How to adjust insulin dosage

When using insulin, you must pay attention to the correct method and dosage, because excessive dosage may cause side effects or other adverse injuries. However, the dosage of insulin should be decided based on the patient's physical condition and the doctor's advice.

1. Dose adjustment: The principle is to adjust diet and physical activity first, and then adjust insulin after blood sugar stabilizes.

(1) The semi-quantitative urine sugar level in four times and four segments is the best indicator for adjusting the insulin dosage. For every (+) result, add 2U.

(2) The total daily addition or subtraction should not be too large, generally not exceeding 8U. Type 1 patients are more sensitive to insulin when their blood sugar is close to satisfactory, so they should be more cautious.

(3) After each adjustment, the patient should generally be observed for 3 to 5 days.

(4) Patients with negative urine sugar and low blood sugar should reduce the dosage promptly.

2. Adjustment of injection frequency: mainly to facilitate blood sugar control.

(1) Short-acting insulin should be injected multiple times at the beginning. After satisfactory control, intermediate-acting or long-acting insulin can be used instead. Long-acting insulin alone is not very effective.

(2) Change to the short-acting + medium-acting method: they can be mixed in any proportion. The commonly used ratio is about 1:1, and the medium-effective ratio can be slightly more.

(3) Add long-acting insulin: The sum of two short-acting insulins is converted into a mixed insulin in the ratio of long-acting to short-acting insulin = 1:2-4. The long-acting insulin should not exceed 1/2 of the short-acting insulin. The long-acting insulin dose before going to bed should generally not exceed 8U.

For example, if you take 12U in the morning and 8U in the afternoon, you can change it to: short-acting + medium-acting, which is 10U+10U, and use it before breakfast.

Or short-acting + long-acting is 16U+4U, 15U+5U, or 14U+6U before breakfast.

3. Variety adjustment: the key lies in the use of skills. When changing from regular insulin to highly purified insulin, from porcine insulin to human insulin, and from domestically produced insulin to imported insulin, it may be necessary to reduce the dose appropriately.

4. Adjust the injection site: Different sites should be used in rotation. For most people, the forearms and abdominal wall absorb faster than the buttocks and front of the thighs. Avoid using it in areas with nodules or fat atrophy as it is difficult to absorb insulin.

5. Adjustment of injection time: Short-acting drugs are generally injected 15 to 30 minutes before meals. If used alone, the medium-acting drug should be taken 30 to 60 minutes before meals.

Injection. For patients with dawn phenomenon, insulin injection should be given early before breakfast, preferably no later than 6:30 am.

6. Adjustment of injection equipment : The equipment includes basket-core glass syringes, disposable plastic syringes, insulin pens and insulin pumps. Currently, the first three are more commonly used.