A BIDO regimen (bedtime insulin, daytime oral agent) may be used by a patient who is still hyperglycemic while receiving an oral hypoglycemic agent.
Patient selection: mild hyperglycemia while on maximal dose of an oral hypoglycemic agent AND preference to avoid a full insulin dosage regimen
Benefits:
(1) minimum number of fingersticks per day
(2) minimum number of insulin injections
Parameters:
(1) fasting glucose level in mg/dL for 2 days in a row
(2) body habitus (lean vs obese)
Insulin used: NPH or glarcine
The initial bedtime dose for a lean patient is 8 to 10 IU insulin. while for an obese patient it is 14 to 16 units.
Fasting Glucose (for 2 days in a row)
Lean Patient
Obese Patient
< 150 mg/dL on both days
0
>= 200 on both days
+2 units
2 times lean
otherwise
+1 unit
Requirements:
(1) The fasting blood glucose values are accurate.
(2) The patient keeps accurate records and submits them to the provider regularly.
(3) The patient understands and can follow the algorithm.
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Purpose: To start a patient on a bedtime insulin, daytime oral agent (BIDO) regimen for mild hyperglycemia.
Specialty: Endocrinology, Clinical Laboratory
Objective: dosage adjustments
ICD-10: T38.3,
