Estimation of initial insulin dosage: (0.3-0.8) × body weight (kg), 0.4 – 0.5 is the cut-off value When starting insulin therapy, all diabetic patients should use short-acting insulin. Moreover, the initial dosage must be estimated according to the following methods on the basis of relatively stable diet and exercise, and then adjusted according to the condition monitoring results. 1. Estimation according to fasting blood glucose: Daily insulin dosage (μ) = [fasting blood glucose (mmol/L)*18-100]*10*weight (kg)*0.6÷1000÷2 100 is the normal value of blood glucose (mg/dl); *18 is the coefficient of converting mmol to mg/dl; x10 is the amount of higher than normal blood glucose per liter of body fluid; x0.6 is the amount of body fluid for 60%; ÷1000 is the conversion of blood glucose mg to grams; ÷2 is 2 grams of blood glucose using 1 μ insulin. To avoid hypoglycemia, the actual use of its 1/2 – 1/3 amount. 2.Estimated by 24-hour urine glucose: Those with mild disease, no diabetic nephropathy and normal renal glucose threshold should give 1μ insulin for every 2 grams of urine glucose. 3.According to body weight: 0.5–0.8μ/kg for high blood sugar and severe disease; 0.4–0.5μ/kg for mild disease; no more than 1.0μ/kg for severe disease and stress. 4.Estimated by 4 times urine sugar: Without diabetic nephropathy and basically normal renal sugar threshold, estimated by how much urine sugar is characterized before each meal. Generally one + needs 4μ insulin. 5.Integrated estimation: There are many factors affecting insulin action in the body, and individual differences are large, so the above calculation may not be in line with the actual situation, therefore, the condition, blood sugar and urine sugar should be integrated, and a certain safe amount should be given first, and then gradually adjusted according to the changes in the condition. (B) How to allocate the insulin dosage According to the above estimation, the insulin should be injected 15 – 30 minutes before three meals daily. Because of the secretion of more hormones antagonizing insulin in the body before breakfast, the insulin dosage should be larger; while the general short-acting insulin peak time 2 – 4 hours, so the dosage before lunch is the smallest; most patients no longer use insulin before bedtime, until the next morning, so the dosage before dinner is larger than before lunch. If you still use it once before bedtime, the amount before dinner should be reduced, and the amount before bedtime is even less to prevent hypoglycemia at night. (C) How to adjust insulin dosage After the initial estimated dosage is observed for 2 – 3 days, the dosage will be further adjusted according to the condition, blood sugar and urine sugar. 1. Qualitative adjustment according to 4 times urine glucose: Only for patients who have no condition to measure blood glucose and have normal renal glucose threshold. Adjustment according to 4 times urine sugar qualitative in the first 3-4 days: insulin dosage before breakfast is based on urine sugar before lunch, insulin dosage before lunch is based on urine sugar before dinner, insulin dosage before dinner is based on urine before bedtime or the next morning (including morning urine of the same day). 2. Adjustment according to blood sugar: diabetic patients, especially type I diabetes and patients with abnormal renal sugar threshold, should adjust insulin dosage according to the blood sugar value before three meals and before bedtime.