Estimated Insulin Calculator for a New Diabetic

Created by David I. Crowley, MD, Pediatrics Residency Class of 2007

Instructions: 1. Pink indicates required fields. Physician must enter value in order to proceed to calculated results. 2. Review the calculated results marked in yellow.

3. After verifying the calculated results, you must enter your final values in the green boxes in order to proceed. 4. Print only the "road maps", with copies for the attending, all residents, nursing staff, and patient's family.
Click tabs below to begin

ulin Calculator for a New Diabetic

d I. Crowley, MD, Pediatrics Residency Class of 2007

Instructions: required fields. Physician must enter proceed to calculated results.

culated results marked in yellow.

the calculated results, you must enter in the green boxes in order to proceed.

road maps", with copies for the dents, nursing staff, and patient's
Click tabs below to begin

Estimated Insulin Calculator for a New Diabetic

Pink = Physician must enter a value for new diabetic Yellow = Physician must review the calculated value Green = Physician must enter the confirmed value Patient Information:
Name: Wt: Age: Short-acting insulin: Long-acting insulin: Total insulin dose: Robert 27 7 Novolog Levemir 0.9 kg yrs Dosed U/kg/day 1 time(s)/day Age <5 years 5-11 years 12+ years Units/kg/day 0.3-0.8 0.5-1.0 0.8-1.5

Hints

To print out a new road map (e.g. for known diabet names, and all green boxes are mandatory to print out

Actual insulin
Total daily insulin given: 24.3 units/day Actual <U> units/day Estimated 9.7 units/day 14.6 5.8 4.4

Long-acting dose (40%): Short-acting dose (60%): Breakfast (short) (40%): Lunch (short) (30%):

units/day (calculated, not used) (calculated, not used)

Nutrition
Calories in ADA diet: Calories from carbs Grams of carbs Grams of carbs/meal 1700 850 212.5 53.125 kcals kcals grams grams/meal Calories = 1000 + 100*age (1/2 of total carbs) (4 cal / 1 gm carbs) (25% per meal)

Carbohydrate coverage
Estimated Actual 9.1 carbs/unit (breakfast): <U> carbs/unit 12.1 carbs/unit (all other): <U> carbs/unit +15gm free with certain snacks

(i.e. 1 Unit / X carbs) (Calculated "base doses" above / Units insulin per meal above)

Blood sugar correction scale

Estimated : Actual : 1 <U> Unit Unit per per 62 mg/dL <#> mg/dL 1500/Total insulin per day (minimum 1U / 25)

Blood Glucose Target Range

Daytime Low Est 80 Actual <#> Est 80 Actual <#> 70 to to to to High 180 <#> 230 <#> <#> Age <3 years old 3-7 yrs old 8+ yrs old Low 100 80 80 High* >200 >180 >150

Bedtime / 2-3 AM / AM snack

Treat hypoglycemia below:

Glucagon dose:

mg

<#> mg IM

(use only if unarousable or seizing) <20 kg 0.5 mg

Robert's Insulin Road Map

12/29/2012 16:35 My long-acting insulin is: Levemir I take <U> units Levemir once a day. I take Novolog before all meals and snacks. I use the scale below to help me decide how much to give. If my blood sugar is ever under <#>, I use the hypoglycemia road map instead.

My short-acting insulin is: Novolog

Carbohydrate coverage Breakfast 1 Unit / <U> gm carbs All other meals/snacks 1 Unit / <U> gm carbs

AM Snack, 15gm free Bedtime Snack, 15gm free

Daytime Breakfast, Lunch, Afternoon Snack, and Dinner Daytime Rule = <U> Unit per <#> ><#> Blood Glucose Below <#> <#> <#> to to #VALUE! #VALUE! Novolog See hypoglycemia road map Carb coverage dose only CALL MD

Nighttime AM Snack, Bedtime Snack and nighttime Nighttime Rule = <U> Unit per <#> ><#> Blood Glucose Below <#> <#> <#> to to ###### ###### Novolog See hypoglycemia road map Carb coverage dose only CALL MD

Additional comments:

Time to Wait Between Shot and Eating Under 100 0 minutes 100 - 149 5 minutes 150 - 199 10 minutes 200 - 249 15 minutes 250 - 299 20 minutes 300 or OVER 25 minutes

Check Urine for Ketones when: 1. Blood sugar above 240 2. Every time your child goes to bathroom when sick 3. Call the Diabetes Center when your child has moderate or large ketones

Prepared by:

Robert's Hypoglycemia (low blood sugar) Road Map

12/29/2012 16:35 Retest Blood Grams of carbs sugar in 15-20 to eat minutes No extra needed 8 gm complex carbs No No

Blood Sugar

Time of Test

What to do next Eat and give shot. Subtract <U> unit insulin for carb coverage. Nothing more needed. If blood sugar greater than <#> and shot time, give shot and eat meal. If blood sugar greater than <#> and NOT shot time, eat meal meal only. If blood sugar less than <#>, repeat 15 gm fast-acting carbs and retest in another 15-20 minutes. Once blood sugar is more than <#>, eat and give shot if appropriate. If blood sugar greater than <#>, give 8 gm fast-acting carbs. If blood sugar less than <#>, give another 15 gm fast-acting carbs carbs, then retest in 15-20 minutes. If blood sugar greater than <#> and shot time, give shot and eat meal. If blood sugar greater than <#> and NOT shot time, eat meal only. If blood sugar less than <#>, give another 15-22 gm fast-acting carbs, then retest in 15-20 minutes. Once blood sugar greater than <#>, eat and give shot if appropriate. If blood sugar greater than <#>, give 8 gm fast-acting carbs. If blood sugar less than <#>, give another 15-22 gm fast-acting carbs, then retest in 15-20 minutes.

Before a meal or snack

#VALUE!
Between meals, before bedtime snack, or overnight

Before a meal or snack

15 gm fastacting carbs

Yes

46 - <#>

Between meals, before bedtime snack, or overnight

15 gm fastacting carbs

Yes

Before a meal or snack

22 gm fastacting carbs

Yes

0 - 45

Between meals, before bedtime snack, or overnight

22 gm fastacting carbs

Yes

Examples of fast-acting carbs to treat low blood sugar:

15 Grams (1 Carb) 4 oz apple or orange juice 3 oz grape juice 4 teaspoons sugar 1 tablespoon honey 4 tablets DEX 4 3 BD Glucose tabs 5-6 oz regular soda 1 tablespoon chocolate syrup (full strength) 1 tablespoon maple syrup (full strength) 22 Grams (1 and 1/2 Carb) 6 oz apple or orange juice 4 and 1/2 oz grape juice 6 teaspoons sugar 1 and 1/2 tablespoon honey 6 tablets DEX 4 4-5 BD Glucose tabs 7-8 oz regular soda 1 and 1/2 tablespoon chocolate syrup (full strength) 1 and 1/2 tablespoon maple syrup (full strength)

Examples of complex carbs:

8 gm (1/2 Carb) 4 oz milk 2 oz ice cream

If unarousable or seizures:

Give <#> mg GLUCAGON

Rapport sur la compatibilit concernant Diabetes_InsulinRoadmap.xls Excut le 24.03.2009 18:20 Les fonctionnalits suivantes de ce classeur ne sont pas prises en charge dans les versions antrieures d'Excel. Celles-ci risquent d'tre perdues ou dgrades si vous enregistrez le classeur dans un format de fichier antrieur.

Perte significative de fonctionnalit

Nb d'occurrences

Ce classeur contient des donnes dans des cellules qui se trouvent en dehors de la limite des lignes et des colonnes du format de fichier slectionn. Les donnes se trouvant au-del de 256 (IV) colonnes ou de 65 536 lignes ne seront pas enregistres. Les rfrences de formule vers des donnes de cette zone renverront l'erreur #REF.

'Step 1--Enter data'!E47