Regimen | Breakfast | Lunch | Dinner | Bedtime |
1* | RA + N | RA | N | |
2¶ | RA | RA | RA | N |
3 | RA | RA | RA | G or De |
4 | RA + G or De | RA | RA | |
5 | RA + GΔ | RA | RA + GΔ |
De: degludec; G: glargine; N: NPH (neutral protamine Hagedorn) insulin; RA: any rapid-acting analog (lispro, aspart, or glulisine).
* 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.