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Patient’s Method of Figuring Meal-time Insulin Doesn’t Quite Work

Sep 29, 2020

Guiding a patient on figuring meal-time insulin dosing

Recently I assessed an 84-year-old inpatient with diabetes for his insulin usage at home. In reporting his dosing, he stated that after he checked his glucose before each meal, he took the “first two numbers of the result,” and made his dosage for meal-time insulin. For example, if the glucose reading were 240, he would take 24 units of Humalog. 

I asked him if this was his instruction per his provider, and he said, “No, but it was the only thing that made sense to me that I could remember.”

A specific teaching plan with simple dosing was designed for him, and a home health evaluation for medication administration safety was also made on his return home. 

Lesson Learned:  

This example again reiterates the importance of having the patient give you a verbal and sometimes a practice demonstration of what they understand to be the practice for medication administration. 

Janet Howard-Ducsay, RN, BA/BSN, CDE 
Diabetes Nurse Educator




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