Practice question from Endocrine: Diabetes & Insulin Management

A 68 kg patient with newly diagnosed type 1 diabetes needs insulin therapy. Using 0.5 units/kg/day, what is the appropriate total daily dose and how should it be divided between basal and bolus insulin? A. TDD 34 units: 17 units basal, 17 units bolus divided among meals B. TDD 68 units: 34 units basal, 34 units bolus divided among meals C. TDD 34 units: 24 units basal, 10 units bolus divided among meals D. TDD 50 units: 25 units basal, 25 units bolus divided among meals E. TDD 34 units: 10 units basal, 24 units bolus divided among meals

Answer

A

Explanation

For type 1 diabetes initiation, calculate TDD as 0.5 units/kg/day: 0.5 × 68 kg = 34 units total. In a basal-bolus regimen, divide this 50/50: 17 units as long-acting basal insulin (glargine, detemir, or degludec) given once daily, and 17 units as rapid-acting bolus insulin divided among three meals (approximately 6 units before each meal). This mimics physiologic insulin secretion.

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