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Insulin Dose Calculator

Insulin Dosing

Insulin Dosing

Two hour post-prandial Blood Glucose <160 mg/dl Aim for 50% of Blood Glucose s in target range Look for consistent pattern in Blood Sugar s for >3 days Compare Blood Sugar for same time each day Consider eating and activity patterns during day Maintain a 50:50 mix of Basal to Bolus Insulin Insulin dose 10-20 units: Adjust by 2 units Insulin dose >20 units: Adjust by 10% Insulin dose Decrease rapid Insulin ( Lispro ) at dinner One Unit covers each 10-15 grams carbohydrate Add 1-2 units for every 50 mg/dl Glucose >150 Indications to adjust basal Insulin (e.g. Glargine ) All Blood Glucose s high (within 50 mg/dl) Increase basal Insulin per adjustment above Critical to distinguish 3 AM low BG from high BG Indications to adjust Bolus Insulin (e.g. Lispro ) Two hour post-prandial >40-60 mg/dl over premeal Increase rapid acting Insulin before meal Average Insulin doses after titrating from start Images: Related links to external sites (from Bing) These images are a random sampling from a Bing search on the term "Insulin Dosing." Click on the image (or right click) to open the source website in a new browser window. Search Bing for all related images Related Studies (from Trip Database) Open in New Window A short-acting form of insulin. Regular insulin is obtained from animal or recombinant sources. The onset of action of regular insulin occurs at 30-90 minutes after injection; its effect lasts for 6 to 8 hours. Endogenous human insulin, a pancreatic hormone composed of two polypeptide chains, is important for the normal metabolism of carbohydrates, proteins and fats; it has anabolic effects on many types of tissues. (NCI04) Insulin (51 aa, ~6 kDa) is encoded by the human INS gene. This protein is involved in the direct regulation of glucose metabolism. protein hormone secrete Continue reading >>

Mealtime Dosage Calculator

Mealtime Dosage Calculator

The mealtime dosage calculator is intended as an aid in figuring mealtime rapid-acting insulin requirements. It should only be used under the supervision and guidance of your health care team. Mealtime Dosage Calculator Instructions **IMPORTANT!!! Do not use the Mealtime Dosage Calculator without first discussing your exact insulin requirements with the clinician who prescribes your insulin. All values entered into the calculator should be determined with the guidance of your health care team. note: the Mealtime Dosage Calculator will work on most major spreadsheet programs, including Excel. To Use The Mealtime Insulin Dose Calculator: 1. You will need to enter your insulin dosage formulas into the boxes in the top left. Information can only be entered in the YELLOW boxes. First, enter the meal/situation that the chart applies to. For example, “breakfast” or “lunch before exercise” or “all meals”. Second, enter your target blood glucose (your “ideal value”). This should be one exact number in mg/dl, such as “100” or “120”. Third, enter your sensitivity factor. This is the amount that one unit of insulin lowers your blood glucose. Fourth, enter your carb:insulin ratio. This is the grams of carbohydrate “covered” by one unit of insulin. Fifth, enter an exercise factor (if needed). An exercise factor of 1.00 means that you will not be exercising and want to take your usual dose. If you want to lower your doses by 25% in anticipation of exercise, enter “.75”. If you want to lower your doses by 33%, enter “.67”. If you want to take half of your usual doses, enter “.50”. 2. The numbers on the large chart will update to reflect your mealtime insulin doses based on the parameters entered above. Find the grams of carbohydrate in the top ro Continue reading >>

Fda Approves Insulin Dose Calculator That's Connected To A Smartphone App

Fda Approves Insulin Dose Calculator That's Connected To A Smartphone App

FDA approves insulin dose calculator that's connected to a smartphone app The FDA has approved Glooko's Mobile Insulin Dosing System. Glooko's new system calculates long-acting insulin dosages and sends Type 2 diabetes patients reminders on their cellphones. Long-acting insulin maker Novo Nordisk already has a partnership with Glooko and is watching the development of the new product "with great interest." The Food and Drug Administration has approved a mobile system that could simplify diabetes management for some patients. Doctors treating Type 2 diabetes with long-acting insulin are supposed to instruct patients on how to calculate the proper dosage. They then fine-tune the suggestions based on how well the treatment is working to move blood sugar levels in an appropriate range. Glooko's Mobile Insulin Dosing System allows doctors to set a dosage and pulls data from the patient's glucose monitor to recalculate levels based on the reading. It's integrated into Glooko's existing mobile app and sends reminders to patients' cellphones when it's time to take another dose. "There's an enormous unmet need for both [clinicians and patients] clinicians who aren't comfortable with dosing and therefore don't put people on long-acting insulin," said Glooko CEO Rick Altinger. "It's a wonderful drug if taken in the right amount at the right time in the right way. This overcomes a big need for clinicians and saves them time. For patients, math is hard." Altinger said the company decided to develop the system after learning some doctors and patients struggle with manual calculations and ensuring patients are following their treatment plan. The insight also came from analyzing data from Glooko's existing diabetes management platform. To test whether the system improved outcomes, Glo Continue reading >>

Insulin Initiation Dose Calculator (type 2 Diabetes)

Insulin Initiation Dose Calculator (type 2 Diabetes)

Tweet This calculator helps people with diabetes to determine the correct initial insulin dose for type 2 diabetes patients. This calculator was invented in the UK Prospective Diabetes Study (Source: N England Journal of Medicine; 357: September 21). How to use the Insulin Initiation Dose Calculator To calculate the number of units required per day, simply input: Your weight Your height Your fasting blood glucose Your gender You will then be presented with the initial dose in IU/day. This tool is meant for indicative purposes only. Please consult your GP or healthcare team to determine your insulin initiation dose. Tweet Type 2 diabetes mellitus is a metabolic disorder that results in hyperglycemia (high blood glucose levels) due to the body: Being ineffective at using the insulin it has produced; also known as insulin resistance and/or Being unable to produce enough insulin Type 2 diabetes is characterised by the body being unable to metabolise glucose (a simple sugar). This leads to high levels of blood glucose which over time may damage the organs of the body. From this, it can be understood that for someone with diabetes something that is food for ordinary people can become a sort of metabolic poison. This is why people with diabetes are advised to avoid sources of dietary sugar. The good news is for very many people with type 2 diabetes this is all they have to do to stay well. If you can keep your blood sugar lower by avoiding dietary sugar, likely you will never need long-term medication. Type 2 diabetes was formerly known as non-insulin-dependent or adult-onset diabetes due to its occurrence mainly in people over 40. However, type 2 diabetes is now becoming more common in young adults, teens and children and accounts for roughly 90% of all diabetes cases worldwi Continue reading >>

Calculation Of The Initial Insulin Dosage

Calculation Of The Initial Insulin Dosage

The dose of Caninsulin and the interval between injections has to be tailored to suit each individual diabetic dog. Hypoglycemia Hypoglycemia is a major concern. To help avoid hypoglycemia: The dog's body weight should be rounded down to the nearest whole kilogram The calculated dose of insulin rounded down to the nearest whole or half unit This helps to avoid overdosing particularly during initial stabilization. Starting insulin dose for dogs In diabetic dogs the dose of Caninsulin can be given once daily or twice daily. After calculation of the starting insulin dose, subsequent adjustments to establish the maintenance dose may be required. For more information see product leaflet or dose adjustment. Once daily administration The once daily Caninsulin starting dose of 0.5 IU/kg (label may vary - for guidance see the product leaflet) was established and confirmed in dogs, based primarily on clinical response. Remember to round the dog’s bodyweight down to the nearest whole kilogram and the calculated dose down to the nearest whole or half unit. Twice daily administration Many specialists recommend that intermediate acting insulins be administered twice daily to dogs. Starting dose in the range of: 0.4-0.7 IU/kg twice daily is usually used, with larger bodyweight dogs started at the lower end of the range. (Ref: Broussard JD, Wallace, MS. Insulin treatment of diabetes mellitus in the dog and cat. In Kirk's Current Veterinary Therapy XII Small Animal Practice. Bonagura J ed. Saunders, Philadelphia, 1995. p. 393-8.) 0.25-0.5 IU/kg twice daily (Ref: Fleeman LM, Rand JS. (2001) Management of canine diabetes. Veterinary Clinics of North America: Small Animal Practice 31, 855-80.) The starting insulin dose range is thus taken as: 0.25-0.7 IU/kg twice daily - larger bodyweigh Continue reading >>

Tips For Calculating A Total Daily Dose Of Insulin

Tips For Calculating A Total Daily Dose Of Insulin

You can use one of several methods to determine a safe, initial dose Published in the August 2007 issue of Today’s Hospitalist. Evidence keeps mounting that high blood sugars lead to worse outcomes in hospitalized patients “and that sliding scale regimens produce both more hyperglycemia and hypoglycemia. But as hospitalists switch from sliding scale to basal and bolus dosing, how do they calculate a safe total daily dose to start with? Experts say that physicians can use any of three different strategies, depending on whether patients have been using insulin as either an outpatient or in the ICU. ~ Deepak Asudani, MD Baystate Medical Center Any one of these approaches will produce a safe, conservative initial dose, but experts warn that none of the strategies by itself is a slam dunk. You still have to bring art to each approach, adjusting doses according to such factors as illness severity and eating status. Related article: Keeping it simple with insulin regimens, July 2013 Here’s a look at how two hospitalists use these strategies in their day-to-day practice. 1. Base total sub-Q dose on insulin infusion rates. When Deepak Asudani, MD, a hospitalist at Baystate Medical Center in Springfield, Mass., transitions patients from IV insulin in the ICU to sub-Q insulin on the wards, he uses the following formula: Take the average hourly insulin infusion rate over the past six hours and multiply that rate by 20. That gives you a number that should equal 80% of the daily infusion dose. “It’s a little correction to prevent any hypoglycemia,” says Dr. Asudani. Because patients’ insulin needs are tapering down a bit as they exit the ICU, he adds, you don’t need to supply the same daily dose. For patients eating substantial amounts of food, you can use that calcul Continue reading >>

Calculating Insulin Dose

Calculating Insulin Dose

You'll need to calculate some of your insulin doses. You'll also need to know some basic things about insulin. For example, 40-50% of the total daily insulin dose is to replace insulin overnight. Your provider will prescribe an insulin dose regimen for you; however, you still need to calculate some of your insulin doses. Your insulin dose regimen provides formulas that allow you to calculate how much bolus insulin to take at meals and snacks, or to correct high blood sugars. In this section, you will find: First, some basic things to know about insulin: Approximately 40-50% of the total daily insulin dose is to replace insulin overnight, when you are fasting and between meals. This is called background or basal insulin replacement. The basal or background insulin dose usually is constant from day to day. The other 50-60% of the total daily insulin dose is for carbohydrate coverage (food) and high blood sugar correction. This is called the bolus insulin replacement. Bolus – Carbohydrate coverage The bolus dose for food coverage is prescribed as an insulin to carbohydrate ratio.The insulin to carbohydrate ratio represents how many grams of carbohydrate are covered or disposed of by 1 unit of insulin. Generally, one unit of rapid-acting insulin will dispose of 12-15 grams of carbohydrate. This range can vary from 4-30 grams or more of carbohydrate depending on an individual’s sensitivity to insulin. Insulin sensitivity can vary according to the time of day, from person to person, and is affected by physical activity and stress. Bolus – High blood sugar correction (also known as insulin sensitivity factor) The bolus dose for high blood sugar correction is defined as how much one unit of rapid-acting insulin will drop the blood sugar. Generally, to correct a high blood Continue reading >>

“calculating Insulin Dose” In Type 1 Diabetes From Diabetes Education Online

“calculating Insulin Dose” In Type 1 Diabetes From Diabetes Education Online

Your doctor will prescribe an insulin dosing regimen for you to get you started on your type 1 diabetes that will include the three components of intensive insulin therapy: Basal Insulin Dosage – a once or twice daily dose of long acting insulin [glargine or detemir] Bolus Dosage – a short acting insulin dosage based on the amount of the carbohydrates in each meal [aspart, glulisine, or lispro] (To learn how to determine the amount of carbohydrates in each meal see Counting Carbohydrates from Diabetes Education Online). Bolus Correction Dose For A High Blood Sugar – a correction factor dosage to bring your blood sugar level back to the target range when it gets too high (out of the target range) [aspart, glulisine, or lispro]. However, each of these three dosages can change over time or even throughout the day and you will learn how to adjust up or down each of these three components. Of course, your diabetes team should always be available by phone or internet to counsel you on an appropriate insulin dosage for any of the three components of intensive insulin therapy if you’re unsure. What follows are the first three examples* from “Calculating Insulin Dosage” from Diabetes Education Online which will show you how you will do it: *Example #4, “Formulas commonly used to create insulin dose recommendations” is in the next post of my blog study notes (and, of course, on the “Calculating Insulin Dosage” page from Diabetes Education Online). First, some basic things to know about insulin: Approximately 40-50% of the total daily insulin dose is to replace insulin overnight, when you are fasting and between meals. This is called background or basal insulin replacement. The basal or background insulin dose usually is constant from day to day. The other 50-6 Continue reading >>

Smartphone Apps For Calculating Insulin Dose: A Systematic Assessment

Smartphone Apps For Calculating Insulin Dose: A Systematic Assessment

Abstract Medical apps are widely available, increasingly used by patients and clinicians, and are being actively promoted for use in routine care. However, there is little systematic evidence exploring possible risks associated with apps intended for patient use. Because self-medication errors are a recognized source of avoidable harm, apps that affect medication use, such as dose calculators, deserve particular scrutiny. We explored the accuracy and clinical suitability of apps for calculating medication doses, focusing on insulin calculators for patients with diabetes as a representative use for a prevalent long-term condition. We performed a systematic assessment of all English-language rapid/short-acting insulin dose calculators available for iOS and Android. Searches identified 46 calculators that performed simple mathematical operations using planned carbohydrate intake and measured blood glucose. While 59% (n = 27/46) of apps included a clinical disclaimer, only 30% (n = 14/46) documented the calculation formula. 91% (n = 42/46) lacked numeric input validation, 59% (n = 27/46) allowed calculation when one or more values were missing, 48% (n = 22/46) used ambiguous terminology, 9% (n = 4/46) did not use adequate numeric precision and 4% (n = 2/46) did not store parameters faithfully. 67% (n = 31/46) of apps carried a risk of inappropriate output dose recommendation that either violated basic clinical assumptions (48%, n = 22/46) or did not match a stated formula (14%, n = 3/21) or correctly update in response to changing user inputs (37%, n = 17/46). Only one app, for iOS, was issue-free according to our criteria. No significant differences were observed in issue prevalence by payment model or platform. The majority of insulin dose calculator apps provide no prote Continue reading >>

New Apps Calculate Your Insulin Doses

New Apps Calculate Your Insulin Doses

Trying to calculate your insulin doses for injections, without the help of an insulin pump "wizard"? There's an app for that! (of course) First came basic insulin dose calculators like RapidCalc. But providing more personalized recommendations in a so-called "insulin titration app" was something of a challenge, because these provide real medical treatment decision support and therefore require FDA approval -- as opposed to so many diabetes logging apps that do not. The first regulatory breakthrough for a "mobile prescription therapy aid" that analyzes users' past data trends to deliver personalized recommendations came with WellDoc's BlueStar app in 2013. That was followed in 2015 by the Accu-Chek Connect app, that also calculates and recommends insulin amounts. WellDoc just recently snagged an expanded label for its BlueStar app that allows patients to use it without a doctor's prescription -- adding to the accessibility of this mobile tech tool. The FDA's decision last year to allow a dosing claim for the Dexcom G5 CGM system seems to have helped pave the way for even more smartphone-based decision therapy tools. And now, two new apps have snagged FDA clearance and are almost ready for prime time: Lilly's Go Dose In December, Eli Lilly got FDA clearance on its new mobile app called Go Dose, which can be used for the Lilly-branded Humalog insulin to titrate doses. This is the company's first class II ("moderate-risk") mobile app approved by the FDA. This one is designed for adults with type 2 diabetes, and is focused on meal-time insulin use for Humalog U-100 only. There is a Go Dose version for patients to use at home, and the Go Dose Pro clinical version for use by healthcare professionals. As of now, it's only compatible with iOS devices (iPads and iPhones), but hop Continue reading >>

Eli Lilly Gets Fda Clearance For Insulin Dose Calculator App

Eli Lilly Gets Fda Clearance For Insulin Dose Calculator App

Updated with statement from Eli Lilly Indianapolis-based pharma company Eli Lilly recently recieved FDA 510K clearance for a new mobile app called Go Dose, a diabetes management and insulin dosing app for users of Humalog, Lilly's rapid-acting insulin. The clearance is for prescription use, but includes two versions of the app: Go Dose, for patients, and Go Dose Pro, for healthcare providers. "The Go Dose System, comprised of the Go Dose and Go Dose Pro applications, is for use in home and clinical settings to aid in the review, analysis, and evaluation of historical blood glucose test values to support type 2 diabetes mellitus management," the company writes in the submission document. "The Go Dose System is a mobile application for use with iPad or iPhone mobile devices. The Go Dose System provides recommendations for titrating prandial Humalog dosing one meal at a time using blood glucose values entered by the patient." While there are a number of insulin dosage calculator apps available, not many are FDA-cleared despite clear guidance from the FDA that insulin dosage apps require premarket approval. A 2015 study found 46 such apps on iOS and Android stores and reported that "none of the apps included in this study appear to have completed registration, labeling, or other general controls which are the minimal requirements for products in both regimes". Diabetes management app mySugr offers a bolus calculator to European customers but hasn't introduced it to the US because of the regulatory burden. And Eli Lilly's choice of predicate devices -- desktop and Palm Pilot software -- further suggest very few if any FDA clearances exist for smartphone-based insulin dosage calculators. There is at least one, however: Roche's Accu-Check connect app, which launched in 2015. " Continue reading >>

Effect Of A Computerized Insulin Dose Calculator On The Process Of Glycemic Control

Effect Of A Computerized Insulin Dose Calculator On The Process Of Glycemic Control

Abstract Background Glycemic control is important to patients’ outcomes. However, the process of maintaining glycemic control is risk laden and labor intensive for nurses. Objectives To examine the effects of using a computerized insulin dose calculator to facilitate management of glycemic control for critically ill cardiac patients. Methods A prospective randomized controlled trial was conducted with a sample of 300 intensive care patients, 141 randomized to the calculator group and 159 in the control (paper protocol) group. A convenience sample of 44 intensive care nurses responded to a nurse satisfaction survey. Results A significantly higher percentage of glucose measurements were in the target range in the calculator group than in the control group (70.4% [SD, 15.2%] vs 61.6% [SD, 17.9%], Z = −4.423, P < .001), and glucose variance was significantly less in the calculator group (35.5 [SD, 18.3] mg/dL vs 42.3 [SD, 21.2] mg/dL, Z = −3.845, P < .001). Fewer hypoglycemic events occurred in the calculator group (7 vs 18), although this difference was not statistically significant. Nurse satisfaction was higher for the calculator group than for the control group (8.4 [SD, 1.4] vs 4.8 [SD, 2.4], Z = −5.055, P < .001). Nurses’ deviation from the protocol was also less in the calculator group than in the control group. Conclusions Management of glycemic control and nurse satisfaction were improved with use of the dose calculator. Improving nurses’ processes of care may improve nurses’ use of time and patient care overall. Studies with larger sample sizes over time are needed to determine these relationships. Notice to CE enrollees A closed-book, multiple-choice examination following this article tests your understanding of the following objectives: Identify th Continue reading >>

Diabetes Calculator For Kids

Diabetes Calculator For Kids

Everything matters when it comes to your child's care. Thats why Nationwide Children's has developed an online resource for managing your child's diabetes. Our goal is to empower families to successfully manage diabetes at home in order to provide as normal a life as possible for patients with diabetes. Managing your childs diabetes requires the proper balance between insulin dose, food and activity on a daily basis. It is important to keep your childs blood sugars within a target range at all times. This online resource will enable you to calculate the insulin dosage given to your child prior to eating. The Diabetes Calculator for Kids is an electronic tool that calculates rapid acting insulin bolus dosage in 5 easy steps. Each chart is customized based on the child's personal input and information that is generally provided by a doctor or diabetes educator. Please consult your physician with any questions related to your individual diabetes management plan. Add the Diabetes Calculator for Kids to Your Website You can embed the Diabetes Calculator for Kids on your blog or website. Just copy the below code and paste it into your website. Please Note: The Diabetes Calculator for Kids will work on any webpage but it looks best on a webpage with a white background. The area on your webpage where you embed the calculator should be at least 660 pixels wide and 670 pixels in height. The Diabetes Calcultor for Kids is provided by Nationwide Children's Hospital Continue reading >>

Interactive Dosing Calculator

Interactive Dosing Calculator

Lantus® is a long-acting insulin analog indicated to improve glycemic control in adults and pediatric patients with type 1 diabetes mellitus and in adults with type 2 diabetes mellitus. Lantus® should be administered once a day at the same time every day. Limitations of Use: Lantus® is not recommended for the treatment of diabetic ketoacidosis. Contraindications Lantus® is contraindicated during episodes of hypoglycemia and in patients hypersensitive to insulin glargine or one of its excipients. Warnings and Precautions Insulin pens, needles, or syringes must never be shared between patients. Do NOT reuse needles. Monitor blood glucose in all patients treated with insulin. Modify insulin regimen cautiously and only under medical supervision. Changes in insulin strength, manufacturer, type, or method of administration may result in the need for a change in insulin dose or an adjustment in concomitant oral antidiabetic treatment. Do not dilute or mix Lantus® with any other insulin or solution. If mixed or diluted, the solution may become cloudy, and the onset of action/time to peak effect may be altered in an unpredictable manner. Do not administer Lantus® via an insulin pump or intravenously because severe hypoglycemia can occur. Hypoglycemia is the most common adverse reaction of insulin therapy, including Lantus®, and may be life-threatening. Medication errors, such as accidental mix-ups between basal insulin products and other insulins, particularly rapid-acting insulins, have been reported. Patients should be instructed to always verify the insulin label before each injection. Severe life-threatening, generalized allergy, including anaphylaxis, can occur. Discontinue Lantus®, treat and monitor until symptoms resolve. A reduction in the Lantus® dose may be re Continue reading >>

Sanofi Gets Fda Clearance For Insulin Dose Calculator App

Sanofi Gets Fda Clearance For Insulin Dose Calculator App

Following in the footsteps of Eli Lilly and Roche, Sanofi has quietly received FDA clearance for a smartphone app with a built-in insulin dose calculator. According to FDA documents, the app, cleared at the end of March, is called My Dose Coach. A pending trademark application gives a more in-depth description of the app, describing it as "downloadable software in the nature of a mobile application for use by patients with diabetes, for calculating and monitoring insulin dosages". The trademark application also suggests the app will contain some kind of database of diabetes information. We've reached out to Sanofi for comment and will update this story if they reply. While there are a number of insulin dosage calculator apps available, not many are FDA-cleared despite clear guidance from the FDA that insulin dosage apps require premarket approval. A 2015 study found 46 such apps on iOS and Android stores and reported that "none of the apps included in this study appear to have completed registration, labeling, or other general controls which are the minimal requirements for products in both regimes". A few pharma companies have bucked the trend recently though. Eli Lilly recieved FDA 510K clearance in January for a new mobile app called Go Dose, a diabetes management and insulin dosing app for users of Humalog, Lilly's rapid-acting insulin. The clearance is for prescription use, but includes two versions of the app: Go Dose, for patients, and Go Dose Pro, for healthcare providers. Diabetes management app mySugr offers a bolus calculator to European customers but hasn't introduced it to the US because of the regulatory burden. And Eli Lilly's choice of predicate devices in its January clearance -- desktop and Palm Pilot software -- further suggest very few if any FDA cle Continue reading >>

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