Problem:
Starting basal dose is: 24.4.
wt: 122 kg x 0.2 = 24.4
You educate the patient on the importance of increasing his basal insulin dose by 1-2 units once to twice weekly until fasting glucose levels are within normal range. He is compliant with this instruction and returns in three months for re-evaluation. He is currently administering 40 units of basal insulin each evening. While his fasting glucose levels are less than 130 mg/dl, his post-prandial dinner glucose level is averaging 230 mg/dl. You desire to initiate bolus rapid-acting insulin with dinner. Please provide the dose of bolus rapid-acting insulin with dinner. Do you change his basal insulin dose; if so, what is the new dose?