How to control the dosage of insulin when blood sugar is high?

High blood sugar is the most typical symptom of diabetes and is also an important cause of various discomforts in patients. The phenomenon of high blood sugar is very difficult for people with diabetes to control, but the condition can currently be alleviated and controlled through advanced insulin injections. This allows the patient to live like a normal person. However, insulin is a powerful drug that requires quantitative injection. Let’s take a look at how to control the dosage of insulin when blood sugar is high.

How to use insulin

Take a medium-acting insulin once before going to bed and take oral hypoglycemic drugs during the day: Overweight diabetic patients are prone to gain weight after injecting insulin. If the blood sugar of such patients is not too high, they can take biguanide hypoglycemic drugs three times orally during the day to lower blood sugar, lipids and weight, and then inject an intermediate-acting insulin before going to bed to counteract the morning hyperglycemia caused by insulin resistance.

Use intermediate-acting insulin once a day: The effect of intermediate-acting insulin lasts for about 12 hours, so generally diabetic patients need to inject it twice a day. However, if the patient's pancreatic function damage is relatively mild, and only the blood sugar level is high after the three meals during the day, while the fasting blood sugar level is well controlled at night without eating, a medium-acting insulin injection can be given before breakfast. On the contrary, if the patient's blood sugar is well controlled during the day and only the fasting blood sugar is high, such as obese diabetic patients who eat too much at dinner or have a significant increase in blood sugar in the early morning, a mid-acting insulin injection can be given before bed. The injection dose is calculated at 0.2 units per kilogram of body weight. If patients inject intermediate-acting insulin before going to bed, the peak of insulin action can occur just before breakfast. This helps patients control early morning hyperglycemia.

1. Calculation of insulin dosage

Estimated based on body weight: generally start with a small dose, 0.3-0.4U/kg.

According to the severity of the disease, the daily physiological secretion of insulin is 40-50U, so moderate cases can start with 4-10U; severe cases 16-20U. The dosage is subcutaneous injection 30 minutes before meals, 3 times a day.

According to the estimate of urine sugar excretion: 1U insulin is used for every 2g of sugar.

Estimated by blood glucose concentration:

Blood sugar calculation formula: Insulin dosage = (blood sugar mmol/L-5.6mmol/L) × 0.6 kg body weight ÷ 11.1.

For example, if the patient weighs 60kg and his blood sugar is 11.2mmol/L, then the amount of insulin to be supplemented = (11.2-5.6)×0.6×60÷11.1=18U.

Note, this is only an approximate estimate. It should be used in 2-3 times, with the first dose being 1/3-1/2 of the total amount.