Dr Daves Insulin Calculator by maclaren1

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									Estimated Insulin Calculator for a New Diabetic
    Created by David I. Crowley, MD, Pediatrics Residency Class of 2007

                    Instructions:
   1. Pink indicates required fields. Physician
   must enter value in order to proceed to
   calculated results.
   2. Review the calculated results marked in
   yellow.

   3. After verifying the calculated results, you
   must enter your final values in the green
   boxes in order to proceed.
   4. Print only the "road maps", with copies for
   the attending, all residents, nursing staff, and
   patient's family.
                         Click tabs below to begin
        Estimated Insulin Calculator for a New Diabetic
Pink = Physician must enter a value for new diabetic                            Hints
Yellow = Physician must review the calculated value
Green = Physician must enter the confirmed value                                To print out a new road map (e.g. for known dia
                                                                                name, insulin names, and all green boxes are man
                                                                                new "road map"
                        Patient Information:
                       Name:     <Name>
                          Wt:    <Wt>         kg
                         Age:    <Age>        yrs                                   Age         Units/kg/day
         Short-acting insulin:   Novolog                                        <5 years        0.3-0.8
         Long-acting insulin:    Lantus            Dosed    1     time(s)/day   5-11 years      0.5-1.0
          Total insulin dose:    <#>         U/kg/day                           12+ years       0.8-1.5

                            Actual insulin
       Total daily insulin given: #VALUE! units/day

                                 Estimated                 Actual
     Long-acting dose (40%):      #VALUE! units/day        <U> units/day

    Short-acting dose (60%): #VALUE! units/day
      Breakfast (short) (40%): #VALUE! (calculated, not used)
          Lunch (short) (30%): #VALUE! (calculated, not used)


                                 Nutrition
         Calories in ADA diet:   #VALUE!     kcals                              Calories = 1000 + 100*age
           Calories from carbs   #VALUE!     kcals                              (1/2 of total carbs)
               Grams of carbs    #VALUE!     grams                              (4 cal / 1 gm carbs)
          Grams of carbs/meal    #VALUE!     grams/meal                         (25% per meal)


                      Carbohydrate coverage                                     (i.e. 1 Unit / X carbs)
                               Estimated                Actual
       carbs/unit (breakfast): #VALUE!                   <U> carbs/unit         (Calculated "base doses" above /
        carbs/unit (all other): #VALUE!                  <U> carbs/unit         Units insulin per meal above)
                                     +15gm free with certain snacks


                   Blood sugar correction scale
                  Estimated :        1       Unit    per   #### mg/dL           1500/Total insulin per day
                      Actual :      <U>      Unit    per   <#> mg/dL            (minimum 1U / 25)

                   Blood Glucose Target Range
                                           Low             High
                     Daytime           Est 80         to   150                       Age        Low         High*
                                    Actual <#>        to   <#>                  <3 years old    100       >200
                                                                                3-7 yrs old     80        >180
  Bedtime / 2-3 AM / AM snack          Est 80         to   200                  8+ yrs old      80        >150
                                    Actual <#>        to   <#>

Treat hypoglycemia below:                     60           <#>


                                                                                (use only if unarousable or seizing)
             Glucagon dose:                   1     mg     <#> mg IM            <20 kg           0.5 mg
                                  <Name>'s Insulin Road Map
                                             4/21/2010 20:16

  My long-acting insulin is:   Lantus                   I take <U> units Lantus once a day.

  My short-acting insulin is: Novolog                   I take Novolog before all meals and snacks. I
                                                        use the scale below to help me decide how
                                                        much to give.
                                                        If my blood sugar is ever under <#>, I use the
                                                        hypoglycemia road map instead.

               Carbohydrate coverage
  Breakfast                 1 Unit / <U> gm carbs
  All other meals/snacks    1 Unit / <U> gm carbs           Bedtime Snack, 15gm free


                       Daytime                                               Nighttime
    Breakfast, Lunch, Afternoon Snack, and Dinner                    Bedtime Snack and nighttime

          Daytime Rule = <U> Unit per <#> ><#>                  Nighttime Rule = <U> Unit per <#> ><#>

       Blood Glucose                  Novolog                   Blood Glucose             Novolog
   Below          <#>            See hypoglycemia              Below       <#>       See hypoglycemia
                                     road map                                            road map
    <#>      to    #VALUE!      Carb coverage dose             <#>    to   ######   Carb coverage dose
                                        only                                                only
    <#>      to    #VALUE!           CALL MD                   <#>    to   ######        CALL MD




Additional comments:




  Time to Wait Between Shot and Eating                       Check Urine for Ketones when:
  Under 100    0 minutes                                1. Blood sugar above 240
  100 - 149    5 minutes                                2. Every time your child goes to bathroom when sick
  150 - 199    10 minutes                               3. Call the Diabetes Center when your child has
  200 - 249    15 minutes                                    moderate or large ketones
  250 - 299    20 minutes
  300 or OVER 25 minutes


                                                     Prepared by:
               <Name>'s Hypoglycemia (low blood sugar) Road Map
                                                4/21/2010 20:16


                                                                Retest Blood
                                                Grams of carbs
 Blood Sugar           Time of Test                            sugar in 15-20              What to do next
                                                    to eat
                                                                  minutes
                                                                                   Eat and give shot. Subtract <U>
                 Before a meal or snack         No extra needed         No         unit insulin for carb coverage.
 #VALUE!
                 Between meals, before           8 gm complex                      Nothing more needed.
                                                                        No
               bedtime snack, or overnight           carbs
                                                                                   If blood sugar greater than <#>
                                                                                   and shot time, give shot and eat
                                                                                   meal.
                                                                                   If blood sugar greater than <#>
                                                                                   and NOT shot time, eat meal
                                                  15 gm fast-                      meal only.
                 Before a meal or snack                                 Yes
                                                  acting carbs                     If blood sugar less than <#>,
                                                                                   repeat 15 gm fast-acting carbs
                                                                                   and retest in another 15-20
  46 - <#>                                                                         minutes. Once blood sugar is
                                                                                   more than <#>, eat and give shot
                                                                                   if appropriate.
                                                                                   If blood sugar greater than <#>,
                                                                                   give 8 gm fast-acting carbs.
                 Between meals, before            15 gm fast-                      If blood sugar less than <#>, give
                                                                        Yes
               bedtime snack, or overnight        acting carbs                     another 15 gm fast-acting carbs
                                                                                   carbs, then retest in 15-20
                                                                                   minutes.
                                                                                   If blood sugar greater than <#>
                                                                                   and shot time, give shot and eat
                                                                                   meal.
                                                                                   If blood sugar greater than <#>
                                                                                   and NOT shot time, eat meal
                                                  22 gm fast-                      only.
                 Before a meal or snack                                 Yes
                                                  acting carbs                     If blood sugar less than <#>, give
                                                                                   another 15-22 gm fast-acting
                                                                                   carbs, then retest in 15-20
   0 - 45                                                                          minutes. Once blood sugar
                                                                                   greater than <#>, eat and give
                                                                                   shot if appropriate.
                                                                                   If blood sugar greater than <#>,
                                                                                   give 8 gm fast-acting carbs.
                 Between meals, before            22 gm fast-                      If blood sugar less than <#>, give
                                                                        Yes
               bedtime snack, or overnight        acting carbs                     another 15-22 gm fast-acting
                                                                                   carbs, then retest in 15-20
                                                                                   minutes.


                Examples of fast-acting carbs to treat low blood sugar:            Examples of complex carbs:

                    15 Grams (1 Carb)              22 Grams (1 and 1/2 Carb)               8 gm (1/2 Carb)
                 4 oz apple or orange juice         6 oz apple or orange juice                4 oz milk
                      3 oz grape juice               4 and 1/2 oz grape juice               2 oz ice cream
                    4 teaspoons sugar                  6 teaspoons sugar
                    1 tablespoon honey             1 and 1/2 tablespoon honey
                      4 tablets DEX 4                    6 tablets DEX 4
                    3 BD Glucose tabs                 4-5 BD Glucose tabs
                    5-6 oz regular soda                7-8 oz regular soda
               1 tablespoon chocolate syrup      1 and 1/2 tablespoon chocolate
                       (full strength)                 syrup (full strength)
               1 tablespoon maple syrup (full   1 and 1/2 tablespoon maple syrup
                          strength)                        (full strength)




If unarousable or seizures:                     Give <#> mg GLUCAGON

								
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