insulin dosage

 insulin types :

1-very short acting (lispro , aspart , glulisine)

2-short acting (regular insulin "soluble insulin" also called act-rapid)

3-intermediate acting(NPH"isophane",lente)

4-long acting (ultra lente)

5-basal long acting (glargine , degludec ,detemir)

DKA dose :

0.1-0.05unit/kg/hr of soluble insulin given iv infusion in fluid

SLIDING scale dose after DKA resolve :

SC dose given according to RBS (mg/dL)

0-90 nill

91-180 =0.1unit/kg

181-270=0.2unit/kg

271-360=0.3unit/kg

361-450=0.4unit/kg

451-and more=0.5unit/kg

HOME dose after discharge :

SC doses of either regular , NPH , glargine or mixed , and the regimen is can be 2 doses regimen ,3doses regimen ,4doses regimen 

according to age 

if patient with DKA

prepubertal 0.75-1unit/kg/day

pubertal 1-1.2unit/kg/day

adult 0.8-1unit/kg/day

if patient didn't have DKA just hyperglycemia :

prepubertal 

0.25u/kg/day

pubertal 

0.5-0.75u/kg/day

adult 

0.25-0.5u/kg/day


insulin side effects :

hypoglycemia , lipodystrophy , injection site reaction(erythema ,swelling), hypokalemia , arm-leg swelling , heart failure , allergic reaction, weight gain.

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