Insulin Dosing Basics - Initiating Insulin for T2DM and Converting Insulin Products 



Insulin dosing can be complex and is super patient-specific, but here are the very basics! For type 2 diabetes, we initiate basal insulin at 10 units/day usually, or weight-based. Before initiating bolus insulin for type 2 diabetes, be sure to think about whether a GLP1 could provide enough control or if bolus insulin is truly needed. When titrating insulin doses if patients experience unexplained hypoglycemia, decrease the dose by 10-20%. Lastly, when converting from short to rapid insulin or from NPH to basal insulin, decrease the dose by 20% to account for lack of cross tolerance. This is important because we are seeing a movement away from using short and NPH insulin since rapid and basal insulins more closely mimic physiologic insulin, so you're bound to run into patient cases where converting is needed.



Jarred Prudencio, PharmD - https://www.instagram.com/ambcarerx



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