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Adult Inpatient Insulin to Carbohydrate Ratio (ICRs)

Adult Inpatient Insulin to Carbohydrate Ratio (ICRs) - Clinical Hub, UW Health Clinical Tool Search, UW Health Clinical Tool Search, Clinical Practice Guidelines, Diabetes and Endocrinology, Related


Insulin to Carbohydrate Ratios (ICRs)
(for Adult Inpatients)
1:4
Insulin to Carb Ratio (ICR)
(1 unit of insulin covers 4
grams of carbohydrate)
Nutritional Dose
Grams of
Carbs Eaten
Units of
Insulin
0-1 0
2-5 1
6-9 2
10-13 3
14-17 4
18-21 5
22-25 6
26-29 7
30-33 8
34-37 9
38-41 10
42-45 11
46-49 12
50-53 13
54-57 14
58-61 15
62-65 16
66-69 17
70-73 18
74-77 19
78-81 20
82-85 21
86-89 22
90-93 23
94-97 24
98-101 25
1:8
Insulin to Carb Ratio (ICR)
(1 unit of insulin covers 8
grams of carbohydrate)
Nutritional Dose
Grams of
Carbs Eaten
Units of
Insulin
0-3 0
4-11 1
12-19 2
20-27 3
28-35 4
36-43 5
44-51 6
52-59 7
60-67 8
68-75 9
76-83 10
84-91 11
92-99 12
Patient who eats 35 grams
of carbs would receive 4
units of insulin to cover
nutritional needs (plus
more if correction insulin
ordered for pre-meal
hyperglycemia)
See reverse side
for other ICRs
Custom Ratios
If provider orders a ratio that
is not 1:4, 1:5, 1:8, 1:10,
1:12, 1:15, or 1:20, you will
need to calculate the
appropriate insulin dose as
follows:
Total Grams of
Carbohydrates
Eaten
# grams per unit
insulin (1:x)

Example:
 If ICR is 1:3 and patient ate 30
grams of carbohydrate, you
would administer 10 units of
insulin
(30 ψ 3 = 10)

If dose needs to be rounded,
do so as follows:
• ˂ .5, round down
Example: If ICR is 1:25 and
patient ate 30 grams of
carbohydrate, you would
administer 1 unit of insulin (30
ψ 25 = 1.2 or 1 unit)

• ≥ .5, round up
Example: If ICR is 1:8 and
patient ate 30 grams of
carbohydrate, you would
administer 4 units of insulin (30
ψ 8 = 3.75 or 4 units)
= # units
insulin
1:5
Insulin to Carb Ratio (ICR)
(1 unit of insulin covers 5
grams of carbohydrate)
Nutritional Dose
Grams of
Carbs Eaten
Units of
Insulin
0-2 0
3-7 1
8-12 2
13-17 3
18-22 4
23-27 5
28-32 6
33-37 7
38-42 8
43-47 9
48-52 10
53-57 11
58-62 12
63-67 13
68-72 14
73-77 15
78-82 16
83-87 17
88-92 18
93-97 19
98-102 20
Patient who eats 35 grams
of carbs would receive 7
units of insulin to cover
nutritional needs (plus
more if correction insulin
ordered for pre-meal
hyperglycemia)
Association AD. Professional
Practice Committee for the
Standards of Medical Care
in Diabetes-2017. Diabetes
Care. Jan 2017;40 Suppl
1:S1-135.
Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:
 
04/2017CCKM@uwhealth.org

1:10
Insulin to Carb Ratio (ICR)
(1 unit of insulin covers 10
grams of carbohydrate)
Nutritional Dose
Grams of
Carbs Eaten
Units of
Insulin
0-4 0
5-14 1
15-24 2
25-34 3
35-44 4
45-54 5
55-64 6
65-74 7
75-84 8
85-94 9
95-104 10
Patient who eats 35 grams
of carbs would receive 4
units of insulin to cover
nutritional needs (plus
more if correction insulin
ordered for pre-meal
hyperglycemia)
1:15
Insulin to Carb Ratio (ICR)
(1 unit of insulin covers 15
grams of carbohydrate)
Nutritional Dose
Grams of
Carbs Eaten
Units of
Insulin
0-7 0
8-22 1
23-37 2
38-52 3
53-67 4
68-82 5
83-97 6
Patient who eats 35 grams
of carbs would receive 2
units of insulin to cover
nutritional needs (plus
more if correction insulin
ordered for pre-meal
hyperglycemia)
Insulin to Carbohydrate Ratios (ICRs)
(for Adult Inpatients)
See reverse side
for other ICRs
1:20
Insulin to Carb Ratio (ICR)
(1 unit of insulin covers 20
grams of carbohydrate)
Nutritional Dose
Grams of
Carbs Eaten
Units of
Insulin
0-9 0
10-29 1
30-49 2
50-69 3
70-89 4
90-109 5
Patient who eats 35 grams
of carbs would receive 2
units of insulin to cover
nutritional needs (plus
more if correction insulin
ordered for pre-meal
hyperglycemia)
1:12
Insulin to Carb Ratio (ICR)
(1 unit of insulin covers 12
grams of carbohydrate)
Nutritional Dose
Grams of
Carbs Eaten
Units of
Insulin
0-5 0
6-17 1
18-29 2
30-41 3
42-53 4
54-65 5
66-77 6
78-89 7
90-101 8
102-113 9
Patient who eats 35 grams
of carbs would receive 3
units of insulin to cover
nutritional needs (plus
more if correction insulin
ordered for pre-meal
hyperglycemia)
Step 1: Select ICR that corresponds with provider orders.
Step 2: Determine nutritional dose of insulin based on number of
carbohydrates patient ate.
Step 3: Determine if correction insulin is ordered/needed for pre-
meal hyperglycemia.
Step 4: Document carb grams eaten and insulin given.
Last Updated 2/12/2016 I Last Reviewed 3/23/2017
Questions? Contact Inpatient Diabetes Quality Committee
Copyright © 2017 University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised: 04/2017CCKM@uwhealth.org