From the Guidelines
For a 148-pound woman, a typical starting dose of long-acting insulin would be around 10-13 units once daily, based on the common weight-based dosing of 0.1-0.2 units per kilogram of body weight for basal insulin, as recommended by the most recent guidelines 1. This recommendation is based on the patient's weight, approximately 67.3 kg, and the guidelines for initiating basal analog or bedtime NPH insulin, which suggest starting with 10 units per day or 0.1-0.2 units/kg per day 1. The most commonly prescribed long-acting insulins include insulin glargine (Lantus, Toujeo), insulin detemir (Levemir), and insulin degludec (Tresiba), which should be administered at the same time each day to maintain consistent blood glucose control. When starting long-acting insulin, it's essential to monitor blood glucose levels closely and adjust the dose gradually, typically by 2 units every 3 days to reach the target fasting glucose goal without hypoglycemia, as suggested by the guidelines 1. The dose may need to be adjusted based on individual factors such as insulin sensitivity, activity level, and concurrent medications. Hypoglycemia (low blood sugar) is the main risk of insulin therapy, so the patient should be educated about recognizing and treating low blood sugar symptoms. Long-acting insulin works by providing a steady baseline of insulin throughout the day to control blood glucose between meals and overnight, mimicking the body's natural basal insulin secretion. Key considerations for adjusting the insulin dose include assessing the adequacy of the insulin dose at every visit, evaluating for overbasalization, and considering adjunctive therapies if the A1C remains above goal 1.
From the Research
Insulin Dosing for a 148lb Woman
- The provided studies do not directly address the calculation of weight-based insulin doses for a 148lb woman 2, 3, 4, 5, 6.
- The studies focus on the use of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) in the management of type 2 diabetes, including their efficacy, safety, and potential benefits beyond glucose control 2, 3, 4, 5, 6.
- None of the studies provide a specific formula or guideline for calculating weight-based insulin doses for individuals with type 2 diabetes 2, 3, 4, 5, 6.
Relevant Information
- GLP-1 RAs have been shown to be effective in reducing HbA1c levels, promoting weight loss, and potentially providing cardiovascular benefits in individuals with type 2 diabetes 2, 3, 4, 5, 6.
- The use of GLP-1 RAs in combination with other glucose-lowering therapies, including insulin, may be beneficial for some individuals with type 2 diabetes 4, 5, 6.
- However, the provided studies do not provide specific guidance on the calculation of weight-based insulin doses for a 148lb woman 2, 3, 4, 5, 6.