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Question:

From Knightdale, North Carolina, USA:

To correct our daughter's high blood sugars, her pediatric endocrinologist gave us two correction ratios. I thought I understood while we were in her office, as she explained them, but now I don't know how to put them into practical use to correct my daughter's highs. The numbers she wrote down in her daily log are 125/75 and 120/80. Can you give me some examples of how this works?

Answer:

Clearly, this is a question you need to ask your daughter's Diabetes Team right away. Please do not hesitate to ask or think that they will think less of you! On the contrary, they want you to feel comfortable in home management and would rather you ask than make a mistake.

I am not certain how to interpret these ratios. It would help if I knew what your child's usual insulin dosing consisted of and what insulin they suggested you use for a correction. Typically, one would give a "target sugar" and then a "sensitivity factor." The sensitivity factor often is thought of as the estimate that you would expect a single unit of short-acting insulin to lower the glucose. The target is what you are aiming for.

For example, I might give a "correction formula" as current blood glucose minus the target blood glucose and divide this by the sensitivity factor. Let's say the current glucose level is 400 mg/dL [22.2 mmol/L] and your target is 150 mg/dL [8.3 mmol/L] and your sensitivity factor is 50 mg/dL [2.8 mmol/L]. So, for each 50 mg/dL [2.8 mmol/L] the glucose is more than 150 mg/dL [8.3 mmol/L], you would give 1 unit of short-acting insulin. If the current glucose is 400 mg/dL [22.2 mmol/L], then you would give 5 units. (400 - 150) = 250; 250/50 = 5.

So, I think, but am not certain, that your child's physician has perhaps given you two possible formulas. The first is the target of 125 mg/dL [6.9 mmol/L] with a sensitivity factor of 75 mg/dl [4.2 mmol/L] and the second is a target of 120 mg/dl [6.7 mmol/L] with a sensitivity factor of 80 mg/dl [4.4 mmol/L].

So, for the first formula, you would take the current blood glucose and subtract 125 and then divide the resulting number by 75. In the second formula, you would take the current blood glucose and subtract 120 and then divide the resulting number by 80. The final number you get would be the amount of fast-acting insulin to give.

Why might you be given two different options? I don't know. Please confirm your instructions with your own Diabetes Team.

DS

DTQ-20041002080641
Original posting 10 Oct 2004
Posted to Daily Care and Other

  
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Last Updated: Tuesday April 06, 2010 15:09:58
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