Lispro sliding scale protocol

Sliding scale insulin therapy is one way a person with diabetes can work out how much insulin to take before a meal without causing negative effects on the body. I use a sliding scale of humalog at mealtimes and i use 14 units of lantis each evening. Historically, sliding scale regular insulin was the issue now rapid acting insulins are a concern. Do not administer insulin lispro u200 200 unitsml iv. Oct 08, 2019 insulin lispro u100 humalogr may be diluted with insulin diluting medium for humalog to provide concentrations of u10 or u50. Sep 25, 2019 these images are a random sampling from hmalog bing search on the term insulin sliding scale. Glycemic control in hospitalized patients not in intensive. In a typical day, between 2028 units multiple times a day.

Insulin protocols for hospital management of diabetes. Apr 08, 2019 im a newly diagnosed lada diabetic, less than a month. Using an insulin infusion without a standardized protocol and trained. You need to talk with your doctor or see a specialist who deals with diabetes. If youre a diabetic, your body either cant produce enough insulin or cant use insulin efficiently.

Is humalog maybe not the right choice if i need such high dosing. Insulin is the foundation of treatment for many people with diabetes. Insulin sliding scale dose blood sugar low dose moderate dose high dose 60 110 no insulin no insulin no insulin 111 150 2 units 4 units 6 units 151 200 4 units 8 units 10 units 201 250 6 units 10 units 12 units 251 300 8 units 12 units 15 units 301 350 10 units 14 units 18 units. However, sliding scale insulin ssi administration is regimens are offered low, intermediate, and high intensity, which differ in the quantities of ssi to be administered at given glucose thresholds.

Evaluation of a standardized sliding scale insulin preprinted. Johnston, md u ncontrolled hyperglycemia in hospitalized patients with or without a previous diagnosis of diabetes is associated with adverse outcomes and longer lengths of stay. But this just shows you that different people have different needs. Order order details insulin aspart moderate dose insulin aspart sliding scale 0. Sliding scales contact provider if maximum glucose is exceeded very low schedule insulin sensitive bg 150199. The second, referred to as conventional or sliding scale insulin therapy, more loosely approximates. Admelog, humalog insulin lispro dosing, indications. Insulin for gestational and pregestational diabetes. Apr 05, 2019 sliding scale insulin therapy is one way a person with diabetes can work out how much insulin to take before a meal without causing negative effects on the body. The main goal in designing an insulin regimen is to mimic how the body normally releases insulin. Unless used for occasional coverage for short periods of time, do not leave patients on regular insulin sliding scale riss as only form of treatment. You take the same longacting insulin dose no matter what the blood glucose level. This is done about four times a day every five to six hours, or before meals and at bedtime. Sliding scale regular or humalog insulin uw health.

Despite persistent expert recommendations urging its abandonment, the use of sliding scale insulin. If a patient is able and expected to eat all, give supplemental lispro insulin before each meal and at bedtime following the usual column. Continue to repeat 10 units subcut and poc blood sugar checks every 30 minutes until blood glucose is less than 300 mgdl, then resume normal poc blood sugar check and insulin aspart sliding scale. Guidelines for inpatient diabetes management these recommendations do not take into account individual patient situations, and do not substitute for clinical judgment. Find out how it works and learn about problems with this diabetes. Apr 01, 2020 do not dilute or mix other insulins with insulin lispro u100 that is to be used in an external insulin pump. May 01, 2010 glycemic control in hospitalized patients who are not in intensive care remains unsatisfactory. Insulin protocols for managing dka critical care veterinary. Doctors give trusted answers on uses, effects, sideeffects, and cautions. Administer 12 units subcut, notify provider, and repeat poc blood sugar check in 30 minutes. The general principles of sliding scale therapy are. Sliding scale insulin protocol follow ssi reference text medications medication sentences are per dose. When using a sliding scale, eat the same amount of carbohydrate at each meal.

Mixed insulin is more likely to cause hypoglycemia8,19 and generally requires a fixed meal schedule8. Rapid acting insulin analogs lispro, aspart, and glulisine have been used in studies for the treatment of uncomplicated mild to moderate dka. Correction insulin, also called sliding scale insulin, is given to reduce an elevated. This page includes the following topics and synonyms. Humalog insulin sliding scale answers on healthtap. In this video, you will learn how to use the correction factor and insulin to carb ratio on a sliding scale to determine how much insulin to give with a meal. Cats rarely received the prescribed daily dose due to rate adjustments based on the sliding scale loosely following macintire use of lispro insulin for treatment of diabetic ketoacidosis in dogs. The endocrinologist cant see me until june so im trying to figure a lot out on my own. Administer 14 units subcut, notify provider, and repeat poc blood sugar check in 30 minutes. Jan 24, 2020 novolog mix 70 30 dosing administration lines for hcps understanding insulin on board iob calculations openaps rational sliding scale insulin dosage prescribing 75 25 and 50 mi humalog module 5 understanding insulin therapyhumalog mix 75 25 insulinsliding scale lispro insulinhumalog insulin lispro human og uses dosage sidesliding scale lantus 100 units mlinsulin lispro injectioninsulin dose. Adult sliding scale for insulin aspart novolog umc health system. As the nighttime scale only considers the amount of insulin required to drop your blood sugar level back into the target range, it should not be used to cover a bedtime snack. Basal insulin orders prandialbolus meal insulin orders correction dose insulin although technically a sliding scale, it will be referred to as correction dosing misc insulin orders e. You will need to calculate a total daily dose if needed.

Started in 1995, this collection now contains 6767 interlinked topic pages divided into a tree of 31 specialty books and 732 chapters. Humalog insulin lispro insulin sliding scale moderate dose, qid, ac and hs, protocol 70140 0 units 141 180 2 units 181 220 4 units 221 260 6 units 261 300 8 units 301 340 10 units 340 12 units and call md. Insulin sliding scale, correctional insulin dosing. C c insulin therapy should be initiated for treatment of persistent hyperglycemia. Outpatient management of diabetes uses evidencebased guidelines for management and stresses tight glycemic control. If patient unable to do multiple daily injections, consider switching to mixed insulin instead of adding prandial insulin. Do not use sliding scale insulin for longterm diabetes management for individuals residing in the nursing home. Inpatient management of hyperglycemia and diabetes vasudev magaji, md, ms, and jann m. In most sliding scale insulin therapy regimens, your blood sugar is taken using a glucometer. The amount of carbohydrate to be eaten at each meal is preset.

Correctional subcutaneous sliding scale insulin to be administered indicate frequency. Give supplemental insulin lispro following the sliding scale protocol 1d for blood glucose 140 mgdl. The sweet success guidelines, revised in 2002 do not completely reflect this information since they were being revised just as the new therapies became available in pregnancy. Using sliding scale to determine insulin dose youtube. Intensive insulin therapy closely mimics the natural insulin production. Humalog sliding scale insulin coverage blood sugar result humalog insulin coverage subq 60 124 no coverage 125 150 2 units of humalog insulin subq 151 200 4 units of humalog insulin subq 201 250 6 units of humalog insulin subq 251 300 8 units of humalog insulin subq 301 350 10 units of humalog insulin subq. Start nutritional insulin lispro, aspart, glulisine or regular based on appetite generally about 0. Longacting insulin glarginedetemir or nph, once or twice a day with short acting insulin aspart, glulisine, lispro, regular. In the hospital, it is best to give when meal tray is in front of patient or immediately after eating if it is unclear whether the patient will eat. In slidingscale insulin therapy, the dose is based on your blood sugar level. Nclex practice question on insulin registered nurse rn. Mar 24, 2017 in this video, you will learn how to use the correction factor and insulin to carb ratio on a sliding scale to determine how much insulin to give with a meal. Optimizing glucose management in hospitalized patients using.

If you have type 2 diabetes, there are two main ways to replace insulin. The bolus insulin is based on the blood sugar level before the meal or at bedtime premixed. In addition to the increasing prevalence of diabetes in the united states. Inpatient diabetes management endotext ncbi bookshelf. Per sliding scale, you administer 4 units of insulin lispro humalog subcutaneously at 1. Also, order a correctional sliding scale lispro, aspart, glulisine or. Diabetes facts 2012 and guidelines 2011 yale school of medicine.

Correction insulin sliding scale, supplemental, bolus. Designing an insulin regimen diabetes education online. Inpatient hyperglycemia management of the nonpregnant adult consider a diabetes endocrine or medicine consult. Insulin for gestational and pregestational diabetes there have been several changes in the management of diabetes during pregnancy, including the use of insulin analogs. Determine the distribution of the tdd calculated above based on nutrition regimen.

Sliding scale regimens may include a bedtime high blood sugar correction. Type 2 diabetes adult outpatient insulin guidelines if postmeal glucose levels 180. The report calls for more studies to compare slidingscale insulin with other insulin regimens before doctors make the final verdict. Sliding scale regular humulin insulin physician order set. Also, order a correctional sliding scale lispro, aspart, glulisine or regular based on bmi see table 1.