| Indication | Suggested starting doses for insulin |
| Patient with high blood glucose on OGTT, or random hyperglycemia with worsening lung function and weight loss | Long-acting (basal) insulin 0.1 units/kg every morning. For patients on glucocorticoids, use starting dose of insulin 0.2 units/kg. Increase dose by increments of 0.1 units/kg, aiming for postprandial blood glucose <140 mg/dL (7.8 mmol/L), without hypoglycemia. |
| Hypoglycemia prior to the midday meal when basal insulin is given in the morning, or postprandial blood glucose is in target range, but A1C is high | Split the basal insulin twice per day (two-thirds in morning, one-third in evening) and increase the dose incrementally up to a maximum of 0.5 units/kg. |
| Inability to reach glycemic targets on basal insulin alone | Add prandial insulin (0.5 units rapid-acting insulin for each 15 g carbohydrate, given just prior to the meal), in addition to basal insulin. |
| Hyperglycemia in hospital for infection or pulmonary exacerbation, or patient on glucocorticoids | Increase starting dose of basal insulin to 0.2 units/kg. Most patients also require prandial insulin during intercurrent infections. |
| High blood glucose in patient on overnight enteral feeds | Basal insulin 0.1 units/kg at bedtime or combination of short-acting and intermediate-acting insulin. |
| Difficulties reaching glycemic goals with above regimens, and/or desire for more convenient or physiological insulin replacement | Continuous subcutaneous insulin infusion (insulin pump). |
