TABLE 2.

Basal and Prandial Insulin Initiation and Titration Algorithms From World Medical Societies (63)

MeasureADA/EASDAACE/ACEIDFCDA
Basal algorithm
 Initial dose10 units/day10 units/dayNot specified10 units/day
 Titration2 units every 3 days1–3 units every 2–3 days2 units every 3 days1 unit daily
 Target A1C (%)<7.0≤6.5≤6.5≤7.0
 Target FPG (mg/dL)70–130<110*<11072–126
Prandial algorithm
 Initial dose4 units5 unitsNot specifiedTotal daily dose of 0.3–0.5 units/kg 40% of total = basal 20% of total = bolus (3 times/day)
 Titration2 units every 3 days2–3 units every 2–3 days2 units every 3 daysNot available
 Target A1C (%)<7.0≤6.5≤6.5≤7.0
 Target PPG (mg/dL)<180≤140<14590–180§
  • * FPG target recommendations from the AACE 2011 guidelines

  • For initiation of intensive basal bolus therapy.

  • PPG target recommendations from AACE 2011 guidelines

  • § Adjust to 90–144 mg/dL if A1C targets are not being met.

  • AACE, American Association of Clinical Endocrinologists; ACE, American College of Endocrinology; ADA, American Diabetes Association; CDA, Canadian Diabetes Association; EASD, European Association for the Study of Diabetes; FPG, fasting plasma glucose; IDF, International Diabetes Federation; PPG, postprandial glucose.