Titration of insulin over time is critical to improving glycaemic control and preventing diabetes-related complications.

1. Titration Of Insulin

2. Titration Of Insulin
‘Titration of insulin over time is critical to improving glycaemic control and preventing diabetes-related
complications’
For a diabetic, especially one with Type 2 diabetes, managing insulin levels is a big problem. The levels of
insulin taken by a diabetic never remain the same and have to be managed depending on what they
have eaten that day and the physical activity they indulged in. Managing the levels of insulin intake is
called as titration - the increase or decrease in dosage.
Insulin therapy is most commonly used when titrating insulin levels for patients with type 2 diabetes, if it
is not being managed by oral medicines. Insulin therapy may be initiated as an addition or replacement,
starting at 0.3 - 0.6 unit per kg. When replacing, 50 per cent of daily insulin dose is given as basal and 50
per cent as bolus, divided between breakfast, lunch, and dinner. Titration of insulin over time is critical
to improving glycaemic control and preventing diabetes-related complications.
The initial dosage of insulin depends on the individual and the person’s insulin sensitivity. Insulin
therapy may be started with a set dosage, such as 10 units daily, or by using weight-based equations.
For example, a 120 kg patient requiring basal-bolus and correction insulin would need 36 units of basal
insulin; 12 units of short-acting insulin before each meal; and, for correction, 1 unit of a short-acting
insulin for every 25 mg per dL above the set glucose target.
Fasting glucose levels are used to titrate basal insulin, whereas both pre-prandial and post-prandial
glucose readings are used to titrate lunch and dinner time insulin. Physicians may increase or decrease
basal and bolus insulin by 10 per cent based on the patient's glucose readings. It is a safe and effective
way to give patients the right to adjust insulin on their own. Typically, insulin is increased or decreased
by 2 to 3 units every three to seven days if the patient's blood glucose level is not within set targets.
A diabetic should always consult their physician or endocrinologist about titrating their insulin levels
instead of experimenting on their own. Visit your nearest Apollo Sugar clinic to get your sugar levels
tested and learn more about the benefits of titration.

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