Long-Acting Insulin Self-Adjustment (“Three By Three”)

Long-Acting Insulin Self-Adjustment ("Three By Three") [link url="//www.soapnote.org/endocrine-metabolic/long-acting-insulin-adjustment-calc/" memo="try the interactive version at //goo.gl/69rRR1"]
Note:  These instructions are designed to help you adjust your own insulin. These instructions only apply for long-acting insulins like Lantus or Levemir and do not apply to NPH, Insulin 70/30, or short-acting insulins like Regular or Humalog.

Your long-acting insulin is [select value="Glargine (brand name is Lantus)|Detemir (brand name is Levemir)"]
Your dose of long-acting insulin is [text size=5] units [select value="every morning|every evening|every morning and evening"].

ADJUSTING YOUR OWN INSULIN
1. Check your morning blood sugar everyday prior to eating or drinking anything (fasting).  
2. Know your goals! Goal fasting blood sugar less than [text default="130"].
3. Adjust your long-acting insulin every 3 days as follows:
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If ALL of your blood sugars greater than [text default="130"]. --> INCREASE by 3 units
If ALL of your blood sugars between [text default="80 and 130"]. --> NO CHANGE
If ANY of your blood sugars less than [text default="80"]. --> DECREASE by 3 units
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4. Tell your medical provider how much insulin you are taking at every office visit.
5. Bring your meter, diary, or log of your blood sugars to every office visit.

[checkbox memo="References (Hide/Show)" name="footnotes" value=""][conditional field="footnotes" condition="(footnotes).isNot('')"]
[link url="https://www.ncbi.nlm.nih.gov/pubmed/19515182" memo="Blonde L, Merilainen M, Karwe V, Raskin P; TITRATE Study Group. (2009) Diabetes Obes Metab. 11(6):623-31."][/conditional]