Flexible Insulin Therapy

Why flexible insulin therapy? Think for a second and the answer is clear---that's what everyone else's pancreas is doing. Insulin is given in varying amounts depending on the need at that moment.

Advantages: FIT allows the most flexible lifestyle: eat when you want in the amounts that you want. Better control with exercise. Makes blood sugar testing meaningful because the readings provide real information which can be acted upon.

Disadvantages: Requires more frequent dosing of insulin in smaller amounts, or an insulin pump.

How Is It Done?

Matching insulin doses to lifestyle allows better control and improves sensitivity to insulin. This is the appeal of multiple injections and insulin pumps: having both improved blood sugars and a varied, healthy lifestyle.

With both multiple daily injections and insulin pumps, insulin is matched to three needs:

1. Background Need: Insulin is required in the bloodstream all the time. This relatively steady background need is met when 55% to 60% of the total insulin dose is given as Lente, NPH, or Ultralente, or as the basal rate on a pump. This insulin keeps the blood sugar steady when not eating.
2. Carbohydrate Coverage: The remaining 40% to 55% of the daily insulin need is given as Humalog or Regular that is divided into doses before each meal. Meal doses are matched to the amount of carbohydrate in each meal.
3. Bring Down Highs: Additional Humalog or Regular is given as an individually tuned sliding scale that precisely lowers any occasional highs.

Talk with your physician if you are interested in improving your control through FIT. The books and information offered at the Diabetes Mall are designed to make control easier.