Methodology & Formulas
Every formula used on this site — with the source, the equation, a worked example, and known limitations.
Total Daily Dose (TDD)
Formula
Dose factor: 0.4–0.6 u/kg/day for most adults. This calculator uses 0.5 u/kg (midpoint) for Type 1 and 0.2 u/kg as a conservative start for insulin-naïve Type 2.
Worked example: 70 kg adult with Type 1 → TDD = 70 × 0.5 = 35 units/day. Typical split: ~50% basal (17–18 u), ~50% bolus pool (17–18 u).
Source: ADA Standards of Medical Care in Diabetes 2024, Section 9 (Pharmacologic Approaches); AACE Comprehensive Type 2 Diabetes Management Algorithm 2020.
Limitations: Does not account for current insulin regimen, existing TDD, activity level, dietary habits, concurrent medications, renal function, or degree of insulin resistance.
Insulin-to-Carb Ratio — The 500 Rule
Formula
Result = grams of carbohydrate covered by 1 unit of rapid-acting insulin.
Worked example: TDD = 35 → ICR = 500 ÷ 35 ≈ 14.3g carbs per unit. If eating 45g carbs at a meal: bolus = 45 ÷ 14.3 ≈ 3 units.
Source: Walsh J, Roberts R, Bailey T. "Guidelines for Optimal Bolus Calculator Settings in Adults." J Diabetes Sci Technol. 2011;5(1):129–135. Also cited in ADA/AACE patient education materials. The 450 Rule is an alternative used by some clinicians.
Limitations: Assumes consistent carbohydrate absorption. Dietary fat and protein content, glycemic index, and meal timing all affect postprandial glucose beyond what a simple carb count captures.
Insulin Sensitivity Factor (ISF) — 1800 / 1500 Rule
Formula
Result = mg/dL blood glucose drop per 1 unit of insulin.
Worked example (rapid): TDD = 35 → ISF = 1800 ÷ 35 ≈ 51 mg/dL per unit. To correct from 220 to 100 mg/dL: (220 − 100) ÷ 51 ≈ 2.4 units.
Source: Davidson PC, Hebblewhite HR, Steed RD, Bode BW. "Analysis of guidelines for basal-bolus insulin dosing: basal insulin, correction factor, and carbohydrate-to-insulin ratio." Endocr Pract. 2008;14(9):1095–1101. The 1700 Rule is a variant sometimes used for mixed insulin.
Limitations: ISF can vary by time of day (dawn phenomenon), exercise, and stress. The formula gives a single average estimate; real-world ISF often needs individual tuning.
Correction Dose
Formula
Result rounded to nearest 0.5 unit, per common clinical practice.
Worked example: Current BG = 220 mg/dL, Target = 100 mg/dL, ISF = 51 → (220 − 100) ÷ 51 = 2.35 → rounded to 2.5 units.
Source: ADA Standards of Care; Hirsch IB. "Insulin Analogues." N Engl J Med. 2005;352:174–183.
Limitations: Does not account for insulin on board (IOB) from recent doses, meal contributions, or exercise. Clinical bolus calculators in pumps/CGM systems apply IOB subtraction that this simple formula omits.
HOMA-IR (Insulin Resistance)
Formula
Glucose in mg/dL or mmol/L; insulin in μU/mL (mIU/L).
Interpretation (approximate): <1.0 = optimal sensitivity; 1.0–1.9 = early resistance; ≥2.0 = significant insulin resistance; ≥2.9 = strong resistance. Thresholds vary by population.
Source: Matthews DR, Hosker JP, Rudenski AS, et al. "Homeostasis model assessment: insulin resistance and β-cell function from fasting plasma glucose and insulin concentrations in man." Diabetologia. 1985;28(7):412–419.
Limitations: Validated for fasting, steady-state conditions only. Not applicable to insulin-treated patients, those with liver disease, or in non-fasting states. Does not directly measure insulin sensitivity — it models it.
QUICKI (Insulin Sensitivity Index)
Formula
Uses log base 10. Higher values = greater insulin sensitivity.
Interpretation: Normal ≈ 0.45; mild resistance ≈ 0.30–0.45; significant resistance <0.30. Values are not directly comparable to HOMA-IR.
Source: Katz A, Nambi SS, Mather K, et al. "Quantitative Insulin Sensitivity Check Index: A Simple, Accurate Method for Assessing Insulin Sensitivity in Humans." J Clin Endocrinol Metab. 2000;85(7):2402–2410.
Insulin Unit Conversions
U-100 Insulin (standard concentration)
U-100 means 100 units per 1 mL. This is the standard concentration for most insulin products in the US. U-200, U-300, and U-500 concentrations exist — always state the concentration explicitly.
Source: FDA Guidance on Insulin Product Labeling; ADA insulin storage and handling recommendations.
Important: Mixing up concentrations is a serious medication error risk. U-500 is 5× more concentrated than U-100. Always confirm concentration with your pharmacist.
Day Supply
Formula
E.g., one 10 mL vial of U-100 = 1,000 units. At 35 units/day: 1,000 ÷ 35 = 28.6 → 28 days supply.
Source: Standard pharmacy dispensing calculation. See also: American Society of Health-System Pharmacists (ASHP) insulin dispensing guidelines.
Master Reference List
- American Diabetes Association. Standards of Medical Care in Diabetes — 2024. Diabetes Care. 2024;47(Suppl 1). Link
- AACE/ACE. Comprehensive Type 2 Diabetes Management Algorithm 2020. Link
- Walsh J, Roberts R, Bailey T. "Guidelines for Optimal Bolus Calculator Settings in Adults." J Diabetes Sci Technol. 2011;5(1):129–135.
- Davidson PC et al. "Analysis of guidelines for basal-bolus insulin dosing." Endocr Pract. 2008;14(9):1095–1101.
- Matthews DR et al. "Homeostasis model assessment." Diabetologia. 1985;28(7):412–419.
- Katz A et al. "Quantitative Insulin Sensitivity Check Index (QUICKI)." J Clin Endocrinol Metab. 2000;85(7):2402–2410.
- NIDDK. Insulin, Medicines, & Other Diabetes Treatments. Link
Last reviewed: June 2025 · All formulas verified against primary sources above