This leaflet is designed for people taking basal bolus insulin regimens for treating diabetes. Most people take an injection of fast acting insulin with each meal (examples include: Fiasp®, NovoRapid®, Humalog®) and then a further injection of longer acting insulin on an evening or at bedtime (examples include: Lantus®, Abasaglar®, Toujeo®, Tresiba®.)
Why have I been given this leaflet?
This is to support you with adjusting your insulin doses to achieve blood glucose readings which are within target range. Keeping blood glucose readings within range as much as possible will minimise risks of complications due to diabetes.
When should I test my blood glucose levels?
We would recommend testing your blood glucose levels four times a day, before meals (before breakfast, before lunch, before evening meal) and before bed.
You may also to test your glucose levels more frequently if you are feeling unwell.
What should my blood glucose targets be?
For most people with diabetes, we would recommend keeping blood glucose levels between 4-7 mmol/L before meals.
These targets may vary according to individual circumstances, depending on previous discussions with your diabetes team. If you are unsure what glucose levels to aim for, please discuss this with a member of the diabetes team.
How do I know when to adjust my insulin doses?
Look at the trend of glucose readings over at least a 3-day period. If most of these readings are too high or too low, then consider adjusting your insulin doses.
Do not adjust insulin doses if only one or two readings in a 3-day period are not in target.
Which insulin doses do I need to adjust and how do I do this?
Please refer to the quick guide below. Please feel free to update “My Current Insulin Doses” with the date each time you make adjustments.
| Blood Glucose (mmol/L) | Less than 4 (“low”) | 4 to 7 (“OK”) | Between 7 and 20 (“high”) | More than 20 (“very high”) |
| Before Breakfast | Reduce long acting insulin dose by 10% | No change | Increase long acting insulin dose by 10% | Increase long acting insulin dose by 20% |
| Before Lunch | Reduce morning (breakfast) fast acting insulin dose by 10% | Increase morning (breakfast) fast acting insulin dose by 10% | Increase morning (breakfast) fast acting insulin dose by 20% | |
| Before Evening Meal (Teatime) | Reduce lunchtime fast acting insulin dose by 10% | Increase lunchtime fast acting insulin dose by 10% | Increase lunchtime fast acting insulin dose by 20% | |
| Before Bed | Reduce evening (teatime) fast acting insulin dose by 10% | Increase evening (teatime) fast acting insulin dose by 10% | Increase evening (teatime) fast acting insulin dose by 20% |
My Current Insulin Doses
| Date: | Date: | |
| Morning (breakfast) fast-acting Insulin Dose | 10% =____units 20% =____units | |
| Lunchtime fast-acting Insulin Dose | 10% =____units 20% =____units | |
| Teatime fast-acting Insulin Dose | 10% =____units 20% =____units | |
| Bedtime long-acting Insulin Dose | 10% =____units 20% =____units |
If you require further advice about adjusting insulin doses, please contact a member of the team who normally supports you with diabetes care.