Insulin Therapy Guidelines

for Type 1 Patients

• Ideal therapy should include consistent basal levels of insulin with appropriate adjustment for exercise and dawn phenomenon and with requisite boluses of short-acting insulin to cover meal requirements
• We prefer the "poor man's insulin pump" otherwise known as the "basal-bolus" approach with: (1) Long-acting insulin [one daily dose of glargine] PLUS (2) Boluses of very short-acting insulin prior to each meal and (3) Nocturnal intermediate-acting insulin as required
• Suggested starting total daily dose is 0.44 x body weight in kilograms with the most likely titrated total daily dose centering about 0.66 x body weight in kilograms
• Move to the insulin pump to reduce weight gain, hypoglycemia, complications, poor control

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