Controlul diabetului

Posted on January 3, 2009

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Standards of Medical Care in Diabetes—2008

http://care.diabetesjournals.org/cgi/content/full/31/Supplement_1/S5

pentru 10 u.i. Novorapid: 10 u.i: 5 = 2 u.i. actioneaza pe ora

http://item.slide.com/r/1/159/i/GUE0ddFj6z_JyvEA8k6BV2x6doFijRhI/

http://item.slide.com/r/1/91/i/ZmCZrMOd4D9eo7hOUI6xB9ysuYPj6W34/


To convert mmol/l of glucose to mg/dl, multiply by 18.





To convert mg/dl of glucose to mmol/l, divide by 18 or multiply by 0.055.




How Much Carbohydrate is Needed1

Calorie level

~ 1200

~1400

~1600

~1800

~2400

~2800

Calorie range

1200-1500

1300-1600

1400-1700

1600-1900

1800-2300

2200-2800

Carbohydrate grams

180

180

195

210

240

300


The latest trend in meal planning for children with diabetes is carbohydrate counting. CHO counting can be used with prescribed carbohydrate ranges for each meal and snack. Alternatively, patients can be given a CHO/insulin ratio, so that their insulin dose at each meal can be adjusted to the CHO content of their anticipated meal in addition to their pre-prandial blood glucose level.

The good news is that CHO counting and the use of CHO/insulin ratios allow more precision and greater flexibility in eating and lifestyle.

How do you determine a ratio and blood sugar correction factor?

Rules

1500 Rule

Blood Sugar Correction Factor (1500: TDD)

1500 divided by TDD = # of points (mg/dl) blood sugar will be lowered by 1 unit of REGULAR insulin

1700, 1800, 2000 Rule

Correction Factor

Same principle as above – however for RAPID ACTING insulin

Depends on proportion of basal to bolus dose

500 Rule

Insulin to Carb Ratio (500: TDD)

500 divided by the TDD

For RAPID ACTING insulin

Calculating a Dose

Insulin to carb ratio = 1 unit per 15 gm carb

BG correction = 1 unit per 50 over 150

Carb component: 60gm ÷15 = 4 units

Blood sugar correction: 250 -150 = 100 100÷50 = 2 units

Total Dose = 4 units + 2 units = 6 units


“Smart Pumps”- Do the math for you!

Calculating a Correction Dose

Actually, a table might be more useful than the raw conversion factor, since
we usually talk in approximations anyway.

mmol/l mg/dl interpretation
—— —– ————–
2.0 ———35 extremely low, danger of unconciousness
3.0 ———55 low, marginal insulin reaction
4.0 ———75 slightly low, first symptoms of lethargy etc.
5.5 ———100 mecca
5 – 6 ——–90-110 normal preprandial in nondiabetics
8.0 ———150 normal postprandial in nondiabetics
10.0 ——–180 maximum postprandial in nondiabetics
11.0 ——–200
15.0 ——–270 a little high to very high depending on patient
16.5 ——–300
20.0 ——- 360 getting up there
22 ———-400 max mg/dl for some meters and strips
33 ———-600 high danger of severe electrolyte imbalance

Preprandial = before meal
Postprandial = after meal

More conversions:

To convert mmol/l of HDL or LDL cholesterol to mg/dl, multiply by 39.
To convert mg/dl of HDL or LDL cholesterol to mmol/l, divide by 39.

To convert mmol/l of triglycerides to mg/dl, multiply by 89.
To convert mg/dl of triglycerides to mmol/l, divide by 89.

To convert umol (micromoles) /l of creatinine to mg/dl, divide by 88.
To convert mg/dl of creatinine to umol/l, multiply by 88.