NAPLEX (North American Pharmacist Licensure Examination) Practice Exam

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What is the typical starting dose for a basal-bolus insulin regimen in T1D?

0.5 units/kg/day
1 unit/kg/day
0.25 units/kg/day
2 units/kg/day

The correct answer is: 0.5 units/kg/day

For a patient with Type 1 Diabetes (T1D) starting a basal-bolus insulin regimen, the typical starting dose is around 0.5 units/kg/day. This dosage allows for a reasonable balance between the basal (long-acting) and bolus (short-acting) insulins to cover both fasting and postprandial glucose levels adequately. It is essential to start with a conservative dose and adjust it based on the patient's response to avoid hypoglycemia or hyperglycemia. Option B, 1 unit/kg/day, is too high of a starting dose and can increase the risk of hypoglycemia. Option C, 0.25 units/kg/day, is too low and may not provide sufficient coverage for both basal and bolus insulin needs. Option D, 2 units/kg/day, is excessively high and can lead to severe hypoglycemia. Therefore, the most appropriate and commonly used starting dose for a basal-bolus insulin regimen in T1D is around 0.5 units/kg/day.