Table 1—
Insulin glargine and insulin glulisine dose adjustment based on pattern of mealtime blood glucose values for the past week
| Insulin glargine adjustments: both groups
| |
|---|---|
| Mean of last 3-day fasting SMBG mg/dl | Adjustment |
| >180 mg/dl | Increase 8 units |
| 140–180 mg/dl | Increase 6 units |
| 120–139 mg/dl | Increase 4 units |
| 95–119 mg/dl | Increase 2units |
| 70–94 mg/dl | No change |
| <70 mg/dl | Decrease by the same number of units as insulin glulisine increase that titration week or up to 10% of total insulin glargine dose |
| Insulin glulisine adjustments: simple algorithm group
| ||
|---|---|---|
| Mealtime dose | Pattern of mealtime blood glucose values below target* | Pattern of mealtime blood glucose values above target† |
| ≤10 units | Decrease by 1 unit | Increase by 1 unit |
| >11–19 units | Decrease by 2 units | Increase by 2 units |
| ≥20 units | Decrease by 3 units | Increase by 3 units |
| Insulin glulisine adjustments: carbohydrate counting (insulin-to-carbohydrate ratio) group‡
| ||
|---|---|---|
| Mealtime dose | Pattern of mealtime blood glucose values below target* | Pattern of mealtime blood glucose values above target† |
| 1 unit/20 g | Decrease to 1 unit/25 g | Increase to 1 unit/15 g |
| 1 unit/15 g | Decrease to 1 unit/20 g | Increase to 1 unit/10 g |
| 1 unit/10 g | Decrease to 1 unit/15 g | Increase to 2 units/15 g |
| 2 units/15 g | Decrease to 1 unit/10 g | Increase to 3 units/15 g |
| 3 units/15 g§ | Decrease to 2 units/15 g | Increase to 4 units/15 g |
*
If more than one-half of the mealtime blood glucose values for the week were below target.
†
If more than one-half of the mealtime blood glucose values for the week were above target.
‡
Each patient in the carb count group was also given a schedule for a mealtime insulin glulisine correction dose to add a few units if high or subtract a few units if low. §Increase mealtime insulin as needed following this pattern.