The ideal is of course for glucose levels to be in the normal before meal range of between something like 70126 different doctors use slightly different numbers, but this is. This type of prescription is called a sliding scale because the amount of insulin to be administered changes or slides up or down based on the persons blood sugar. Adult sliding scale for insulin regular novolin r umc health. The sliding scale helps to stabilise blood sugar levels by adding glucose if levels drop too low, or by adding insulin if your levels raise too high straight into the bloodstream. The problem with sliding scale insulinthe problem with sliding scale insulin time 0700 break fast 0800 1200 lunch 0 1700 dinner 1800 2100 blood glucose 275 350 400 250 sliding scale 6 units 10 units 12 units 6 units sliding scale insulin treats hyperglycemia with only shortrapid acting insulin without longacting basal insulin. A recommended sliding scale is on the back of the nsw adult subcutaneous insulin prescribing chart. Sliding scale insulin ssi is commonly used to manage hospitalized patients with and without diabetes mellitus. Where can i find a diabetic sliding scale chart online. Guidelines for insulin management for adult diabetics with. Insulin pumps new york state council of healthsystem pharmacists.
For some people, sliding scale insulin adds extra insulin to their usual insulin dose. Can novolog insulin be used as a sliding scale before meals. In addition, the patients previous medication regimen is not considered when determining the slidingscale insulin coverage. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. Although slidingscale insulin is commonly used in the hematology unit, slidingscale insulin alone is not recommended because it does not contribute to the better control of glucose level, as. Blood glucose insulin log institute for family health. The prevalence and persistence of sliding scale insulin use among newly admitted elderly nursing home residents with diabetes mellitus. Slidingscale versus basalbolus insulin in the management. If i do use a sliding scale, i want them to have a low threshold to call me. Sliding scale insulin orders these orders are for patients who do not receive a scheduled dose of insulin premeal pg 1, but who may need insulin prn based on their premeal glucose level quizlet. For intensive insulin therapy, this means your insulintocarbohydrate ratio, blood glucose correction and background dose. This includes in diabetes mellitus type 1, diabetes mellitus type 2, gestational diabetes, and complications of diabetes such as diabetic ketoacidosis and hyperosmolar hyperglycemic states.
Bolter insulin orders california hospital association. Use of a standardized protocol to decrease medication. Diabetes medications chart, diabetes mellitus, types of diabetes, prevent diabetes, diabetes. Administer 14 units subcut, notify provider, and repeat poc blood sugar check in 1 hour. Care of baby 20 management of gestational diabetes mellitus gdm pg23 i. Sliding scale insulintime to stop sliding request pdf. Novolin 70 30 sliding scale download here free healthcaremagic app to ask a doctor all the information, content and live chat provided on the site is intended to be for informational purposes only, and not a substitute for professional or medical advice. Although its use is not recommended, slidingscale insulin therapy is still being used widely. Bg change per unit insulin 1800total insulin daily. However, ssi does not provide good glycaemic control.
Last, the patients progress toward an acceptable blood glucose level. Even if you do not take insulin, you might require it at unique times, such as during pregnancy or if you remain in the medical facility. Research basalbolus insulin versus slidingscale insulin. Postnatal care of women with preexisting diabetes 19 viii.
Sliding scale insulin how is sliding scale insulin abbreviated. Subcutaneous slidingscale insulin ssi has historically been the mainstay of hyperglycaemia management for wardbased patients. In many hospitals in developing countries, particularly in pakistan, a sliding scale is used to calculate the dose of insulin for the management of diabetes. Most endocrinologists will put a diabetic patient who uses insulin on a sliding scale of insulin, depending on what the blood glucose is when you test before a meal. Please practice handwashing and social distancing, and. Sliding scale insulin refers to a treatment regimen that provides no basal insulin and provides only short acting insulin if needed according to blood glucose test results. Blood sugar levels are monitored frequently by manually testing finger pricking and the sliding scale is adjusted manually as required. In time, you may require more than one diabetes medication to control your blood glucose. Institutions should have a hypoglycemia prevention and management protocol. Insulin sensitivity helps to determine the total daily insulin dose, including the background insulin, carbohydrate humalogregular see the carb factors, and sliding scale humalogregular see the 18001500 rule insulin sensitivity is one measure of ones risk for heart disease. Novolog insulin aspart injection 100 uml is an insulin analog indicated to improve glycemic control in adults and children with diabetes mellitus. For example 3 units when my sugar is 200 or over up to 5 units up to sugar level 210 etc.
Data sources include ibm watson micromedex updated 4 may 2020, cerner multum updated 4 may 2020. Do not use sliding scale insulin for long term diabetes. Administer 12 units subcut, notify provider, and repeat poc blood sugar check in 1 hour. 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. Add the number of units needed for food to the number of units needed to correct blood sugar to get your total dose of insulin humalognovologapidra. Insulin is a protein hormone that is used as a medication to treat high blood glucose. Sliding scale to correct a high blood sugar this is the amount of insulin needed to correct high blood sugar. Novolog insulin aspart injection 100 uml indications and usage. Calculate insulin dose for food add up all the carbohydrates in your meal. Insulin therapy in the outpatient setting american college of. I lost my chart and need to know how much insulin to take when my sugar is high. Splitmixed both insulins provide potential basal and prandial effects. Before meals 70 call your diabetes team if you have high or low glucose levels frequently. Continue to repeat 10 units subcut and poc blood sugar checks every 1 hour until blood glucose is less than 300 mgdl, then resume normal poc blood sugar check and insulin regular sliding scale.
Slidingscale and basalbolus insulin regimens are two options available for the treatment of severe or acute hyperglycemia in type 2 diabetes mellitus patients. Adult sliding scale for insulin aspart novolog umc health system. Correction insulin sliding scale, supplemental, bolus. Administer 10 units subcut, notify provider, and repeat. Administer 12 units subcut, notify provider, and repeat poc blood sugar check in 30 minutes.
Many people believe that diabetes is a condition that elevates their blood sugar levels. Sliding scale regular humulin insulin physician order set. When diabetes isnt diagnosed and treated early on, it can wreak havoc on the. Novolog or human insulin was infused until the patients blood glucose decreased to 36 mgdl, or until the patient demonstrated signs of hypoglycemia rise in heart rate and onset of sweating, defined as the time of autonomic reaction r see figure 3.
In setting your insulin doses, it helps to know how sensitive to insulin you are. If a patient is fasting, specify that the sliding scale is to be given q6h and not before meals. It is also used along with glucose to treat high blood potassium levels. This is a reactive way of managing hyperglycemia and should not be used as the sole means of controlling blood glucose unless absolutely necessary.
I frequently use long acting insulins, usually lantus, for their basal insulin requirements, and then either a supplemental if i know theyre going to eat well or a sliding scale. Continue to repeat 10 units subcut and poc blood until blood glucose is less than 300 mgdl, then resume normal poc blood sugar check and insulin regular sliding scale. Adult sliding scale for insulin aspart novolog blood glucose mgdl low dose moderate dose high dose less than 70 initiate hypoglycemia guidelines initiate hypoglycemia guidelines initiate hypoglycemia guidelines. For sliding scale therapy, this refers to premeal dose, bedtime time high blood sugar correction and background dose understand how different insulin formulations act in your body. Divide the total carbohydrates by the insulin to carbohydrate ratio. Intensifications of scheduled and sliding scale insulin, but not oral medications, were associated with a 11. Sliding scale insulin how is sliding scale insulin.
Insulin dosing worksheet sliding scale childrens healthcare of. Novolog dosing novolog insulin aspart injection 100 uml. Read this important information about sliding scale. That being said, i tend to manage the glucose of my patients relatively tight. Shortacting insulin dose humalog novorapid apidra fiasp blood sugar. Slidingscale insulin regimens when administered alone were associated with a threefold higher risk treatment of type 2 diabetes mellitus in the older patient view in chinese administered immediately after a meal to better match the meal size and minimize hypoglycemia. We are asking our website visitors to consent to the use of cookies by healthtap to continue to our website. Cbg testing, for sliding scale insulin, is done prior to administering insulin. Insulin sliding scale, correctional insulin dosing. Novolog mix 7030 flexpen 20 units before breakfast and. Sliding scale of insulin regime for women with preexisting diabetes 1718 vii. Blood glucose level target blood glucosecorrection factor units insulin to be given example. These medicines might consist of diabetes tablets or medicines you inject under your skin, such as insulin.