Insulin therapy dosage

The insulin dosage pattern tliat most closely follows nonnal insulin production is a multiple-dose plan sometimes called intensive insulin therapy. In tins r men, a single dose of intennediate- or long-acting insulin is taken in tlie morning or at bedtima Small doses of regular insulin are taken before meals based on tlie patient s blood ucose levels. This allows for greater flexibility in tlie patient s life-style, but can also be an inconvenience to tlie patient (eg, tlie need to always have supplies witli tliem, tlie lack of privacy, inconvenient schedules). 

Diabetes mellitus, combination therapy PO With insulin Initially, 15-30 mg once a day. Initially, continue current insulin dosage then decrease insulin dosage by 10% to 25% if hypoglycemia occurs or plasma glucose level decreases to less than 100 mg/dl. Maximum 45 mg/day. With sulfonylureas Initially, 15-30 mg/day. Decrease sulfonylurea dosage if hypoglycemia occurs. With metformin Initially, 15-30 mg/day. As monotherapy Monotherapy is not to be used if patient is well controlled with diet and exercise alone. Initially, 15-30 mg/day. May increase dosage in increments until 45 mg/day is reached. 

Conventional insulin treatment with its fixed insulin dosage and food intake has dominated therapy of insulin-dependent diabetes mellitus for nearly 70 years. It has sharply reduced the mortality of diabetic coma. Nevertheless diabetic coma is still the largest single cause of death in diabetic patients under the age of 20 years with an episode rate of 7%, and diabetic coma accounts for 15% of deaths in diabetics under the age of 50 years. 

---