Insulin doses should be reviewed every 1 to 3 days and adjusted according to the patients blood glucose values to achieve effective in-target blood glucose control (5-10 mmol/L). If targets are not being met, insulin doses should be titrated by 10% to 20%.

If the patient's fasting glucose in the morning is consistently high (above 8 mmol/L), the qhs basal dose should be increased by 10% to 20%.

If a recurrent correction dose is needed at a given meal due to a consistently elevated blood glucose, then the correction dose amount should be added to the PREVIOUS meal's bolus dose!

If a patient develops hypoglycemia (blood glucose < 4 mmol/L), use the provincial hypoglycemia protocol. The most responsible healthcare provider should be notified to review the blood glucose values with the patient. Please follow these titration instructions.