Answer to Question 1
Glargine is the basal insulin, so half of the total daily insulin dose (TDD) should be from glargine. He should receive 0.3-0.5 units insulin/kg of body weight. To start, I took an average and used 0.4 units/kg body weight.
165 lbs / 2.2 = 75 kg x 0.4 units/kg = 30 units of insulin (TDD).
50 is glargine: 30 / 2 = 15 units from glargine (basal insulin).
Algorithm for patient that has T1DM with small amount of ketones (use 0.3-0.5 units/kg).
Insulin: carbohydrate ratio:
500 / TDD = 500 / 30 units =16.7 or 17.
This means that for every 17 g of carbohydrates ingested, Matias will need 1 unit of insulin.
Answer to Question 2
Novolog is rapid-acting insulin, or a bolus insulin that is taken to cover the glucose ingested at meals.
Peak: When insulin is at full potential of covering glucose levels or when the highest level of insulin in the blood is reached. 30-90 minutes.
Onset: Time it takes for insulin to begin action. 5-15 minutes (rapid-acting). It begins to cover the glucose quickly, which is why it is given with meals.
Duration: How long insulin lasts in the blood. 3-5 hours.
Glargine is long-acting or basal insulin, also known as background insulin; it covers basic functions.
Peak: None; since it is long acting, there is no peak.
Onset: 2-4 hours. This is the period of time that it takes for the insulin to begin working.
Duration: 20-24 hours. It is designed to cover the background glucose levels, which is why is it usually given at night and/or in the morning and then lasts the whole day.
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