Insulin dose adjustment ....hyperglycaemia

adjusting insulin dose pages from DAFNE

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• What causes hyperglycaemia?
  
• 'Correcting' high blood glucose levels
  

 

 

 

 

 

 

 

 

 

 

Hyperglycaemia is the term used when blood glucose levels rises too high. It is impossible to avoid this all the time, but if blood glucose levels rise often they will cause complications such as retinopathy. If glucose levels rise you need to consider injecting extra insulin to bring glucose levels down.

 

What causes hyperglycaemia?

• to many CPs for the insulin taken....did you forget about a snack?
• not enough insulin for the CPs eaten...have you miscalculated your CPs?
• reduced physical activity
• Illness

Before altering an insulin dose, except in the case of illness, follow the one-step approach.

 

'Correcting' high blood glucose levels

For occasional high blood glucose levels above the target range, consider correcting with quick-acting insulin.

As a general principle

• 1 unit of quick acting insulin lowers blood glucose by 2-3mmol/l.
• For blood glucose levels above 11mmol/l this rule does not necessarily apply.
• record corrective doses in your diary with a + sign, ie 10+1

If corrective doses are required on a regular basis, a pattern of hypoglycaemia develops. Consider adjusting your ratio of quick-acting insulin to CPs, or whether your background insulin might need adjustment.
Only make one change at a time, and measure the effect. If altering background insulin, increase dose by 1-2 units (10-20%) at a time. This is taught in detail on the DAFNE program.