Please follow the instruction to adjust your insulin

(pre-mixed 70/30 or 75/25 insulin) dose

by 1 unit every 1-3 days.
[1] Start pre-mixed 70/30 or 75/25 insulin at

 ______ units at breakfast and _______units at dinner

[2] Check fasting blood glucose level every day

 before breakfast and before dinner

[3] Please adjust your pre-mixed insulin dose EVERY 1-3 DAYS if the
pre-meal glucose levels are consistently outside the target range of 80-
130 mg/dL.

The insulin doses should be adjusted by using the following chart based
on pre-meal glucose levels from the previous days.
It is important that you eat a consistent carbohydrate amount (30-45
grams per meal or use a plate method) during the dose adjustment.

TO ADJUST BREAKFAST DOSE

If PRE-DINNER glucose levels (mg/dL) >130 80-130 <80
from the previous days is-
Adjust your breakfast dose by +1 unit No change −1 unit

TO ADJUST DINNER DOSE

If PRE-BREAKFAST glucose levels >130 80-130 <80
(mg/dL) from the previous days is-
Adjust your DINNER dose by +1 unit No change −1 unit
Blood Glucose Record Name: ____________________

Breakfast Dinner
Date
Blood Glucose Adjust next Dinner insulin Blood Glucose Before Adjust next Breakfast insulin
Before Breakfast dose for out-of-range results Dinner dose for out-of-range results
before breakfast before dinner