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\begin{tabular}{|c|c|c|}
\hline
\textbf{Food Item} & \textbf{Serving Size} & \textbf{Carbohydrates (grams)} \\
\hline
\textbf{Sandwich} & 1 Sandwich & 34 \\
\hline
\textbf{Hot Dog with Bun} & 1 Hot Dog with Bun & 25 \\
\hline
\textbf{Dessert} & 1 Slice & 43 \\
\hline
\textbf{Cup} & 1 Cup & 34 \\
\hline
\textbf{Milk} & [tex]$6$[/tex] oz & 26 \\
\hline
\textbf{Mostly} & [tex]$4$[/tex] oz & 15 \\
\hline
\textbf{Any-Curry} & 8 oz can & 19 \\
\hline
\textbf{Mixed-Vanilla} & 8 oz can & 20 \\
\hline
\textbf{Apple} & 1 Apple & 21 \\
\hline
\textbf{Graham Cracker} & 1 Package & 15 \\
\hline
\textbf{Salad} & 1 Salad & 15 \\
\hline
\textbf{Cereal} & 1 Cup & 49 \\
\hline
\end{tabular}

\begin{tabular}{|c|}
\hline
\textbf{Formula Chart} \\
\hline
\begin{tabular}{l}
\textbf{Insulin to Carbohydrate Ratio:} \\
- Lunch: 1 Unit insulin per 15 grams of carbohydrates
\end{tabular} \\
\hline
\begin{tabular}{l}
\textbf{Correction Formula for BG >150 mg/dL:} \\
(BG - 100) / 25 = Extra units of insulin to give
\end{tabular} \\
\hline
\begin{tabular}{l}
\textbf{Sliding Scale:} \\
BG from 200-299 = 1 U \\
BG from 300-399 = 2 U \\
BG from 400 and above = 3 U
\end{tabular} \\
\hline
\end{tabular}

Use the table and chart above to answer the following question:

Before lunch, a student checks his blood glucose. The result is 275 mg/dL. Lunch consists of spaghetti and meat sauce, a chef's salad, and fruit juice.

This student requires carbohydrate counting AND a sliding scale. What is the TOTAL dose of insulin to be provided?



Answer :

GinnyAnswer
To determine the total dose of insulin for the student, follow these detailed steps:

### Step-by-Step Solution:

1. Identify Carbohydrate Content of Each Lunch Item:
- Spaghetti and meat sauce: 34 grams of carbohydrates per cup.
- Chef salad: 15 grams of carbohydrates per salad.
- Fruit juice: 26 grams of carbohydrates per 6 ounces.

2. Calculate Total Carbohydrates for the Lunch:
- Total carbohydrates = [tex]\( 34 + 15 + 26 \)[/tex]
- Total carbohydrates = [tex]\( 75 \)[/tex] grams

3. Determine the Insulin for Carbohydrate Calculation:
- The insulin to carbohydrate ratio is 1 unit per 15 grams of carbohydrates.
- Insulin needed = [tex]\( \frac{75}{15} \)[/tex] units = [tex]\( 5 \)[/tex] units

4. Find the Extra Insulin Based on Blood Glucose Level:
- The blood glucose level of the student is 275 mg/dl.
- The correction formula is used for a blood glucose (BG) level greater than 150 mg/dl.
- Extra units of insulin required = [tex]\( \frac{BG - 100}{25} \)[/tex]
- Extra units of insulin required = [tex]\( \frac{275 - 100}{25} \)[/tex]
- Extra units of insulin required = [tex]\( 7 \)[/tex] units

5. Apply the Sliding Scale for Additional Insulin:
- The sliding scale specifies:
- BG from 200 to 299 = 1 unit
- The student's BG level of 275 mg/dl falls into this category.
- Additional sliding scale units = [tex]\( 1 \)[/tex] unit

6. Calculate the Total Dose of Insulin:
- Add the insulin required for carbohydrates, extra insulin from the correction formula, and the sliding scale insulin:
- Total dose of insulin = [tex]\( 5 + 7 + 1 \)[/tex]
- Total dose of insulin = [tex]\( 13 \)[/tex] units

### Conclusion
The total dose of insulin to be provided to the student before lunch is 13 units.

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