Once daily insulin titration

Diabetes & endocrinology
NHS Lothian
  • Check capillary blood glucose (CBG) four times per day in inpatients
    • target for most is 6-12 mmol/l
    • Review CBGs daily and prescribe insulin on ward round

 

  • Lantus, abasaglar, tresiba, degludec and toujeo last around 24hrs (once daily)
  • Insulatard, levemir and humulin I last around 12 - 24hrs (once or twice a day)

 

  • Increase insulin every 24 - 48hrs if pre-breakfast CBGs are above target
  • If pre-breakfast CBG at target but CBG rising through the day, please discuss with diabetes team regarding adding in additional treatment e.g. a meal time short acting insulin
  • If any hypoglycaemic events, insulin should be reduced

 

Once daily insulin titration diagram