A correctional insulin dose provides a final insulin adjustment based on the preprandial glucose value. The initial total daily dose of subcutaneous insulin is calculated using a factor of 0.3 to 0.6 units per kg body weight, with one half given as long-acting insulin (the basal insulin dose), and the other one half divided daily over three meals as short-acting insulin doses (nutritional insulin doses). New physiologic subcutaneous insulin protocols use basal, nutritional, and correctional insulin. Evidence for the effectiveness of sliding-scale insulin is lacking after more than 40 years of use. Despite persistent expert recommendations urging its abandonment, the use of sliding-scale insulin remains pervasive in U.S. Glycemic control in hospitalized patients who are not in intensive care remains unsatisfactory.
