| Review : |
 |
 |
patterns of food intake and patterns of physical activity |
|
|
previous experience of insulin therapy as a guide to : |
|
- total insulin dose requirement ( do not use weight-determined insulin
doses)
- diurnal variations in insulin requirement
- experience of hypoglycaemia
- state of injection sites
|
Expect : |
|
|
overnight basal requirements to require up to 50 % of total dose |
|
|
unmodified insulin to last for 6-8 hours, and therefore sometimes to
overlap into the next meal or into the night; reduce doses accordingly |
|
|
high pre-breakfast insulin requirements, due to insulin deficiency at the
end of the night |
|
|
young people’s insulin requirements to be high and changing |
Monitor : |
|
|
achieved control and hypoglycaemia; empathy with insulin injections;
impact of insulin injections on life-style; understanding and needs; acquisition of
injection skills; injection sites; at intervals determined by individual needs and wishes |
Adjust : |
|
|
insulin doses to meet agreed targets and experience of hypoglycaemia (
see below ) |
