R Hanas, CWD 2003
Passing time zones
2-dose treatment
- Going west (longer day):
Extra meals and doses of mealtime insulin
Usual dose of bedtime insulin/basal
rate to the “new night”
- Going east (shorter day):
Decreased number of meals and mealtime doses
Take mealtime insulin with last meal before sleeping
Short-acting insulin: no bedtime insulin
Rapid-acting insulin: small dose of bedtime insulin
- Reduce next intermediate-acting dose with 3-5% per time shift hour on long flights Sane T. BMJ 1990;301:421-22