A 56-year-old man with type 1 diabetes mellitus for 20 years presented to the clinic for routine diabetes management. He reported fluctuations in his blood glucose levels, with frequent morning hyperglycemia and occasional postprandial spikes. Despite adhering to a consistent diet and exercise regimen, he had difficulty achieving optimal glucose control. He was currently using a fixed-dose, premixed insulin regimen but felt it lacked flexibility in managing his blood sugar levels, particularly with varying meal times and physical activity. On review of his glucose log, fasting blood glucose readings were consistently above 180 mg/dL, while postprandial readings often exceeded 250 mg/dL. Hemoglobin A1c was elevated at 8.5%, indicating suboptimal long-term glycemic control. He expressed a desire for better management strategies to reduce complications and improve his quality of life. After discussing various options, the decision was made to transition the patient to a basal-bolus insulin regimen, which mimics the body’s natural insulin release.He is 5 feet 8 inches tall and weighs 70 kgs. He eats 3 meals per day. Based on a starting dose of 0.5 units/kg/day, approximately how many units of basal and bolus insulin will he use per day?
