Related | Insulin to Carbohydrate Ratio (ICRs) (Adult Inpatients)
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
>101, use custom
ratio calculation
See reverse side
for other ICRs
Custom Ratios
If provider orders a ratio that
is not 1:4, 1:5, 1:6, 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 ÷ 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
÷ 25 = 1.2 or 1 unit)
• ≥ .5, round up
Example: If ICR is 1:7 and
patient ate 40 grams of
carbohydrate, you would
administer 6 units of insulin (40
÷ 7 = 5.7 or 6 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
>102, use custom ratio
calculation
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)
American Diabetes
Association. Standards of
Medical Care in Diabetes-
2023. Diabetes Care.
2023;46(Suppl 1): S1-292.
1:6
Insulin to Carb Ratio
(ICR)
(1 unit of insulin
covers 6 grams of
carbohydrate)
Nutritional Dose
Grams of
Carbs Eaten
Units of
Insulin
0-2 0
3-8 1
9-14 2
15-20 3
21-26 4
27-32 5
33-38 6
39-44 7
45-50 8
51-56 9
57-62 10
63-68 11
69-74 12
75-80 13
81-86 14
87-92 15
93-98 16
99-105 17
>105, use custom ratio
calculation
Patient who eats 35 grams
of carbs would receive 6
units of insulin to cover
nutritional needs (plus
more if correction insulin
ordered for pre-meal
hyperglycemia)
Effective 5/25/2023. Contact CCKM@uwhealth.org for previous versions.
Copyright © 2023 University of Wisconsin Hospitals and Clinics Authority. All Rights Reserved. Printed with Permission.
Contact: CCKM@uwhealth.org Last Revised: 05/2023
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
>104, use custom
ratio calculation
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
98-111 7
112-126 8
>126, use custom
ratio calculation
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
110-128 6
>128, use custom
ratio calculation
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
>113, use custom ratio
calculation
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 eaten.
Step 3: Determine if correction insulin is ordered/needed for pre-
meal hyperglycemia.
Step 4: Document carb grams eaten and insulin given.
Last Reviewed April 2023 I Last Updated April 2023
Questions? Contact Inpatient Diabetes Quality Committee
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
>99, use custom ratio
calculation
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)
Effective 5/25/2023. Contact CCKM@uwhealth.org for previous versions.
Copyright © 2023 University of Wisconsin Hospitals and Clinics Authority. All Rights Reserved. Printed with Permission.
Contact: CCKM@uwhealth.org Last Revised: 05/2023
Insulin to Carbohydrate Ratios (ICRs)�(for Adult Inpatients)
Insulin to Carbohydrate Ratios (ICRs)�(for Adult Inpatients)