Which insulin type is used with the 1800-rule correction factor?

Which insulin type is used with the 1800-rule correction factor?

• A. Rapid-acting insulin
• B. Regular insulin
• C. Long-acting insulin
• D. NPH insulin

Answer: (A)

The 1800-rule correction factor is used with rapid-acting insulin because you need a fast-acting insulin to correct high blood glucose quickly without lingering effects. Rapid-acting insulins, like lispro, aspart, and glulisine, start working within minutes, peak in about 1–2 hours, and last roughly 3–5 hours. That quick action makes them ideal for correcting hyperglycemia as a bolus dose taken at or near mealtime. In this rule, the correction factor (how many mg/dL one unit of insulin lowers the glucose) is 1800 divided by the total daily dose. For example, if your total daily dose is 50 units, the correction factor is 1800/50 = 36 mg/dL per unit. If your blood glucose is, say, 72 mg/dL above target, you’d estimate about 2 units (72/36) to bring it down. Regular insulin has a slower onset and is associated with a different rule (1500), so it’s not used with the 1800-rule. Long-acting and NPH are basal insulins and aren’t used for rapid correction doses.

The 1800-rule correction factor is used with rapid-acting insulin because you need a fast-acting insulin to correct high blood glucose quickly without lingering effects. Rapid-acting insulins, like lispro, aspart, and glulisine, start working within minutes, peak in about 1–2 hours, and last roughly 3–5 hours. That quick action makes them ideal for correcting hyperglycemia as a bolus dose taken at or near mealtime.

In this rule, the correction factor (how many mg/dL one unit of insulin lowers the glucose) is 1800 divided by the total daily dose. For example, if your total daily dose is 50 units, the correction factor is 1800/50 = 36 mg/dL per unit. If your blood glucose is, say, 72 mg/dL above target, you’d estimate about 2 units (72/36) to bring it down. Regular insulin has a slower onset and is associated with a different rule (1500), so it’s not used with the 1800-rule. Long-acting and NPH are basal insulins and aren’t used for rapid correction doses.