What dosage of Novolog is recommended for TID?

Question

Hi doctor,

I was diagnosed with TID 14 years back. I will run out of Lantus before the next shipment arrives, but I have plenty of Novolog on hand. My daily dose is 32.5 units Lantus at 10 AM and 12.5 units at 8 PM, with a sliding scale for Novolog (typically 0 to 6 units). What dosage or schedule would you recommend for temporarily relying on Novolog only?

Answer 1

Hi,

Welcome to icliniq.com.

I can tell you right away that your type 1 DM (diabetes mellitus) is not being managed correctly. Those who have type 1 DM cannot make it without basal insulin so insulin it has to be provided 24/7. You should be on balanced Lantus and scheduled Novolog(and not sliding scale of Novolog- Insulin aspart). You can take Novolog but it has to be every 3 to 4 hours, and it has to be scheduled. Also, you need to check your blood sugar every 3 to 4 hours before taking a shot, that is a must. You will run into very high or very low blood sugar and will see an erratic pattern, you will have to adjust the dose accordingly. Watch and check your ketones 2 to 3 times daily, should not stay without Lantus (Insulin glargine) for more than 24 hours. Novolog dose at least should be seven units every four hours (calculated from your current regimen you should need at least 1.8 units of Insulin every hour to survive). If feeling sick with nausea, vomiting, diarrhea, belly pain, blood sugar less than 70 or more than 300 you should go to ER or urgent care center. You are at high-risk ketoacidosis.