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Insulin Sensitivity Factor (ISF / Rule of 1800) Calculator

The **Insulin Sensitivity Factor (ISF)** — also called the *correction factor* — estimates how many blood-glucose (BG) points 1 unit of rapid-acting insulin will drop. It is the foundational tool for correcting hyperglycaemia in type-1 diabetes (and some insulin-treated type-2). **Classical rules**: (a) **Rule of 1800** (rapid analogues — lispro, aspart, glulisine, fast aspart, Lyumjev): ISF (mg/dL) = 1800 ÷ TDD; (b) **Rule of 100** (rapid, mmol/L): ISF (mmol/L) = 100 ÷ TDD; (c) **Rule of 1500** (regular "R" human insulin, slower kinetics): ISF (mg/dL) = 1500 ÷ TDD; (d) **Rule of 83.3** (regular R, mmol/L). TDD = total daily insulin dose (basal + bolus). **Correction dose = (current BG − target BG) ÷ ISF**. Enter TDD, insulin type and BG unit to get ISF; optionally add current / target BG for the correction dose. **Caveat**: this is a *starting-point* estimate (Walsh & Roberts, *Pumping Insulin*); real ISF varies with stress, illness, exercise, menstrual cycle, puberty and time of day, so **all changes must be reviewed by a clinician and verified with CGM data**.

Insulin type
Blood-glucose unit

ISF — BG drop per 1 U of insulin

2.0

Correction bolus (U, estimate)

3.2 U

This is a *starting-point* estimate; real ISF varies with stress, exercise, menstrual cycle, puberty and time of day. All dose adjustments must be made with an endocrinologist or diabetes educator and verified with CGM data.

Formula

Rapid analogue (lispro, aspart, glulisine, fast aspart, Lyumjev): ISF (mg/dL per 1 U) = 1800 / TDD ISF (mmol/L per 1 U) = 100 / TDD Regular "R" human insulin (slower kinetics): ISF (mg/dL per 1 U) = 1500 / TDD ISF (mmol/L per 1 U) = 83.3 / TDD (= 1500 / 18.0182) TDD = total daily insulin dose (basal + bolus + corrections, U/day) Conversion: 1 mmol/L = 18.0182 mg/dL for glucose Correction bolus: U_correction = max(0, (current_BG − target_BG) / ISF) Example (rapid, TDD = 50 U, mmol/L): ISF = 100 / 50 = 2.0 mmol/L per 1 U Current 14 mmol/L, target 6 mmol/L: Correction = (14 − 6) / 2.0 = 4.0 U

Frequently asked

My TDD is 60 U/day on rapid lispro — what should my ISF be?

**Rule of 1800 / Rule of 100**: (a) **mg/dL**: ISF = 1800 ÷ 60 = **30 mg/dL per 1 U**; (b) **mmol/L**: ISF = 100 ÷ 60 ≈ **1.67 mmol/L per 1 U**. **In practice**: if your BG is 14 mmol/L (252 mg/dL) and target 6 mmol/L (108 mg/dL): (i) drop needed = 14 − 6 = 8 mmol/L; (ii) correction = 8 ÷ 1.67 ≈ **4.8 U**. **But subtract IOB** — if you bolused 6 U of lispro 90 min ago, ~3 U is still on board (linear 5-h decay), which will still drop you 3 U × 1.67 = 5 mmol/L. The true correction may be only ~1.8 U. **Caveat**: 1.67 mmol/L is only a *starting point* — your endocrinologist will tune it from CGM data (target: time-below-range < 4 %). Within a single day, real ISF for T1D can swing 0.7×–1.3×.

Why does my morning correction dose under-shoot but afternoon doses work fine?

**The dawn phenomenon is the usual culprit** — between 04:00 and 08:00, growth hormone, cortisol and catecholamines naturally rise, increasing *hepatic insulin resistance* and glycogen output. Real morning ISF runs **20–30 % lower** than afternoon: (a) baseline ISF (e.g. 1.67 mmol/L / U) → morning ISF ≈ 1.2 mmol/L / U; (b) the same 8 mmol/L drop needs ~6.7 U in the morning vs ~4.8 U in the afternoon. **Fixes**: (a) **pumpers**: set time-segmented ISF (00:00 → 1.4 mmol/L / U → 04:00 → 1.2 → 12:00 → 1.67 → 18:00 → 1.8); (b) **MDI users**: split-segment basal insulin (1–2 U NPH at midnight, or move to degludec for flatter 24-h coverage); (c) **automated insulin delivery (AID) systems** (Tandem Control-IQ, Omnipod 5) auto-tune basal every 5 minutes and largely neutralise dawn rise; (d) **lifestyle**: a 10-minute light walk 30 min before breakfast can cut morning resistance ~10–15 %.

What is the difference between ISF and ICR (insulin-to-carb ratio)?

**Both deliver rapid-insulin doses, but for different reasons**: (a) **ICR (insulin-to-carb ratio)** covers *food*: ICR = 500 / TDD (Rule of 500 — rapid) or 450 / TDD (regular R). E.g. TDD 60 U → ICR = 500/60 ≈ 8.3 g carb per 1 U. An 80 g-carb meal → meal bolus = 80 / 8.3 ≈ **9.6 U**. (b) **ISF (insulin sensitivity factor)** covers *high BG correction*: ISF = 1800 / TDD (rapid, mg/dL). E.g. TDD 60 U → ISF = 30 mg/dL / U. (c) **Total bolus = meal + correction** = 9.6 + 4.8 ≈ **14.4 U**. **Note**: both derive from the same TDD, so they must be re-tuned *together* — never change ICR without re-checking ISF. This tool focuses on ISF; pair it with the Carb-to-Insulin Ratio Calculator for the full meal-time picture.

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