Medication Chart For Type 2 Diabetes Page 4
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4Medication Chart for Type 2 Diabetes
page 4 of 4
Insulin Titration Algorithm for Basal/Bolus Insulin
Start with PM or bedtime basal (long acting)
insulin 10 units or 0.2 units per kg
Increase dose by 2 units q 3 days until fasting levels
are 70-130 mg/dl; can increase dose by 4 units q
3 days if fasting glucose >180 mg/dl
A1c <7% after 3 months?
If hypoglycemia occurs,
No
or fasting glucose level
Yes
<70 mg/dl, reduce
bedtime dose by
Check BG 2 hours after meals (start with largest
≥4 units, or
meal). Is post-prandial BG >150 mg/dl?
10% if dose >60 units
No
Yes
Add 4 units short-acting insulin
Check BG 2 hours after remaining
prior to meal. Can increase meal-
meals. Is post-prandial
specific dose by 2 units q 7 days if
BG >150 mg/dl?
BG >180mg/dl
Yes
No
A1c <7% after 3 months?
No
Yes
Add 4 units Regular or short acting analog insulin
at breakfast for high pre-lunch BG, or at dinner
for high bedtime BG
; can increase meal-specific
1,2
dose by 2 units every 7 days if BG >180
Continue
regimen; check
A1c q 6 months
Yes
A1c <7% after 3 months?
No
Continue adjusting basal insulin to control fasting BG and short-
acting (bolus) insulin to control post-prandial glucose.
1. Sulfonylurea should be discontinued when Regular or short acting analog insulin is started.
2. Long acting analog insulin (Glargine) should NOT be mixed with other insulins.
This medication chart is designed to assist clinicians in diabetes management. It is not intended to replace a clinician’s judgment or establish a protocol for all patients.
For national recommendations, references and additional copies of the guideline, go to or call (303) 446-7200. This medication chart was supported with funds from The Colorado Health Foundation.
Developed February 2012.
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