Inpatient and Outpatient Technologies to Assist in the Management of Insulin Dosing

Array of slopes representing the multipliers. In this example, the initial blood glucose level (295 mg/dL) is plotted on the 0.02 slope, indicating the initial insulin rate (4.7 units/hour). The second blood glucose level has decreased from 295 to 256 mg/dL. Therefore, the multiplier is increased by 25%, increasing the insulin dose to 4.9 units/hour. Subsequent serially measured blood glucose levels decrease satisfactorily (205 mg/dL followed by 3.6 units/hour, 168 mg/dL followed by 2.7 units/hour, and 115 mg/dL followed by 1.5 units/hour) until the blood glucose level is less than the low target value (69 mg/dL followed by 0.2 units/hour). At that time, the multiplier shifted downward, and the next two blood glucose levels and insulin doses (98 mg/dL followed by 0.8 units/hour and 110 mg/dL followed by 1 unit/hour) centered in the target range. Reprinted with permission from ref. 19.