Subcutaneous Type 1 Diabetes Mellitus Suggested guidelines for beginning dose Ketones moderate or less: 0.5 U/kg/day SC Ketones large: 0.7 U/kg/day SC Typically, 50-75% of total daily dose is given as intermediate- or long-acting insulin Type 2 Diabetes Mellitus Suggested guidelines for beginning dose; adjust according to blood glucose levels Initial dose: 0.5-1 units/kg/day in divided doses Initial dosages for type 2 diabetic patients are often lower, e.g. 0.3 to 0.6 IU/kg/day. Typically, 50-75% of total daily dose is given as intermediate- or long-acting insulin Morning Give two thirds of daily insulin SC Ratio of regular insulin to NPH insulin 1:2 Evening Give one third of daily insulin SC Ratio of regular insulin to NPH insulin 1:1 Dosing Considerations Dosage of human insulin, must be based on the results of blood and urine glucose tests and must be carefully individualized to optimal effect Dose adjustments should be based on regular blood glucose testing Change insulin doses in small increments: Type 1 diabetes (2 unit change); type 2 diabetes (2-4 unit change). Look for consistent pattern in blood sugars for >3 days Adjust to achieve appropriate glucose control Hepatic impairment: Dosage reduction may be needed.