75% of 12 Units of Detemir Equals 9 Units
For a patient on 12 units of insulin detemir, 75% of that dose is 9 units.
Clinical Context for Dose Reduction
This 25% dose reduction is commonly applied in several clinical scenarios:
Perioperative Management
- The American Diabetes Association recommends giving 60-80% of long-acting analog doses the morning of surgery or procedure, which aligns with this 75% calculation 1
- A 25% reduction in insulin dose given the evening before surgery has been shown to achieve perioperative blood glucose levels in the target range with decreased risk for hypoglycemia 1
Hypoglycemia Prevention
- When more than 2 fasting glucose values per week fall below 80 mg/dL (4.4 mmol/L), guidelines recommend decreasing the basal insulin dose 1
- Despite recognition of hypoglycemia in hospitalized patients, 75% did not have their dose of basal insulin changed before the next administration—a practice that should be avoided 1
Insulin Regimen Simplification in Older Adults
- For older adults requiring regimen simplification, using 70% of the total daily dose as basal-only insulin in the morning is recommended 1, 2
- This approach reduces treatment burden while maintaining adequate glycemic control 2
Hospital Admission Adjustments
- For patients on high-dose home insulin (≥0.6 units/kg/day), reducing the total daily dose by 20% upon hospitalization helps prevent hypoglycemia 3
Important Considerations
The specific reason for dose reduction matters clinically:
- Perioperative reductions are temporary and typically last only for the surgical period 1
- Reductions for hypoglycemia require ongoing monitoring and may need further adjustment 1
- Regimen simplification in older adults represents a more permanent change in treatment strategy 1
Always ensure proper monitoring after any dose reduction, with blood glucose checks at least every 4-6 hours while NPO and supplemental short-acting insulin coverage as needed 1