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Uptodate Reference Title
Multiple daily insulin injections
Multiple daily insulin injections
Regimen
Breakfast
Lunch
Dinner
Bedtime
1*
RA + N
RA
N
2¶
RA
RA
RA
N
3
RA
RA
RA
G or D or De
4
RA + G or D or De
RA
RA
5
RA + GΔ or D
RA
RA + GΔ or D
Rapid-acting analog (lispro, aspart, or glulisine) can be replaced with regular insulin.
RA: any rapid-acting analog (lispro, aspart, or glulisine); N: NPH (neutral protamine hagedorn) insulin; G: glargine; D: detemir; De: degludec. * A small dose of RA may be needed at lunch, depending upon the carbohydrate content of lunch. ¶ If RA is used and there are >4 hours between breakfast and lunch, lunch and dinner, or dinner and bedtime, another regimen should be used. Δ U-300 insulin glargine is generally not administered twice daily, as it has a flatter and more prolonged duration of action than U-100 insulin glargine.