Converting From Pre-Mix To Basal Insulin printable pdf download

Converting From Pre-Mix To Basal Insulin

Dr. Tom Elliott

MBBS, FRCPC

Medical Director

4102 – 2775 Laurel St.

phone:

604.675.2491

Vancouver, BC

fax:

604.875.5931

V5Z 1M9 Canada

email:

info@bcdiabetes.ca

Converting from pre-mix to basal insulin

For more information on basal insulin adjustment, see separate handout on this topic.

Premixed insulin (30/70, 50/50, Mix 25/30/50 etc) is widely prescribed in Type 2 diabetes. For

reasons of convenience or in the interests of reducing hypoglycemia a single shot of basal

insulin may be preferred. Bolus mealtime insulin should not be considered unless target A1c not

met with basal insulin.

BCDiabetes follows these principles for converting to basal insulin.

1. Calculate the total daily dose (TDD) of premixed insulin

example 30/70 40 U before breakfast & 30 U before dinner = 70 Units total

2. Calculate the dose of basal insulin according to indication

a) for hypoglycemia with premix, the dose of basal is 80% of the premix TDD

example 70 Units of premix will become 0.8*70= 56 Units basal

b) where the indication is convenience, the dose of basal = the TDD of premix

example 70 Units of premix will become 70 Units basal

3. Give the entire dose of basal insulin as a single dose before breakfast.

Before breakfast dosing is preferred over bedtime because it is the prebreakfast blood

sugar that ultimately determines the dose of basal insulin. In this way any desirable dose

adjustment can be made at the time of the blood glucose test.

4. Titrate the dose of basal insulin vs the fasting sugar: default target is 5.0-7.0.

For more information on basal insulin adjustment see separate handout on this topic.

Revision: 2014Dec11

Converting From Pre-Mix To Basal Insulin