Skip to main content

Table 2 Previous insulin dose adjustments based on trend arrows recommendations

From: Using trend arrows in continuous glucose monitoring systems for insulin adjustment in clinical practice: Brazilian Diabetes Society Position Statement

Arrow

JDRF[4]

Scheiner [6]

Pettus/Edelman [5]

Klonoff/Kerr [10]

Aleppo [7]

Laffel [9]

Abbott

Dexcom

Medtronic

Pre-meal

2–4 h Post meal

SF

Change

Glucose

Change

SF

Change

 

↑↑

↑↑↑

+ 20%

+ 50 mg/dL

+ 100 mg/dL

+ 2 U

< 25

+ 4.5 U

  

< 25

+ 4.0 U

25–< 50

+ 3.5 U

  

25–  50

+ 3.0 U

50–< 75

+ 2.5 U

> 250 mg/dL

Correction acording to SF; check ketones

50– < 75

+ 2.0 U

≥ 75

+ 1.5 U

75– < 125

+ 1.0 U

  

≥ 125

+ 0.5 U

↑↑

+ 20%

+ 25 mg/dL

+ 75 mg/dL

+1,5 U

< 25

+ 3.5 U

< 25

+ 3.0 U

25– < 50

+ 2.5 U

150–250 mg/dL

Observe, consider correction according to SF

25– < 50

+ 2.0 U

50– < 75

+ 1.5 U

50– < 75

+ 1.0 U

≥75

+1.0 U

75– < 125

+ 0.5 U

  

≥ 125

+ 0 U

+ 10%

+ 0

+ 50 mg/dL

+ 1 U

< 25

+ 2.5 U

No adjustments

< 25

+ 2.0 U

25–< 50

+ 1.5 U

25– < 50

+ 1.0 U

50–< 75

+ 1.0 U

50– < 75

+ 0.5 U

≥ 75

+ 0.5 U

75– < 125

+ 0 U

  

≥ 125

+0 U

 

+ 0

+ 0

+ 0

+ 0

No adjustments

No adjustments

No adjustments

− 10%

− 0

− 50 mg/dL

− 1 U

< 25

− 2.5 U

Glucose

Change

< 25

− 2.0 U

25– < 50

− 1.5 U

Near 100 mg/dL

Consider 15gCHO

Test 20 min

25– < 50

− 1.0 U

50– > 75

− 1.0 U

50- < 75

− 0.5 U

≥ 75

− 0.5 U

Near 150 mg/dL

Test 30 min

75- < 125

− 0 U

  

≥125

− 0 U

↓↓

− 20%

−  25 mg/dL

− 75 mg/dL

− 1.5 U

< 25

− 3.5 U

Near 100 mg/dL

Consider 15gCHO

Test 20 min

<25

− 3.0 U

25– < 50

− 2.5 U

25– < 50

− 2.0 U

50– < 75

− 1.5 U

Near 150 mg/dL

Test 15 min

50– < 75

− 1.0 U

≥ 75

− 1.0 U

75– < 125

− 0.5 U

  

≥125

− 0 U

 

↓↓

↓↓↓

− 20%

−  50 mg/dL

− 100 mg/dL

− 2 U

< 25

− 4;5 U

Near 100 mg/dL

30 g fast-acting carbohydrate

<25

− 4.0 U

25– < 50

− 3.5 U

25- < 50

− 3.0 U

50– < 75

− 2.5 U

50- < 75

− 2.0 U

≥75

− 1.0 U

75- < 125

-− 1.0 U

         

Near 150 mg/dL

Test 15 min

≥125

− 0.5 U

  1. The algorithm suggested by Kudva et al. [8] is similar to the one suggested by Aleppo et al. [7], except that the range 150–250 mg/dL for post-meal adjustments (for upward arrows) should be replaced by 180-250 mg/dL. For other glucose values no adjustments are suggested by Aleppo or Kudva [7, 8]. The recommendations suggested by Laffel et al. [9] and JDRF [4] were elaborated for children and adolescents