Certified Diabetes Care and Education Specialist (CDCES) Practice Exam

If a patient is started on a carbohydrate-controlled diet, what is the calculated bolus dose for their dinner based on previous insulin use?

1. 5 units

2. 10 units

3. 15 units

4. 16 units

The correct answer is: 16 units

In determining the bolus dose of insulin for a patient on a carbohydrate-controlled diet, it is crucial to consider factors such as the patient's total daily insulin requirements, their carbohydrate-to-insulin ratio, and any previous insulin use. The meal-specific bolus is generally derived from calculating the amount of carbohydrates the patient plans to consume and how their body typically responds to insulin. When the bolus dose is calculated to be 16 units, it suggests that the patient has a well-established insulin regimen that correlates with their carbohydrate intake. The calculated bolus aligns with the patient’s historical data indicating that 16 units effectively manages their blood glucose levels post-meal in the context of the carbohydrates they are consuming. This ensures that blood glucose levels remain within target range following dinner. In this scenario, while other doses such as 5, 10, and 15 units may reflect reasonable guesses, the 16-unit dose is specifically tailored based on the patient's previous insulin responses, effectively managing their glycemic control and facilitating optimal postprandial blood sugar levels. Such personalization is key in diabetes management to reduce the risk of both hyperglycemia and hypoglycemia.