Certified Diabetes Care and Education Specialist (CDCES) Practice Exam

What is the calculated basal dose for a patient transitioning from IV to subcutaneous insulin who received 5 units of rapid-acting insulin per hour for 24 hours?

1. 40 units

2. 48 units

3. 60 units

4. 100 units

The correct answer is: 48 units

To determine the correct calculated basal dose for a patient transitioning from IV to subcutaneous insulin, it is important to understand the context of how insulin is administered and converted between these two routes. In this scenario, the patient has been receiving 5 units of rapid-acting insulin per hour for a total of 24 hours. To find the total amount of insulin received over that period, you multiply the hourly rate by the number of hours: 5 units/hour x 24 hours = 120 units of rapid-acting insulin. When transitioning from IV to subcutaneous insulin, it's essential to establish a comparable basal insulin dose that will effectively meet the patient’s needs while considering the different pharmacokinetics of subcutaneous insulin. A common approach is to reduce the total daily dose of insulin by about 20-25% when converting to subcutaneous administration, due to differences in absorption and action times. To determine a suitable basal dose from the total hourly IV infusion, we first note that sustained administration of rapid-acting insulin via IV can be converted directly. Therefore, the total amount given (120 units) would typically reflect a 24-hour basal requirement, indicating a substantial need for basal coverage. In this context, if we assume that a slight reduction was