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

Endocrine, Nutrition & Obesity, Patient Education
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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:
----------------------------------------
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
----------------------------------------
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]
Long-Acting Insulin Self-Adjustment ("Three By Three") 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
Your dose of long-acting insulin is units .

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 .
3. Adjust your long-acting insulin every 3 days as follows:
----------------------------------------
If ALL of your blood sugars greater than . --> INCREASE by 3 units
If ALL of your blood sugars between . --> NO CHANGE
If ANY of your blood sugars less than . --> DECREASE by 3 units
----------------------------------------
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.

References (Hide/Show)
Result - Copy and paste this output:

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