemia before eating reaches less than 7.8 mmol/l, you need to start controlling sugar after eating. To do this, the dosage of a medication with a short-term effect is adjusted.

After eating, glycemia should be no more than 10 mmol/l. If glycemia after eating does not exceed 10 mmol/l, then the patient has developed insulin resistance. The patient is allowed to use tablet medications that are intended to lower sugar levels. But this is only possible when the optimal glycemic level is achieved. In addition, you need to start using sensitizers. If the sugar level is more than 10 mmol/l, after meals you need to replace half of the entire dose of insulin-containing drugs with a prolonged effect with drugs fast action.

These calculations will help you maintain good health. It is recommended to purchase a glucometer to evaluate your readings. All calculations must be very accurate, because... a mistake can cost a person's life. Every patient with type 1 or type 2 diabetes mellitus, before calculating the volume of insulin-containing medications, should mandatory visit a medical specialist and consult in detail with a medical professional about calculating the volume of medications taken.

saharvnorme.ru

Bread units - you need to know about them, remember them and need to understand them. That is why we turned to a researcher at the Department of Endocrinology for complete comprehensive information. General information, examples of calculations and a convenient tablet for downloading. Let's figure it out together!

To facilitate the calculation of the insulin dose before meals, the concept is used "bread unit"(HE). On average, 1 unit of insulin utilizes 12 g of carbohydrates. 1 bread unit contains 12 g of carbohydrates (48-50 kcal), which corresponds to 25 g rye bread, 20 g of white bread (1 piece), one medium apple, one potato, two teaspoons of sugar. Some diabetologists consider it more appropriate to consider 1 XE equal to 10 g of carbohydrates (minus ballast substances that do not affect glycemia), and if we take into account fiber, such as fruits and vegetables, then 1 XE is equal to 15 g of carbohydrates.

Daily calorie intake = 1000 + (100 * age in years)

The general formula for calculating the amount of XE per day for children (up to 15 years):

First way:

XE = Daily caloric intake/100

For example: for a 10-year-old child, the daily energy requirement will be: 1000+ (10x100)=2000/100=20XE kcal.

Another way to calculate XE:

We calculate half of the daily caloric intake - 50% due to the consumption of carbohydrates.

Based on the calculation that 1 g of carbohydrates provides 4 kcal, therefore, 50% of the daily calorie content of food / 4 kcal = number of grams of carbohydrates per day / 12 g = number of XE / day Therefore, for a 10-year-old child the daily energy requirement is will be: 1000 kcal in 1 year + 100 kcal for subsequent years of life (1000 kcal+ (n * 100)). That is, this child is 10 years old: 1000+(10 years x100) = 2000 kcal/day, 50% comes from carbohydrates - 1000 kcal, 1 g of carbohydrates gives 4 kcal, therefore 1000/4 = 250 g of carbohydrates per day. 12 g of carbohydrates – 1 XE, 250/12 = 20.8 XE per day. For breakfast, lunch and dinner, 25% (5 XE each), snacks 10% (2.5 XE), at night 5% (1.5 XE).

EXAMPLE:

A 10-year-old child with diabetes mellitus for 4 years receives 8 units. epidra before meals and 20 units. lantus.

The daily diet will be:

— Breakfast (8 hours): 4 spoons of any ready-made porridge (2 XE), 1 slice of bread (1 XE), 50 g meat (0 XE), cabbage salad (0 XE), juice (fresh) or orange (2 XE ) TOTAL 5 HE

— Snack (10 hours): apple (1 XE), sandwich with cheese (1 XE) TOTAL 2 XE

— Lunch (13-14 hours): borscht (0.5 XE), potato stew with meat 6 spoons (3 XE), cucumber (0 XE), compote s/fr (0.5) 2 “Maria” cookies ( 1 HE) TOTAL 5 HE

— Afternoon snack (16 hours): tomato juice (1 glass) and bread 1XE = 2 XE

— Dinner (19:00): milk porridge (4 tablespoons + 1 glass of milk) - 3 XE, bread -1 XE, fruit - 1 XE = 5 XE

— Snack at night – 1 glass of kefir (1 XE) and 4 “zoological” cookies (0.5 XE) = 1.5 XE

Calculation of carbohydrate load

UC = bolus SDI / XE per day.

(the number of units of bolus insulin per day divided by the number of carbohydrates per day in XE) only the total short-term insulin per day and the total amount of XE per day, including snacks, are taken into account.

This method is approximate and the UK indicator is rechecked and refined during the first two days as a result of constant glycemic control.

Download TABLE OF BREAD UNITS in a convenient PDF format!

It is important for the doctor - how much insulin does the patient actually administer per 1 XE?

For example: 24 units of epidra / for 20 XE (child 10 years old), that is, 1.2 units. insulin is needed for 1 XE, which means for 5 XE * 1.2 = 6 units of epidra. But this condition is met if the glycemic level is not higher than the target (from 6 to 10 mmol/l). When pre-meal glycemia exceeds the target, a “corrective” dose (CD) is added to the dose calculated above to lower glycemia. It is usually determined empirically for each patient, averaging 0.5-1.5-2 units. for each “extra” mmol/l, but not more than 2-3 units. insulin at once. To more accurately calculate insulin CD in accordance with existing glycemia, it is necessary to find out individual sensitivity to insulin (IS), for which the formula is used:

a) CHI = 100 / total daily dose of insulin (SD) (with compensation, i.e. Hb1c level up to 8%)

b) CHI = 1500 / SD / 18 (for decompensation)

For example:

a) 100/44 (24 units of epidra +20 units of lantus) = 2.2 (that is, 1 unit of insulin reduces blood sugar by approximately 2 mmol/l) - in a state of compensation;

b) 1500/44/18 = 1.9 (in case of decompensation, 1 unit of insulin reduces blood sugar by approximately 2 mmol/l).

Thus, if a patient has a glycemia of 14 mmol/l (target glycemia level is 10 mmol), taking into account the CI, the value of the correction dose (CD) will be (14-10)/2 = 2, therefore, for 5 XE eaten to the calculated 6 units . HP is added by 2 more units, for a total of 8 units. epidras.

Thus, the XE system as a method for calculating carbohydrate intake is used in patients with type 1 diabetes not to limit carbohydrate intake, but due to the need to correlate it with insulin doses.

Read also: Table of bread units - can be downloaded

sugar.com

Many diabetics know approximately how many units of insulin they need to take to lower their blood sugar, but an error in dose often leads to hypoglycemia or does not lower blood sugar enough. Some time ago, diabetes schools recommended using a correction scheme high sugar, but believe my experience, this scheme did not always work and not for everyone. In addition, each person's insulin sensitivity changes as diabetes progresses. Therefore, every type 1 diabetic and type 2 diabetic on insulin therapy should be able to calculate their individual dose of insulin required to reduce high blood sugar. Blood sugar correction is done when it is 10.0 mmol/l or higher, and most often before the next meal. The insulin we take with food is called prandial or bolus. If sugar before meals is 10 mmol/l or higher, it is necessary to administer an adequate PRANDIAL DOSE + DOSE FOR CORRECTION (reduction) of blood sugar. FOR CORRECT CALCULATION, THE FOLLOWING PARAMETERS ARE NEEDED:

​1. ACTUAL GLYCEMIA (AG)– blood sugar at the moment.

2. TARGET GLYCEMIA– blood sugar level that every patient should strive for. CG should be recommended by a doctor, taking into account the length of diabetes, age, concomitant diseases etc. For example, children, pregnant women and diabetics with a short period of illness are recommended CG 6-7.5, due to the tendency to hypoglycemia, which is more dangerous than high sugar.

3. INSULIN SENSITIVITY FACTOR– shows how much 1 unit will lower blood sugar (in mmols). short or ultra-short insulin.

FORMULAS FOR CALCULATING FCI:

ULTRA-SHORT (analogues of human insulin) HUMALOG, NOVORAPID, APIDRA
100: SDI = X mmol/l

SHORT-ACTING INSULINS – ACTRAPID NM, HUMULIN R, INSUMAN RAPID
83: SDI = X mmol/l

100 AND 83 are constants derived by insulin manufacturers based on many years of research.
SDI is the total daily dose of all insulin - both bolus (for food) and basal. It is obvious that with flexible insulin therapy, the SDI rarely remains constant. Therefore, for calculations, take the arithmetic average of the SDI over several, 3-7 days.

4. CARBOHYDRATE RATIO (CA)– the amount of carbohydrates that require 1 unit for absorption. prandial insulin.
FORMULA FOR CALCULATING CARBOHYDRATE RATIO
(500: SDI) = X grams of carbohydrates for which 1 unit is needed. insulin. To calculate the UK per 1 XE, you need to divide the number 12 by the resulting amount of carbohydrates X, because 1 XE contains 12 grams of carbohydrates.
For example,
SDI = 50, UC = 500: 50 = 10 g of carbohydrates will be absorbed by 1 unit. insulin, 12: 10 = 1.2 units. insulin is needed for 1 XE, for 5 XE we enter 1.2x5=6 units, for 3.5XE we need to enter 1.2x3.5=4 units.
SDI = 20, UC = 500: 20 = 25g of carbohydrates will be absorbed by 1 unit. insulin, 12:25 = 0.48 units. insulin is needed at 1XE, at 6 XE we will enter 0.48x6 = 3 units, at 2.5 XE we will enter 0.48x2.5= 1 unit. It should be noted that only an insulin pump can administer a dose of insulin with an accuracy of tenths; on syringe pens, the result obtained must be rounded to whole numbers. If the daily dose of insulin is not constant and changes due to bolus insulin, it is necessary to take the arithmetic average of the SDI over several days to calculate the UC.

IMPORTANT! To correctly apply UK in practice, you need to know that the need for insulin changes throughout the day. The highest is at breakfast, the average is at lunch and the lowest is at dinner. Scientists, based on many years of research, have found that the majority of people on the planet have approximately the following:

For breakfast 2.5 - 3 units. insulin on 1XE

For lunch 2 - 1.5 units. on 1XE

For dinner 1.5 - 1 unit. on 1XE

Based on your UC, calculated using the formula and taking into account the need for insulin during the day, you can empirically select your indicator more accurately. To do this, you need to control your blood sugar before meals and 2 hours after meals. Blood sugar should increase after a meal by no more than 2 mmol, and before a meal it should be equal to the blood sugar that was before the previous meal. If blood sugar is before next step food is lower, or there was hypoglycemia between meals, which means the insulin dose was high, i.e. The Criminal Code is higher than necessary and needs to be reduced. In an example it looks like this:

1. On an empty stomach, blood sugar is 6, after 2 hours, blood sugar is 7.5, before lunch, blood sugar is 6.5, after 2 hours, 8, before dinner, blood sugar is 5.8, before bedtime, 6.5. IN in this case The management companies are chosen correctly.

2. On an empty stomach, blood sugar is 6.2, after 2 hours 9, before lunch 9.5, after 2 hours 7, before dinner 4, before bedtime 7. Obviously, the CV for breakfast needs to be increased, for lunch the CV needs to be reduced, for dinner The Criminal Code is adequate.

5. PLANNED QUANTITY OF XE. To calculate XE, you can weigh the product and use the table of bread units to calculate XE per serving. For example, bread, 20 g - 1 XE, which means a piece weighing 30 g - 1.5 XE. You can calculate it by looking at the composition of the product. For example, let's take ice cream. The label says that 100 grams of products contain 49 grams of carbohydrates. Ice cream weight is 90 grams. We count: (49: 100) x 90, and: 12 = 3.7 XE.

6. AMOUNT OF ACTIVE INSULIN (AI). During each hour, the activity of ULTRA-SHORT insulin (AI) decreases by 20-25% of the initial dose. For example, at 8 am, 10 units were administered. humaloga. Its activity will decrease as follows:

8.00 – 10 units.
9.00 – 8 units.
10.00 – 6 units.
11.00 – 4 units.
12.00 – 2 units.
13.00 – 0 units.

7. EXPOSURE TIME TO INSULIN INJECTION. What it is? This is the time from the injection of short human CCI or ultrashort USI insulin to the start of a meal. It is necessary to clearly know the absorption time and peak action of the insulin you are using. The instructions for using insulin always describe its pharmacokinetics.

Pharmakinetics of short (human insulins): onset of action after 30 minutes - 1 hour, peak action after 2-4 hours, duration of action - 6-8 hours.

Pharmakinetics of ultrashort insulins: onset of action after 15-30 minutes, peak action 0.5-1.5 hours (for Novorapid 1-3 hours), maximum action 3-5 hours.

It is obvious that ultra-short insulins are absorbed earlier and are eliminated from the body faster. This must be taken into account when calculating the exposure time of an insulin injection. You need to understand that by the time carbohydrates are absorbed, insulin should already be absorbed and start working - lowering blood sugar. Otherwise, high sugar levels two hours after eating are inevitable. How to do it. Always check your blood sugar before eating:

Blood sugar is normal - exposure time is 10-20 minutes. for USI and 30 minutes for CCI (we make insulin in 10-20 minutes, in 30 minutes)

Blood sugar is high – INCREASE exposure time (do insulin even earlier)

Blood sugar is low - exposure time 0, start eating with fast carbohydrates(take insulin immediately before meals)

Regarding the last recommendation, I would like to add that I do not entirely agree with this approach. What to do if blood sugar is low before a meal, but there is braised cabbage and a piece of chicken? Those. There are no fast carbohydrates. But you won’t be able to feed a small child at all if you give him something sweet before a meal, and insulin has already been administered! In such cases, I stop hypoglycemia with 2 XE (200 ml of juice, 4 pieces of sugar) and only then make insulin, already for the amount of food that I can eat. But this is just my opinion, every diabetic can find his own solution based on the recommendations listed above.

An increase in exposure time is also possible when eating foods with high glycemic index(GI). It must be remembered that products of this series are absorbed very quickly and sharply raise blood sugar. It is not recommended to consume such products if you have diabetes. But, if you sometimes break your diet, then you need to do it wisely.

In addition, it is very important to know:

IN GASTROPATHY – slow absorption of food, we take insulin as late as possible AFTER MEALS.

IN THE ACCELERATED EVACUATION OF FOOD FROM THE STOMACH, insulin should be given as soon as possible, i.e. increase exposure.

So, we know our FCI, UC, CG, looked at the blood sugar before meals (AG), took into account the active insulin AI from the previous injection, now we can calculate how much insulin needs to be given.

FORMULA FOR CALCULATING DOSE FOR CORRECTION OF HIGH BLOOD SUGAR.
(AG - CG): FCI = X units. insulin for correction, then X-AI, if any = dose for correction.

Taking the difference between the actual and target glycemia and dividing it by the sensitivity factor, we get the amount of insulin that needs to be administered. When blood sugar is higher than the target, a positive result is always obtained, which means that you need to ADD insulin to reduce it. If there is active insulin, then it must be subtracted from the resulting number.

EXAMPLE: AG 15, CG 7, FCI=2, AI 1 unit, UK =1.5, we plan to eat 4 HE.
UK x XE = 1.5x4 = 6 units. insulin for food.
(15-7):2 = 4 units, 4-1 units. AI = 3 units. add to decrease.
Total: you need to enter 6+3=9 units. insulin

If the blood sugar before meals is below the target, the result will be a negative number, in this case we must REDUCE the dose for food BY THE NUMBER RECEIVED.

EXAMPLE: AG 4, CG 6, FCI=2, AI no, UK 2, we plan to eat 5 HE.
UK x XE = 2x5 = 10 units. insulin for food
(4-6):2= -1 unit. subtract for increased sugar
Total: you need to enter 10-1=9 units. insulin.

Of course, administering insulin units up to 1/10 (0.9; 2.2; 1.5), which are obtained as a result of these calculations, is only possible with a pump. Syringe pen in increments of 0.5 units. will allow you to administer the dose with an accuracy of 1/2 unit. When using syringe pens in increments of 1 unit, we are forced to round the resulting number of units. All the above calculations are indicative in nature, and the adequacy of the calculated FCI and CM must be confirmed empirically.

studopedia.ru

What types of modern medications are there?

The development of modern bioengineering technologies makes it possible to obtain insulin preparations in large quantities under industrial conditions.

To obtain insulin-containing drugs, we have developed special techniques production.

The quality and purity of artificially obtained insulin depends on the technology used in its synthesis.

Modern pharmacology is capable of obtaining medicinal hormonal drug insulin using two main techniques.

• a synthetic drug that is obtained as a result of modern technologies;
• a medicine that is obtained in the process of hormone synthesis by the pancreas of animals (in modern medical practice it is used less frequently and is a relic of past years).

Medication synthetic products divided into several main categories that have important when using one of the types of therapeutic treatment.

1. Ultra-short and short-acting insulin, which shows its activity within 20 minutes after the injection. Such medications include Actrapid, Humulin-regulator and Insuman-normal. Medications are soluble and are introduced into the body using subcutaneous injections. Sometimes intramuscular or intravenous injections. The maximum activity of the administered medication is observed 2-3 hours after the procedure. This type of insulin-containing medications is used to reduce surges in blood sugar that occur as a result of violation of the recommended diet or severe emotional shock.
2. Medical supplies average duration impact. Such medications affect the body from 15 to 24 hours, so for patients with diabetes it is enough to carry out 2-3 injections per day.
3. Long-acting medications. Their main characteristic is that the effect after the injection manifests itself over a long period of time - from 20 to 36 hours. The effect of insulin on the patient’s body begins to appear a few hours after the injection. Most often, doctors prescribe this type of medicine to patients who have decreased sensitivity to the hormone.

Only the attending physician can prescribe necessary drug patient, so it is difficult to judge which insulin is better. Depending on the complexity of the disease, the need for hormones and a number of other factors, the optimal drug for the patient is selected.

In addition, a medical specialist will be able to clearly explain everything about diabetes, insulin doses, complications, treatment and bread units.

How to calculate the amount of short-acting injection?

Before choosing a dose of insulin, every diabetic has to deal with the concept of bread units for diabetes.

Their use today greatly simplifies the calculation of insulin. One bread unit (per 1 hex) equals ten grams of carbohydrate products. In order to neutralize it, varying numbers of insulin injections may be required.

It is necessary to select the dose taking into account the time period and food consumed, since the degree of activity human body varies significantly at different times of the day. In addition, the secretion of the insular apparatus of the pancreas occurs differently, these are the so-called circadian changes.

It should be taken into account that in the morning two units of the hormone are required per unit of bread, in lunch break- one, and in the evening - one and a half.

In order to correctly calculate the dosage of short-acting insulin units, it is necessary to follow a clearly established algorithm of actions (there is a special table for type 2 diabetes).

Insulin therapy provides the following basic rules and principles of insulin dosage:

1. The number of calories consumed during the day (daily value). This is the main characteristic that you should pay attention to in order to choose the right short-acting insulin. The number of kilocalories during the day is determined based on the physical activity of the diabetic.
2. During the day, the amount of all carbohydrate foods consumed should not exceed 60% of the total amount.
3. By consuming one gram of carbohydrates, the body produces four kilocalories.
4. Insulin dosage is based on the weight of the diabetic. For this, there are special tables (as well as an online insulin calculator), which indicate how many units of insulin must be administered as an injection per kilogram of the patient’s weight.
5. First, you should select a dose of a short-acting hormone, then a prolonged one.

An important point is that endocrinology does not use when calculating (for type 1 and type 2 diabetes) the consumption of foods containing proteins or fats.

Depending on the characteristics of the pathological process, the following dose of insulin is required per kilogram of a diabetic’s weight:

• disease manifestation – 0.5ꓼ
• time period of the so-called “imaginary calm” - 0.4ꓼ
• prolonged development of the pathological process – 0.8ꓼ
• decompensated course of the disease – 1.0 (maximum – 1.5)
• prepubertal time period – 0.6-0.8ꓼ
• puberty in adolescent children – 1.5-2.0.

Therefore, it is necessary to take short-acting insulin.

During therapy, you should donate blood to determine glucose levels and, if necessary, adjust the amount of insulin per 1 kg of weight.

How to calculate the amount of long-acting injection?

How much long-acting insulin should I use? This prolonged hormone is used to neutralize hyperglycemia in the morning on an empty stomach. Treatment is actively used both for the development of diabetes mellitus of the first and second types (to increase the sensitivity of cells to insulin). This does not take into account such a factor as taking a short-acting hormone before meals. Today, there are three categories of diabetics - those who use only the long-acting hormone, patients who need short-acting and ultra-short-acting insulin to neutralize sugar surges, and patients who are unable to do without both types of hormone.

It should be noted that if the dose is incorrectly calculated long-acting insulin, there will be a failure in the calculation of short- and ultra-short-exposure hormones.

One of the basic principles that diabetics need to consider is how to calculate the dose of insulin so that the amount of insulin keeps the glucose level within the normal range.

The prolonged dose of insulin for diabetes mellitus should be calculated based on the following postulates:

1. On the chosen day, you should skip the first meal - breakfast, and start taking blood sugar measurements until lunch every hour.
2. On the second day, you need to have breakfast, then wait three hours and begin measuring your glucose levels every hour before dinner. The main point to consider is skipping lunch.
3. On the third day, a diabetic can eat breakfast and lunch, but skip dinner. The concentration of glucose in the blood is measured throughout the day.

Ideally, morning values ​​should be within normal limits, and their growth increases during the day until the evening. There may be cases when sugar is higher in the morning (does not fall) than in the evening. Then it is necessary to adjust the volume of insulin administered.

Today, the Forsham calculation principle is often used (how to correctly calculate insulin for type 1 and type 2 diabetes, the formula for calculating insulin).

In addition, the following scheme can be taken into account:

• pick up daily consumption hormone, regardless of the time of its exposure - for this you need to use a table and multiply the patient’s weight by the coefficient ꓼ
• remove the amount of short-acting insulin from the resulting indicator, leaving a single dose of the hormone with a prolonged effect.

More complete information on the method of calculating insulin dosage can only be provided by the attending physician, taking into account the characteristics of the patient’s body.

What types of dosage selection are there?

There are several types of insulin therapy that are used today.

Traditional combined type. Using it, the insulin rate will be presented in the form of short- and long-acting injections (in a ratio of 30 to 70). Such indicators are calculated if there is an uneven course of the pathology with frequent surges in sugar. The main advantages of this treatment are the ease of selecting insulin dosages per day and monitoring glycemic levels three times a week. Great for elderly patients and children. To avoid sharp drops glucose levels, you must follow a strict diet.

The intensive type is more difficult to follow. To calculate how many units of insulin are needed during the day, the patient’s weight is taken into account and a special table is used. The long-acting hormone makes up approximately 40-50%, part of which (2/3) is administered in the first half of the day, and the next part in the evening. Short-acting insulin must be administered three times a day in the following ratio - 40% in the morning before meals, and 30% before lunch and dinner.

Traditional insulin therapy is also known as the standard dose regimen. If for certain reasons the patient cannot closely monitor glycemic levels, then medical experts recommend using this treatment regimen.

The following main advantages of this course of treatment can be identified:

1. There are no complex algorithms or calculations for how to calculate insulin doses.
2. Eliminates the need for frequent glucose measurements.

In this case, the patient is only required to strictly follow all the instructions of the attending physician.

diabetes.guru

Features of correct calculation

Without studying special calculation algorithms, selecting the amount of insulin for injection is life-threatening, since a person can expect a lethal dose. An incorrectly calculated dosage of the hormone will reduce blood glucose so much that the patient may lose consciousness and fall into a hypoglycemic coma. To prevent consequences, the patient is recommended to purchase a glucometer to constantly monitor sugar levels.

Correctly calculate the amount of hormone by following the following tips:

• Buy special scales for measuring portions. They must capture mass down to fractions of a gram.
• Write down the amount of protein, fat, and carbohydrates you consume and try to take them in the same amount every day.
• Carry out a weekly series of tests using a glucometer. In total, you need to take 10-15 measurements per day before and after meals. The results obtained will allow you to more carefully calculate the dosage and ensure that the selected injection regimen is correct.

The amount of insulin for diabetes is selected depending on the carbohydrate ratio. It is a combination of two important nuances:

• How much does 1 IU (unit) of insulin cover consumed carbohydrates?
• What is the degree of sugar reduction after injection of 1 unit of insulin.

It is customary to calculate the stated criteria experimentally. This is due to the individual characteristics of the body. The experiment is carried out in stages:

• It is advisable to take insulin half an hour before meals;
• measure glucose concentration before eating;
• after the injection and finishing the meal, take measurements every hour;
• Based on the results obtained, add or reduce the dose by 1-2 units for full compensation;
• Correctly calculating the dose of insulin will stabilize sugar levels. It is advisable to write down the selected dosage and use it in a further course of insulin therapy.

Apply high dosages insulin for type 1 diabetes, as well as after stress or trauma. For people with the second type of disease, insulin therapy is not always prescribed and when compensation is achieved, it is canceled, and treatment continues only with the help of tablets.

The dosage is calculated, regardless of the type of diabetes, based on the following factors:

• Duration of the disease. If a patient has been suffering from diabetes for many years, then only a large dosage of insulin reduces sugar.
• Development of renal or liver failure. Having problems with internal organs requires a downward adjustment of the insulin dose.
• Excess weight. Insulin calculation begins by multiplying the number of units of medication by body weight, so patients suffering from obesity will need more medicine than thin people.
• The use of third-party or hypoglycemic medications. Medicines can enhance or slow down the absorption of insulin, so when combining medication and insulin therapy, you will need to consult an endocrinologist.

It is better for a specialist to select formulas and dosage. He will assess the patient’s carbohydrate ratio and, depending on his age, weight, as well as the presence of other diseases and medications, will draw up a treatment regimen.

Dosage calculation

The dosage of insulin is different in each case. She is influenced various factors during the day, so a glucometer should always be at hand to measure your sugar level and give an injection. To calculate the required amount of hormone you do not need to know molar mass insulin protein, and it is enough to multiply it by the patient’s weight (IU * kg).

According to statistics, 1 unit of insulin is the maximum limit for 1 kg of body weight. Exceeding the permissible threshold does not improve compensation, but only increases the chances of developing complications associated with the development of hypoglycemia (low sugar). You can understand how to choose the dose of insulin by looking at the approximate indicators:

• after diabetes is diagnosed, the basic dosage does not exceed 0.5 units;
• after a year of successful treatment, the dose is left at 0.6 units;
• if diabetes is severe, then the amount of insulin increases to 0.7 units;
• in the absence of compensation, the dose is set to 0.8 units;
• after identifying complications, the doctor increases the dosage to 0.9 units;
• if a pregnant girl suffers from type 1 diabetes, then the dosage is increased to 1 unit (mainly after the 6th month of pregnancy).

Indicators may vary depending on the course of the disease and secondary factors affecting the patient. The algorithm below will tell you how to correctly calculate the insulin dosage by choosing the number of units from the list above:

• At one time, no more than 40 units of insulin are allowed, and the daily limit varies from 70 to 80 units.
• How much to multiply the selected number of units depends on the patient’s weight. For example, a person weighing 85 kg and successfully compensating for diabetes for a year (0.6 units) should inject no more than 51 units of insulin per day (85*0.6=51).
• Long-acting (long-term) insulin is administered 2 times a day, so the final result is divided by 2 (51/2=25.5). In the morning the injection should contain 2 times more units (34) than in the evening (17).
• Short-acting insulin should be used before meals. Its share is half of the maximum permissible dosage(25.5). It is distributed over 3 times (40% breakfast, 30% lunch and 30% dinner).

If glucose is already elevated before the introduction of the short-acting hormone, then the calculation changes slightly:

• 11-12 +2 units;
• 13-15 +4 units;
• 16-18 +6 units;
• 18> + 12 UNITS

The amount of carbohydrates consumed is displayed in bread units (25 g of bread or 12 g of sugar per 1 XE). Depending on the grain indicator, the amount of short-acting insulin is selected. The calculation is carried out as follows:

• in the morning, 1 XE covers 2 units of the hormone;
• at lunchtime, 1 XE covers 1.5 units of the hormone;
• in the evening the ratio of insulin and bread units is equal.

Calculation and technique of insulin administration

Insulin dosage and administration is important knowledge for any diabetic. Depending on the type of disease, slight changes in calculations are possible:

• In type 1 diabetes, the pancreas completely stops producing insulin. The patient has to take short-acting and long-acting hormone injections. To do this, take the total number of permissible units of insulin per day and divide by 2. The long-acting type of hormone is injected 2 times a day, and the short-term type at least 3 times before meals.
• In type 2 diabetes mellitus, insulin therapy is required if severe course illness or if drug treatment does not work. For treatment, long-acting insulin is used 2 times a day. The dosage for type 2 diabetes usually does not exceed 12 units at a time. A short-acting hormone is used for complete depletion of the pancreas.

After completing all the calculations, you need to find out what technique for administering insulin exists:

• wash your hands thoroughly;
• disinfect the stopper of the medicine bottle;
• draw air into the syringe equivalent to the amount of insulin injected;
• Place the bottle on a flat surface and insert a needle through the stopper;
• release the air from the syringe, turn the bottle upside down and draw in the medicine;
• the syringe should contain 2-3 units more than the required amount of insulin;
• stick out the syringe and squeeze out the remaining air from it, while adjusting the dosage;
• disinfect the injection site;
• inject the medicine subcutaneously. If the dosage is large, then intramuscularly.
• Disinfect the syringe and injection site again.

Alcohol is used as an antiseptic. Wipe everything with a piece of cotton wool or cotton swab. For better absorption, it is advisable to inject in the stomach. Periodically, the injection site can be changed on the shoulder and thigh.

Lower blood sugar with folk remedies Products to lower blood sugar

Insulin dose calculation: find out everything you need to know. Learn to manage with minimal doses and keep sugar 3.9-5.5 mmol/l stable 24 hours a day. It is possible to stop spikes in blood glucose levels even in severe type 1 diabetes in adults and children. And even more so, keep normal sugar, as in healthy people, with type 2 diabetes. Understand how to select the optimal dose of insulin, taking into account the individual course of diabetes.

Read the answers to the questions:

You need to observe the behavior of blood sugar in a diabetic at different times for several days, and then select an insulin therapy regimen.

Please note that large doses of insulin are unstable and unpredictable. Their strength is different days may differ by ±56%. To have good diabetes control, you need to manage this problem. The main remedy is switching to, which reduces the dosage by 2-8 times.

Diabetics who limit their carbohydrate intake should not inject more than 8 units of insulin at a time. If you need a higher dose, divide it into 2-3 approximately equal injections. Do them one after another in different places with the same syringe.

Treatment of diabetes with insulin - where to start:

Many diabetics who are treated with insulin find that episodes low sugar in the blood cannot be avoided. They think that terrible hypoglycemia attacks are an inevitable side effect. In fact, You can keep your blood sugar at a stable level even with severe autoimmune disease. And even more so with relatively mild type 2 diabetes. There is no need to artificially increase your blood glucose levels to protect yourself from dangerous hypoglycemia. Watch a video that discusses this issue. Learn how to balance your diet and insulin doses.

Below are answers to questions that patients often have.

What foods contain insulin?

None food products do not contain insulin. Also, there are no tablets containing this hormone yet. Because when administered orally, it is destroyed in the gastrointestinal tract, does not enter the bloodstream and does not affect glucose metabolism. Today, insulin to lower blood sugar can only be introduced into the body through injections. Inhalation aerosols are available, but they should not be used because they do not provide an accurate and stable dosage. Good news: needles insulin syringes and syringe pens are so thin that you can learn.

At what blood sugar levels are insulin injections prescribed?

Besides the most severe cases, diabetics need to first switch to it and sit on it for 3-7 days, monitoring their blood sugar. It may turn out that you don't need insulin injections at all.

Read about tablets containing metformin:

After switching to a healthy diet and starting to take metformin, you need to collect information about the behavior of sugar during each day for 3-7 days. Having accumulated this information, it is used to select optimal doses of insulin.

Diet, metformin and physical activity together they must bring the glucose level back to normal, as in healthy people - 3.9-5.5 mmol/l stably 24 hours a day. If such indicators cannot be achieved, add more insulin injections.

Don’t agree to live with a sugar level of 6-7 mmol/l, much less higher! These numbers are officially considered normal, but in reality they are elevated. With them, complications of diabetes develop, albeit slowly. Hundreds of thousands of diabetics who suffer from problems with their legs, kidneys and vision bitterly regret that at one time they were too lazy or afraid to inject themselves with insulin. Don't repeat their mistake. Use low, carefully measured doses to achieve levels consistently below 6.0 mmol/L.

It is often necessary to inject extended-release insulin at night in order to have normal blood sugar the next morning on an empty stomach. Read. First of all, figure out whether you need injections of extended-release medications. If they are necessary, start doing them.

Read about long-acting insulin preparations:

Tresiba is such an outstanding drug that the site administration has prepared a video about it.

Once you start injecting insulin, don’t even think about giving up your diet. If you are overweight, continue taking the pills. Try to find time and energy to exercise.

Measure your sugar before each meal and 3 hours after it. It is necessary to determine within a few days after which meals the glucose level regularly increases by 0.6 mmol/l or more. Before these meals you need to inject short or ultra-short insulin. This supports the pancreas in situations where it does not cope well on its own. Read more about choosing the optimal dosage before meals.

Important! All insulin preparations are very fragile and easily spoil. Study them and follow them diligently.

Sugar levels of 9.0 mmol/l and higher may be detected, even despite strict adherence to the diet. In this case, you need to immediately start giving injections, and only then add other medications. Also, people with type 1 diabetes and thin people who have been diagnosed with type 2 diabetes start using insulin immediately after a low-carb meal, bypassing the pill.

At high rates glucose in the blood, you need to start insulin therapy immediately, it is harmful to delay time.

What is the maximum dose of insulin per day?

There are no restrictions on the maximum daily dose of insulin. It can be increased until the glucose level of a diabetic patient returns to normal. IN professional magazines Cases have been described where patients with type 2 diabetes received 100-150 units per day. Another issue is that high doses of the hormone stimulate fat deposits in the body and worsen the course of diabetes.

The site teaches you how to keep your blood sugar consistently normal 24 hours a day and still manage with minimal doses. Read more and. First of all, you should go to . Diabetics who are already being treated with insulin, after switching to a new diet, should immediately reduce the dosage by 2-8 times.

How much insulin is needed for 1 bread unit (XE) of carbohydrates?

It is believed that for one unit of bread (XE) eaten for lunch or dinner, you need to inject 1.0-1.3 units of insulin. For breakfast - more, up to 2.0-2.5 units. In fact, this information is not accurate. It is better not to use it for actual calculation of insulin doses. Because different diabetics have different sensitivity to this hormone. It depends on the patient's age and weight, as well as other factors listed in the table below.

A pre-meal dose of insulin that would be appropriate for an adult or teenager may kill a small diabetic child. On the other hand, a tiny dose that would be sufficient for a child would have virtually no effect on an overweight adult with type 2 diabetes.

You need to carefully figure out through trial and error how many grams of carbohydrates eaten are covered by 1 unit of insulin. Approximate data is given in. They need to be clarified individually for each diabetic, accumulating statistics on the effect of injections on his body. - this is a real and serious danger. To avoid it, treatment begins with obviously low, insufficient doses. They are slowly and carefully increased at intervals of 1-3 days.

Diet options depending on diagnosis:

The website explains how to use it to treat diabetes. By switching to this diet, you can stop spikes in glucose levels and keep your blood sugar at a stable 3.9-5.5 mmol/l, like in healthy people.

Diabetics who follow healthy diet, they count their carbohydrate consumption not in bread units, but in grams. Because grain units only cause confusion without bringing any benefit. On a low-carbohydrate diet, the maximum carbohydrate intake does not exceed 2.5 XE per day. Therefore, it makes no sense to calculate insulin doses by bread units.

How much does 1 unit of insulin reduce blood sugar?

Materials from the Federal State Budgetary Institution “Endocrinological Research Center” of the Ministry of Health of the Russian Federation say that 1 unit of insulin reduces blood sugar by an average of 2.0 mmol/l. This figure is clearly underestimated. Using this information is useless and even dangerous. Because insulin works differently for all diabetics. It has a much stronger effect on thin adults, people with type 1 diabetes, and children. Except in cases where storage rules were violated and the insulin deteriorated.

Different preparations of this hormone differ significantly in strength. For example, ultra-short types of insulin Humalog, NovoRapid and Apidra are approximately 1.5 times stronger than short-acting Actrapid. The types of extra-long-acting, extended-acting, intermediate-acting, short-acting and ultra-short-acting insulin each work differently. They affect blood sugar differently. The purposes of their administration and the methods for calculating dosages are not at all similar. It is not possible to use any average effectiveness for all of them.

Read about short-acting and ultra-short-acting insulin preparations:

Example. Let's say you have determined through trial and error that 1 unit of NovoRapid reduces your glucose level by 4.5 mmol/l. After that, you learned about the miraculous and switched to it. says that short-acting insulin is better suited for a low-carbohydrate diet than ultra-fast insulin. Therefore, you are going to change NovoRapid to Actrapid, which is approximately 1.5 times weaker. To calculate your starting dose, you assume that 1 unit will lower your blood sugar by 4.5 mmol/L / 1.5 = 3.0 mmol/L. Then, within a few days, you will clarify this figure based on the results of the first injections.

Each diabetic needs to use trial and error to find out exactly how much 1 unit of insulin he injects reduces his glucose level. It is not advisable to use it to calculate your individual doses average figure, taken from the Internet. However, you have to start somewhere. You can use the following information provided by Dr. Bernstein to calculate your starting dose.

approximately by 3 mmol/l. The more the patient weighs and the higher the fat content in his body, the weaker the insulin works. The relationship between body weight and the strength of insulin is inversely proportional and linear. For example, in an obese patient with type 2 diabetes weighing 126 kg, 1 unit of Humalog, Apidra or NovoRapid will reduce sugar approximately by 1.5 mmol/l.

To calculate the appropriate dose, you need to make a proportion taking into account the body weight of the diabetic. If you don't know how to make a proportion and can't count without making mistakes, it's better not to even try. Seek help from someone advanced in arithmetic. Because an error in the dosage of potent rapid insulin can have serious consequences, even kill the patient.

Training example. Let's say a diabetic weighs 71 kg. His rapid insulin is, for example, NovoRapid. By calculating the proportion, you can find out that 1 unit of this drug will reduce sugar by 2.66 mmol/l. Did your answer match this figure? If yes, then it's ok. Let us repeat that this method is only suitable for calculating the first, starting dose. The figure you get by calculating the portion needs to be clarified based on the results of the injections.

How much sugar reduces 1 unit depends on body weight, age, level of physical activity of the person, the drug used and many other factors.

Factors affecting insulin sensitivity

The higher the sensitivity, the more each administered unit (IU) of insulin lowers sugar. Approximate figures are given in, as well as in. This data can only be used to calculate the starting dosage. Then they need to be clarified individually for each diabetic based on the results of previous injections. Don't be lazy to choose carefully optimal dosages to keep glucose levels stable at 4.0-5.5 mmol/l 24 hours a day.

How many units of insulin are needed to reduce sugar by 1 mmol/l?

The answer to this question depends on the following factors:

• age of the diabetic;
• body mass;
• level of physical activity.

Several other important factors are listed in the table above. Having accumulated information over 1-2 weeks of injections, you can calculate how much 1 unit of insulin lowers sugar. The results will be different for long-acting, short-acting and ultra-short-acting drugs. Knowing these numbers, it is easy to calculate the dose of insulin that will reduce blood sugar by 1 mmol/l.

Keeping a diary and doing calculations is a hassle and takes up some time. However, this is the only way to select optimal dosages, maintain stable normal glucose levels and protect against diabetes complications.

When will the results of the injection appear?

This question requires a detailed answer because different types of insulin take effect at different rates.

Insulin preparations are divided into:

• extended - Lantus, Tujeo, Levemir, Tresiba;
• medium - Protafan, Biosulin N, Insuman Bazal GT, Rinsulin NPH, Humulin NPH;
• fast acting - Actrapid, Apidra, Humalog, NovoRapid, domestic.

There are also two-phase mixtures - for example, Humalog Mix, NovoMix, Rosinsulin M. However, it is not recommended to use them. They are not discussed on this site. To achieve good control of diabetes, you need to switch from these drugs to the simultaneous use of two types of insulin - long-acting and fast (short or ultra-short).

It is further assumed that the diabetic follows and receives low doses of insulin that correspond to it. These doses are 2-7 times lower than those to which doctors are accustomed. Treatment of diabetes with insulin according to Dr. Bernstein's methods allows you to achieve stable blood sugar levels of 3.9-5.5 mmol/l. This is real even with severe violations glucose metabolism. However, insulin in low doses ah starts working later and stops working earlier than standard high doses.

Fast (short and ultra-short) insulin begins to act 10-40 minutes after the injection, depending on the drug administered and dose. However, this does not mean that after 10-40 minutes the glucometer will show a decrease in sugar. For the effect to appear, you need to measure your glucose level no earlier than after 1 hour. It is better to do this later - after 2-3 hours.

Study the details. You should not inject large doses of these drugs to get quick effect. You will almost certainly inject yourself with more of the hormone than you should, and this will lead to hypoglycemia. There will be hand trembling, nervousness and other unpleasant symptoms. There may even be loss of consciousness and death. Handle rapid-acting insulin with care! Before using, thoroughly understand how it works and how to determine the appropriate dosage.

Medium- and long-acting insulin preparations begin to work 1-3 hours after the injection. They give a smooth effect that is difficult to track with a glucometer. A single sugar measurement may not reveal anything. You need to self-monitor your blood glucose levels several times every day.

Diabetics who give themselves long-acting insulin injections in the morning see their results in the evening, based on the results of the whole day. It is useful to build visual graphs of sugar levels. On the days when long-term insulin was given, they will differ significantly in better side. Of course, if the dose of the drug is correctly selected.

An injection of extended-release insulin given at night gives results the next morning. Fasting sugar levels improve. In addition to measuring in the morning, you can also monitor your glucose levels in the middle of the night. It is advisable to check your sugar at night in the first days of treatment, when there is a risk of overdoing the starting dose. Set an alarm to wake up at right time. Measure your sugar, record the result and continue sleeping.

Research before starting diabetes treatment with this remedy.

How much insulin should be injected if a diabetic's blood sugar is very high?

The required dose depends not only on blood sugar, but also on body weight, as well as on the individual sensitivity of the patient. There are many factors that affect insulin sensitivity. They are listed above on this page.

It will be useful to you. Short-acting and ultra-short-acting drugs are administered to diabetics when they need to quickly reduce high sugar levels. Long-acting and intermediate-acting insulin should not be used in such situations.

In addition to injecting insulin, it will be useful for a diabetic to drink a lot of water or herbal tea. Of course, without honey, sugar and other sweets. Drinking liquid dilutes the blood, reduces the concentration of glucose in it, and also helps the kidneys remove some of the excess glucose from the body.

A diabetic needs to determine exactly how much 1 unit of insulin reduces his glucose level. This can be learned over a period of days or weeks through trial and error. Each time the dose is calculated, the resulting figure must be adjusted for weather, infectious diseases and other factors.

There are situations when sugar has already jumped, you need to bring it down urgently, but you have not yet had time to accumulate accurate data by trial and error. How to calculate the insulin dose in this case? You will have to use indicative information.

You can use the dose calculation method below at your own peril and risk. An overdose of insulin can cause unpleasant symptoms, impaired consciousness and even death.

In an adult with a body weight of 63 kg, 1 unit of ultra-short insulin Humalog, Apidra or NovoRapid lowers blood sugar approximately by 3 mmol/l. The greater your body weight and the higher your body fat content, the weaker your insulin works. For example, in an obese patient with type 2 diabetes weighing 126 kg, 1 unit of Humalog, Apidra or NovoRapid will reduce sugar approximately by 1.5 mmol/l. It is necessary to make a proportion taking into account the body weight of the diabetic.

If you don’t know how to make a proportion, and you’re not sure that you can calculate it accurately, then it’s better not to even try. Seek help from someone competent. An error in the dosage of short-term or ultra-fast insulin can have serious consequences, even kill the patient.

Let's say a diabetic weighs 71 kg. His rapid insulin is for example Apidra. Having drawn up the proportion, you calculated that 1 unit will reduce sugar by 2.66 mmol/l. Let's say the patient's blood glucose level is 14 mmol/l. It needs to be reduced to 6 mmol/l. Difference with target: 14 mmol/l - 6 mmol/l = 8 mmol/l. Required insulin dose: 8 mmol/l / 2.66 mmol/l = 3.0 units.

Let us repeat once again that this is an approximate dose. It is guaranteed not to be a perfect fit. You can inject 25-30% less to reduce the risk of hypoglycemia. This calculation method should only be used if the patient has not yet accumulated accurate information through trial and error.

The drug Actrapid is approximately 1.5 times weaker than Humalog, Apidra or NovoRapid. It also takes effect later. However, Dr. Bernstein recommends using it. Because short-term insulin is better compatible with a low-carbohydrate diet than ultra-short insulin.

The insulin dose calculation method given above is not suitable for diabetic children. Because their sensitivity to insulin is several times higher than that of adults. An injection of rapid insulin in a dose calculated according to the indicated method will most likely cause severe hypoglycemia in the child.

What are the features of calculating the dose of insulin for diabetic children?

In diabetic children up to adolescence Insulin sensitivity is several times higher than in adults. Therefore, children require negligible doses compared to adult patients. As a rule, parents who control diabetes in their children have to dilute insulin saline solution, purchased at a pharmacy. This helps to accurately inject doses of 0.25 units.

Above, we discussed how to calculate the insulin dose for an adult with a body weight of 63 kg. Let's say a diabetic child weighs 21 kg. It can be assumed that he will need a dose of insulin 3 times less than an adult, with the same blood glucose levels. But this assumption will be incorrect. A suitable dose will most likely be not 3, but 7-9 times less.

Diabetic children are at significant risk of episodes of low blood sugar caused by insulin overdose. To avoid an overdose, start insulin injections with deliberately low doses. Then they are slowly increased until the blood glucose level becomes stably normal. It is undesirable to use potent drugs Humalog, Apidra and NovoRapid. Try Actrapid instead.

Children under 8-10 years old can start injecting insulin with a dose of 0.25 units. Many parents doubt that such a “homeopathic” dose will have any effect. However, most likely, you will notice the effect from the first injection based on the glucometer readings. If necessary, increase the dose by 0.25-0.5 units every 2-3 days.

The information on calculating insulin doses given above is suitable for diabetic children who strictly adhere to the dose. Fruits and others should be excluded completely. The child needs to be explained the consequences of using junk food. There is no need to use an insulin pump. However, it is advisable to wear a continuous glucose monitoring system if you can afford it.

Insulin therapy is currently the only way to prolong life for people with type 1 diabetes and severe type 2 diabetes. Correct calculation of the required dose of insulin allows you to simulate as much as possible natural production of this hormone in healthy people.

The dosage selection algorithm depends on the type of drug used, the chosen insulin therapy regimen, nutrition and physiological characteristics of the patient with diabetes. All patients with diabetes need to be able to calculate the initial dose, adjust the amount of the drug depending on carbohydrates in food, and eliminate occasional ones. Ultimately, this knowledge will help avoid multiple complications and give you decades of healthy life.

Types of insulin by duration of action

The vast majority of insulin in the world is produced in pharmaceutical factories using genetic engineering technologies. Compared to outdated preparations of animal origin, modern products are characterized by high purification, minimum side effects, stable, well-predictable action. Currently, two types of hormones are used to treat diabetes: human and insulin analogues.

Molecule human insulin completely repeats the molecule of the hormone produced in the body. These are short-acting agents; their duration of operation does not exceed 6 hours. NPH insulins also belong to this group. average duration. Their action time is longer, about 12 hours, due to the addition of protamine protein to the drug.

Insulin analogs are structurally different from human insulin. Due to the peculiarities of the molecule, these drugs can be used to more effectively compensate for diabetes. These include ultra-short-acting agents that begin to reduce sugar 10 minutes after injection, long- and extra-long-acting agents that work from 24 hours to 42 hours.

Calculation of the required amount of long-acting insulin

Normally, the pancreas secretes insulin around the clock, approximately 1 unit per hour. This is the so-called basal insulin. It helps maintain blood sugar at night and on an empty stomach. To simulate background insulin production, a medium- and long-acting hormone is used.

For patients with type 1 diabetes, this insulin is not enough; they require injections of fast-acting drugs at least three times a day, before meals. But with type 2 of the disease, one or two injections are usually enough long insulin, since a certain amount of the hormone is secreted additionally by the pancreas.

The calculation of the dose of long-acting insulin is carried out first, since without fully meeting the basal needs of the body it is impossible to select the right dosage short drug, and periodic sugar spikes will occur after eating.

Algorithm for calculating insulin dose per day:

1. We determine the patient's weight.
2. We multiply the weight by a factor of 0.3 to 0.5 for type 2 diabetes, if the pancreas is still able to secrete insulin.
3. We use a coefficient of 0.5 for type 1 diabetes at the onset of the disease, and 0.7 – 10-15 years after the onset of the disease.
4. We take 30% of the received dose (usually up to 14 units) and distribute it into 2 injections - morning and evening.
5. We check the dosage over 3 days: on the first day we skip breakfast, on the second day we skip lunch, on the third day we skip dinner. During periods of fasting, glucose levels should remain close to normal.
6. If we use NPH insulin, we check glycemia before dinner: at this time, sugar may be reduced due to the peak effect of the drug.
7. Based on the data obtained, we adjust the calculation of the initial dose: reduce or increase by 2 units until glycemia is normalized.

The correct dosage of the hormone is assessed according to the following criteria:

• to maintain normal fasting glucose per day, no more than 2 injections are required;
• no night (measurement is carried out at night at 3 o’clock);
• before meals, the glucose level is close to the target;
• the dose of long-acting insulin does not exceed half of the total amount of the drug, usually from 30%.

Short term insulin requirement

To calculate short-term insulin, a special concept is used - a bread unit. It is equal to 12 grams of carbohydrates. One XE is about a slice of bread, half a bun, half a serving of pasta. You can find out how many units of bread are on a plate using scales, which indicate the amount of XE in 100 g of different products.

Over time, diabetic patients no longer need to constantly weigh food, but learn to determine the carbohydrate content in it by eye. As a rule, this approximate amount is sufficient to calculate the insulin dose and achieve normoglycemia.

Algorithm for calculating the dosage of short-acting insulin:

1. We set aside a portion of food, weigh it, and determine the amount of XE in it.
2. We calculate the required dose of insulin: multiply XE by the average amount of insulin produced in a healthy person in given time days (see table below).
3. We administer the drug. Short-acting - half an hour before meals, ultra-short - right before meals or immediately after.
4. After 2 hours we measure blood glucose, by this time it should be normalized.
5. If necessary, adjust the dose: to reduce sugar by 2 mmol/l you need one additional unit of insulin.

To facilitate the calculation of insulin, a food diary will help, which indicates glycemia before and after meals, the amount of XE consumed, the dose and type of drug administered. It will be easier to choose a dose if at first you eat the same type, consuming approximately the same portions of carbohydrates and proteins at a time. You can count XE and keep a diary online or in special programs for phones.

Insulin therapy regimens

There are two insulin therapy regimens: traditional and intensive. The first involves constant doses of insulin calculated by the doctor. The second includes 1-2 injections of a pre-selected amount of a long hormone and several short ones, which are calculated each time before meals. The choice of regimen depends on the severity of the disease and the patient’s readiness to independently control blood sugar.

Traditional mode

The calculated daily dose of the hormone is divided into 2 parts: morning (2/3 of the total) and evening (1/3). Short insulin is 30-40%. You can use ready-made mixtures in which short-term and basal insulin have a ratio of 30:70.

The advantages of the traditional regimen are the absence of the need to use daily dose calculation algorithms and rare glucose measurements once every 1-2 days. It can be used for patients who are unable or unwilling to constantly control their sugar.

The main disadvantage of the traditional regimen is that the volume and timing of insulin injections does not correspond at all to the synthesis of insulin in a healthy person. If a natural hormone is secreted to supply sugar, then everything happens the other way around: in order to achieve normal glycemia, you have to adjust your diet to the amount of insulin administered. As a result, patients are faced with a strict diet, each deviation from which can result in or.

Intensive mode

Intensive insulin therapy is generally recognized throughout the world as the most progressive insulin administration regimen. It is also called basal-bolus, as it is capable of simulating both constant, basal, hormone secretion and bolus insulin released in response to an increase in blood glucose.

The undoubted advantage of this regime is the absence of a diet. If a patient with diabetes has mastered the principles of correct dosage calculation and glycemic correction, he can eat like any healthy person.

Scheme intensive use insulin:

In this case, there is no specific daily dose of insulin; it changes daily depending on dietary habits, level of physical activity or exacerbation of concomitant diseases. There is no upper limit for the amount of insulin; the main criterion for the correct use of the drug is glycemic levels. Diabetic patients using an intensive regimen should use a glucometer several times during the day (about 7) and, based on the measurement data, change the subsequent dose of insulin.

Numerous studies have proven that achieving normoglycemia in diabetes mellitus is possible only with intensive use of insulin. In patients, the likelihood of nephropathy and heart problems decreases by 60% (7% versus 9% on the traditional regimen).

Correction of hyperglycemia

After starting to use insulin, it is necessary to adjust the amount of the drug by 1 XE depending on individual characteristics. To do this, take the average carbohydrate coefficient for this technique food, insulin is administered, glucose is measured after 2 hours. Hyperglycemia indicates a deficiency of the hormone; the coefficient needs to be increased slightly. If sugar is low, we reduce the coefficient. By constantly keeping a diary, after a couple of weeks you will have data on your personal insulin needs at different times of the day.

Even with a properly selected carbohydrate ratio, hyperglycemia can sometimes occur in patients with diabetes. It can be caused by infection, stressful situation, unusually little physical activity, hormonal changes. If hyperglycemia is detected, a corrective dose, the so-called boost, is added to the bolus insulin.

To more accurately calculate the injection dose, you can use an adjustment factor. For short-acting insulin it is equal to 83/daily insulin, for ultra-short insulin – 100/daily insulin. For example, to reduce sugar by 4 mmol/l, a patient with daily dose A 40 unit bolus user of Humalog would make the following calculation: 4/(100/40) = 1.6 units. We round this value to 1.5, add insulin to the next dose and administer it before meals, as usual.

Hyperglycemia can also be caused by incorrect technique for administering the hormone:

• It is better to inject short insulin into the stomach, long insulin into the thigh or buttock.
• The exact interval from injection to meal is indicated in the instructions for the drug.
• The syringe is not removed for 10 seconds after the injection; all this time the skin fold is held.

If the injection is done correctly, visible reasons There is no hyperglycemia, and sugar continues to rise regularly, you need to visit your doctor to increase the dose of basal insulin.

High concentrations of glucose in the blood have a detrimental effect on all systems of the body. It is characteristic of type 1-2 diabetes mellitus. Sugar increases due to insufficient production of the hormone by the pancreas or its poor absorption. If diabetes is not compensated for, then the person will face serious consequences (hyperglycemic coma, death). The basis of therapy is the introduction of short- and long-acting artificial insulin. Injections are required mainly for people with type 1 disease (insulin-dependent) and severe forms of the second type (non-insulin-dependent). The attending physician should tell you how to calculate the insulin dose after receiving the examination results.

Without studying special calculation algorithms, selecting the amount of insulin for injection is life-threatening, since a person can expect a lethal dose. An incorrectly calculated dosage of the hormone will reduce blood glucose so much that the patient may lose consciousness and fall into a hypoglycemic coma. To prevent consequences, the patient is recommended to purchase a glucometer to constantly monitor sugar levels.

Correctly calculate the amount of hormone by following the following tips:

• Buy special scales for measuring portions. They must capture mass down to fractions of a gram.
• Write down the amount of protein, fat, and carbohydrates you consume and try to take them in the same amount every day.
• Carry out a weekly series of tests using a glucometer. In total, you need to take 10-15 measurements per day before and after meals. The results obtained will allow you to more carefully calculate the dosage and ensure that the selected injection regimen is correct.

The amount of insulin for diabetes is selected depending on the carbohydrate ratio. It is a combination of two important nuances:

• How much does 1 IU (unit) of insulin cover consumed carbohydrates?
• What is the degree of sugar reduction after injection of 1 unit of insulin.

It is customary to calculate the stated criteria experimentally. This is due to the individual characteristics of the body. The experiment is carried out in stages:

• It is advisable to take insulin half an hour before meals;
• measure glucose concentration before eating;
• after the injection and finishing the meal, take measurements every hour;
• Based on the results obtained, add or reduce the dose by 1-2 units for full compensation;
• Correctly calculating the dose of insulin will stabilize sugar levels. It is advisable to write down the selected dosage and use it in a further course of insulin therapy.

High dosages of insulin are used for type 1 diabetes, as well as after stress or trauma. For people with the second type of disease, insulin therapy is not always prescribed and when compensation is achieved, it is canceled, and treatment continues only with the help of tablets.

The dosage is calculated, regardless of the type of diabetes, based on the following factors:

• Duration of the disease. If the patient has been suffering from diabetes for many years, then only a large dosage reduces sugar.
• Development of renal or liver failure. The presence of problems with internal organs requires a downward adjustment of the insulin dose.
• Excess weight. The calculation begins by multiplying the number of units of medication by body weight, so obese patients will need more medication than thin people.
• The use of third-party or hypoglycemic medications. Medicines can enhance or slow down the absorption of insulin, so when combining medication and insulin therapy, you will need to consult an endocrinologist.

It is better for a specialist to select formulas and dosage. He will assess the patient’s carbohydrate ratio and, depending on his age, weight, as well as the presence of other diseases and medications, will draw up a treatment regimen.

Dosage calculation

The dosage of insulin is different in each case. It is influenced by various factors throughout the day, so a glucometer should always be at hand to measure your sugar level and give an injection. To calculate the required amount of the hormone, you do not need to know the molar mass of the insulin protein, but simply multiply it by the patient’s weight (IU * kg).

According to statistics, 1 unit is the maximum limit for 1 kg of body weight. Exceeding the permissible threshold does not improve compensation, but only increases the chances of developing complications associated with the development of hypoglycemia (low sugar). You can understand how to choose the dose of insulin by looking at the approximate indicators:

• after diabetes is diagnosed, the basic dosage does not exceed 0.5 units;
• after a year of successful treatment, the dose is left at 0.6 units;
• if diabetes is severe, then the amount of insulin increases to 0.7 units;
• in the absence of compensation, the dose is set to 0.8 units;
• after identifying complications, the doctor increases the dosage to 0.9 units;
• if a pregnant girl suffers from type 1 diabetes, then the dosage is increased to 1 unit (mainly after the 6th month of pregnancy).

Indicators may vary depending on the course of the disease and secondary factors affecting the patient. The algorithm below will tell you how to correctly calculate the insulin dosage by choosing the number of units from the list above:

• No more than 40 units are allowed to be used at a time, and the daily limit varies from 70 to 80 units.
• How much to multiply the selected number of units depends on the patient’s weight. For example, a person weighing 85 kg and successfully compensating for diabetes for a year (0.6 units) should inject no more than 51 units per day (85*0.6=51).
• Long-acting (long-term) insulin is administered 2 times a day, so the final result is divided by 2 (51/2=25.5). In the morning the injection should contain 2 times more units (34) than in the evening (17).
• Short-acting insulin should be used before meals. It accounts for half of the maximum permissible dosage (25.5). It is distributed over 3 times (40% breakfast, 30% lunch and 30% dinner).

If glucose is already elevated before the introduction of the short-acting hormone, then the calculation changes slightly:

• 11-12 +2 units;
• 13-15 +4 units;
• 16-18 +6 units;
• 18> + 12 UNITS

The amount of carbohydrates consumed is displayed in bread units (25 g of bread or 12 g of sugar per 1 XE). Depending on the grain indicator, the amount of short-acting insulin is selected. The calculation is carried out as follows:

• in the morning, 1 XE covers 2 units of the hormone;
• at lunchtime, 1 XE covers 1.5 units of the hormone;
• in the evening the ratio of insulin and bread units is equal.

Calculation and technique of insulin administration

Dosage is important knowledge for any diabetic. Depending on the type of disease, slight changes in calculations are possible:

• In type 1 diabetes, the pancreas completely stops producing insulin. The patient has to take short-acting and long-acting hormone injections. To do this, take the total number of permissible units of insulin per day and divide by 2. The long-acting type of hormone is injected 2 times a day, and the short-term type at least 3 times before meals.
• In type 2 diabetes mellitus, insulin therapy is required if the disease is severe or if drug treatment does not produce results. For treatment, long-acting insulin is used 2 times a day. The dosage for type 2 diabetes usually does not exceed 12 units at a time. A short-acting hormone is used for complete depletion of the pancreas.

After completing all the calculations, you need to find out what technique for administering insulin exists:

• wash your hands thoroughly;
• disinfect the stopper of the medicine bottle;
• draw air into the syringe equivalent to the amount of insulin injected;
• Place the bottle on a flat surface and insert a needle through the stopper;
• release the air from the syringe, turn the bottle upside down and draw in the medicine;
• the syringe should contain 2-3 units more than the required amount of insulin;
• stick out the syringe and squeeze out the remaining air from it, while adjusting the dosage;
• disinfect the injection site;
• inject the medicine subcutaneously. If the dosage is large, then intramuscularly.
• Disinfect the syringe and injection site again.

Alcohol is used as an antiseptic. Wipe everything with a piece of cotton wool or a cotton swab. For better absorption, it is advisable to inject in the stomach. Periodically, the injection site can be changed on the shoulder and thigh.

How much does 1 unit of insulin reduce blood sugar?

On average, 1 unit of insulin lowers glucose concentration by 2 mmol/l. The value is checked experimentally. In some patients, sugar drops by 2 units once, and then by 3-4, so it is recommended to constantly monitor glycemic levels and inform your doctor about all changes.

How to use

The use of long-acting insulin creates the appearance of the pancreas working. Administration occurs half an hour before the first and last meals. Short-acting and ultra-short-acting hormones are used before meals. The number of units varies from 14 to 28. Various factors influence the dosage (age, other diseases and medications, weight, sugar level).

Correct calculation of insulin will help not only improve the patient’s condition and well-being, but also prolong the life of a diabetic. Prescribing therapy that is relevant in each individual case leads to a qualitative improvement in life, reducing the likelihood of crises, and “smoothing out” exacerbations. Today, every person can independently monitor their blood glucose levels using special devices and test strips. Based on the information obtained during continuous monitoring, as well as test results, the doctor prescribes drug therapy and selects the right type of drug. If all instructions are strictly followed, the disease will progress more slowly, and resistance will not form so quickly.

What is a selection algorithm?

A selection algorithm is a calculation formula that calculates the required composition of a substance to reduce blood sugar levels by the required number of units. One dosage of insulin must fully meet the needs of the individual patient.

You need to understand that the dose of insulin is not chosen randomly and is not the same for all patients with this diagnosis.

There is a special formula that can be used to calculate the dose of insulin, taking into account the characteristics of the course and type of the disease itself. The calculation formula is not the same for type 1 diabetes in different periods.

The medicinal composition is sold in ampoules of 5 ml. Each milliliter (1 cube) is equal to 40 or 100 units of substance (IU). The calculation of the insulin dose in patients with pancreatic dysfunction is carried out using a special formula using various coefficients: the approximate number of units of solution is calculated per kilogram of weight. If obesity or even a slight excess of the index is detected, the coefficient must be reduced by 0.1. If there is a deficiency of body weight, increase by 0.1. The selection of dosage for subcutaneous injections depends on the medical history, tolerability of the substance, results laboratory research.

Calculation of doses:

• 0.4-0.5 U/kg for persons with newly diagnosed type 1 diabetes.
• 0.6 IU/kg for patients with an illness diagnosed more than a year ago in good compensation.
• 0.7 U/kg for diabetics with type 1 disease, duration from 1 year with unstable compensation.
• 0.8 U/kg for people with type 1 diabetes in a decompensated situation.
• 0.9 U/kg for persons with type 1 diabetes in a state of ketoacidosis.
• 1.0 U/kg for patients in puberty or III trimester pregnancy.

The dose calculation when using insulin is carried out taking into account the condition, lifestyle, and nutrition plan. Use of more than 1 unit per 1 kg of weight indicates an overdose. You can select the dose of insulin for a patient with diabetes diagnosed for the first time using the following calculation: 0.5 units x body weight in kilograms. After the start of therapy, the body's need for additional use medications may decrease. More often this occurs in the first six months of treatment and is normal reaction. In the subsequent period (around 12–15 months), the need will increase, reaching 0.6 units. With decompensation, as well as when ketoacidosis is detected, the insulin dose due to resistance increases, reaching 0.7-0.8 units per kilogram of weight.

It is better to leave the calculation of insulin doses to a specialist! Based on analyzes and results necessary examinations, it will calculate your correct daily dose.

Prolonged hormone

Prolonged - a drug with a long period of action, which develops not from the moment of insulin administration, but after some time. The use of a prolonged substance is permanent, not episodic. Even despite the doctor’s instructions and discussion of details during an oral consultation, the diabetic does not know the rules for calculating insulin and how much to administer. The fact is that a prolonged hormone must be used to reduce glucose levels to normal indicators on an ongoing basis. It is required for both types of diabetes, but not for everyone. Many people do not need a long-acting product - the doctor prescribes only a short or ultra-short one, which stops sudden surges in sugar after administration.

It’s easy to choose a dose of a long-acting hormone. After all, the required volume of insulin administration will not depend on changes in sugar levels during the day due to food intake, as well as the administration of ultra-short or short-term insulin before meals. The drug is necessary for stable maintenance of normal parameters and is not prescribed for the relief of acute attacks.

• Day 1 – start measuring glucose levels hourly from the moment you wake up until lunch, without eating during this period of time (record the results).
• Day 2 - have breakfast, and after three hours begin hourly measurements until the evening meal (lunch is excluded).
• Day 3 – breakfast and lunch are allowed, dinner is excluded – measured hourly throughout the day.

If insulin doses are determined correctly, then in the morning of the 1st day the parameters will be within 4.9–5 mmol/l, on the second day – no higher than 7.9–8 mmol/l, and on the third ─ less than 11.9–12 mmol/l. If the indicators are normal, then everything is in order and the volume of the calculated substance is correct. If sugar levels drop, insulin doses need to be reduced - an overdose is likely. At levels above these values, the dose and insulin administration are increased.

Determination of the short-term hormone norm

A hormone with a short period of action is called short. It is prescribed to relieve attacks, when sharp jumps glucose levels, as well as before meals. It will reduce glucose levels to the required parameters. Before administering insulin, it is recommended to determine the dosage needed for a person. To do this, the patient measures his sugar throughout the week and records the readings. If the daytime results are normal, and after dinner the blood glucose level increases sharply, then a short form of the substance will be prescribed to the patient every day in the evening - before meals. If sugar spikes are observed after every meal, three-time insulin injections cannot be avoided. You will have to take the drug every time before meals.

To constantly monitor your blood sugar levels, use a glucometer! With its help, you can do the analysis right at home!

The attending physician should select the daily dosage of the drug, guided by the data obtained during the experiment: the injection is given 40 minutes before meals. Next, the values ​​are measured 30 and 20 minutes before meals. If sugar has decreased by 0.3 mmol/l, you can start eating without fear of a hypoglycemic effect. If there was no decrease even 40 minutes after the injection, then the patient postpones the meal, while simultaneously measuring the indicators every 5 minutes until the first changes are recorded. The experiment continues until the dosage of the short-term hormone changes by 50%. This experiment is needed when the glucometer readings are not higher than 7.6 mmol/l. After all, a correctly selected set of drugs, taking into account the individual characteristics of the body, is extremely necessary for the patient.

Taking ultra-short hormone

Ultra-short hormone is also administered before meals, but the procedure lasts for 15-5 minutes. Its action is even more limited in time than the action of a short-term hormone; it occurs faster, but also ends faster. The required amount of medicine can be calculated taking into account the values ​​​​obtained during the experiment. As a rule, the calculation is carried out in the same way as in the previous case, but taking into account the reduced period of time for the onset of action of the substance.

In any case, determine the volume of substance required to provide the desired therapeutic effect, the doctor should. The specialist knows how much 1 unit of insulin reduces blood glucose levels, taking into account the characteristics of the human body, based on theoretical knowledge, laboratory test results and anamnesis data. Both exceeding the required dosage and not receiving the required volume of units is dangerous for the health of a diabetic. Therefore, self-prescription or withdrawal of the drug can negatively affect the condition and lead to undesirable consequences.