Sliding scale insulin patient handout pdf

Sliding scale regular insulin ssi in the management of patients with diabetes was the standard practice as early as 1934 1 and was also used in the hyperglycemic emergency diabetic ketoacidosis 2. Refer to diabetes education clinic for insulin education upon discharge. Sliding scale insulin regimens for type 2 diabetes. For information about the sort evidence rating system, go to orgafpsort. 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. Insulin injection resources tip sheets on insulin injection best practices we created a series of tip sheets for diabetes care and education specialists to use when assisting their patients with understanding how insulin. In the slidingscale method, the dose of insulin to be taken is based on your blood sugar level, just before your meal. Mashfiqul hasan phase b resident department of endocrinology bsmmu 2. 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. Correction insulin sliding scale, supplemental, bolus.

Optimizing glucose management in hospitalized patients. Diabetes patient handout pdf doctor for sugar diabetes salmon and type 2 diabetes scarborough centre for healthy communities diabetes sanatogen protein drink diabetic. 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. This sliding scale assumes that 1 unit of regular will. Started in 1995, this collection now contains 6767 interlinked topic pages divided into a tree of 31 specialty books and 732 chapters. Sliding scale insulin ssi, a treatment regimen that has been around. Slidingscale versus basalbolus insulin in the management. This patient information booklet is not intended to be exhaustive and should. The sunnybrook diabetes education sundec program, offers group. There are different types of insulin depending on how quickly they work, when they peak, and how long they last. 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. National subcutaneous insulin charts australian commission.

Insulin injection resources american association of. Some people also take it if blood sugars are high at bedtime. Novolog sliding scale insulin chart photos of novolog sliding scale insulin. Guide to starting and adjusting insulin for type 2 diabetes cadth. The amount of carbohydrate to be eaten at each meal is preset. 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. Selfmonitoring of blood glucose should be individualized. Novolin 7030 novoelin 70% nph, human insulin isophane suspension and. The sliding scale method is more precise than fixed dose insulin in that it takes account of the fact that peoples blood glucose is not always in the normal range before meals. 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. Stepbystep patient injection guide becton dickinson.

Mixed insulin is more likely to cause hypoglycemia8,19 and generally requires a fixed meal schedule8. Insulin helps your cells use the sugar and other carbohydrates you eat for energy. Diabetes record for patients taking insulin breakfast lunch supper bedtime other comments. Sliding scale insulin regimens for type 2 diabetes using multiple daily injections. 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. In those patients managed with insulin infusion, adjust hourly to achieve target. The sliding scale group was treated using ad hoc sliding scale. Sliding scale insulin regimens approximate daily insulin requirements. Do not change the type of insulin you use unless told to do so by your healthcare provider. These earlier studies used urine glucose for sliding scale, but with demonstration of inaccuracy of urine glucose 3, blood glucose replaced urine glucose for sliding scale in diabetic. Below are two examples of an insulin sliding scale. Getting started on levemir flextouch flextouchthe only prefilled insulin pen with no pushbutton extension1 accurate dosing from 1 to 80 units1 works with novo nordisk pen needlesa large, clear dosing window endofdose clickb prefilled with 300 units of levemir low injection force push button1. The dose doesnt take into account how much insulin a patient needed in the past, nor does it consider how sensitive a patient has been to its effects.

Samplea patient information booklet for adults who have diabetes. Stepwise dosing and titration of insulin for type 2 diabetes in the ambulatory setting. Type 2 diabetes adult outpatient insulin guidelines if postmeal glucose levels 180. Current intensive insulin regimen for type 2 diabetes. Read this booklet and the insulin passport alongside all the other information about. Injection is usually taken 2 times per day with breakfast and dinner. Canadian agency for drugs and technologies in health 600865 carling avenue, ottawa, ontario, 1s 5s8. Insulin drug chart for nursing printable sliding scale. Sliding scale insulin refers to a treatment regimen that provides no basal insulin and.

Getting started on novolog flexpen a discreet, prefilled, dialadose insulin pen please see additional important safety information on next page. The higher your blood glucose the more insulin you take. It is difficult to 9obtain optimal control without occasional, mild episodes of hypoglycemia. In this therapy model, blood sugar is taken about four times. Each handout is written in easy to understand language with. Diabetes facts 2012 and guidelines 2011 yale school of medicine. Administer 12 units subcut, notify provider, and repeat poc blood sugar check in 1 hour. Diabetes facts 2012 and guidelines 2011 yale school of. Your health care team may have given you this information as part of your care. Nph insulin has elevated risk of hypoglycemia so use with extra caution6,8,15,17. 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. Novolog mix 7030, novolin mix 7030, humalog mix 7525, humulin. Each handout is written in easy to understand language with simple illustrations. Errors and poor outcomes with sliding scale insulin dosing studies demonstrate, and experts agree, that there is little evidence for using only sliding scale insulin to control blood glucose.

Most people who take humalog use a sliding scale or take a certain dose routinely throughout the day. Healthcare professionals are advised to use clinical discretion and consideration of the circumstances of the individual patient when using the chart to manage bgls. Guide to starting and adjusting insulin for type 2. Insulin orders for patients with type 2 diabetes order set. Consider using a basalbolus and supplemental correction insulin regimen. Sliding scale requires a bit more patient investment than fixed dose, as you might imagine. Sliding scales are less effective in covering a premeal high blood sugar, because the high blood glucose correction and food bolus cannot be split. Historically, sliding scale regular insulin was the issue now rapid acting insulins are a concern. Veterinary practice guidelines 2018 aaha diabetes management guidelines for dogs and cats ellen behrend, vmd, phd, dacvim, amy holford, vmd, dacvimy, patty lathan, vmd, dacvim, renee rucinsky, dvm, dabvpy, rhonda schulman, dvm, dacvim abstract diabetes mellitus dm is a common disease en countered in canine and feline medicine. Veterinary practice guidelines 2018 aaha diabetes management. Adjust insulin dose every 3 days until bg sliding scale depending on sensitivity. For information about the sort evidence rating system, go to org afpsort. Administer 12 units subcut, notify provider, and repeat poc blood sugar check in 30 minutes.

Sliding scale regular humulin insulin physician order set. Insulin, given either intravenously or subcutaneously, is the preferred regimen for effectively treating hyperglycemia in the hospital. Insulin dosing worksheet sliding scale insulin to carbohydrate ratio 1 unit. Calculate insulin dose for food add up all the carbohydrates in your meal. The general principles of sliding scale therapy are. Type 2 diabetes mellitus is a chronic, progressive disease characterized by multiple defects in glucose metabolism, the core of which is insulin resistance in muscle, liver, and adipocytes. Insulin injection resources tip sheets on insulin injection best practices we created a series of tip sheets for diabetes care and education specialists to use when assisting their patients with understanding how insulin works and teaching proper injection technique, whether using a syringe, pen, or pump for delivery. An understanding of different insulin s, their action and safe dose adjustments a step by step approach is provided to teaching your patient the basics about starting insulin. Normal blood glucose and insulin levels over 24 hours. Sliding scale regular or humalog insulin uw health. Administer 14 units subcut, notify provider, and repeat poc blood sugar check in 1 hour. It is used to improve blood sugar control in patients with dmii.

Single dose of insulin that combines either rapidacting or shortacting and intermediateacting insulin in a fixed ratio. Basal insulin is best starting insulin choice for most patients. If the premeal blood sugar is high, you take higher dose of insulin. Stepwise dosing and titration of insulin for type 2 diabetes. The bolus insulin is based on the blood sugar level before the meal or at bedtime premixed. Stepwise dosing and titration of insulin for type 2. Veterinary practice guidelines 2018 aaha diabetes management guidelines for dogs and cats ellen behrend, vmd, phd, dacvim, amy holford, vmd, dacvimy, patty lathan, vmd, dacvim, renee. Started in 1995, this collection now contains 6767 interlinked topic pages divided into a tree. The sliding scale method does not accommodate changes in insulin needs related to snacks or to stress and activity.

You take the same longacting insulin dose no matter what the blood glucose level. Please practice handwashing and social distancing, and check out our resources for adapting to these. Controlling blood glucose levels in hospital patients. Correction insulin corrects or lowers high blood sugars before meals. Insulin regimens for type 2 diabetes using one daily injection of insulin. In the sliding scale method, the dose of insulin to be taken is based on your blood sugar level, just before your meal. Longacting insulin glarginedetemir or nph, once or. Table 1 provides additional potential indications for iv insulin infusion. Another longheld tradition is use of the sliding scale for glycemic control in hospitalized patients, with insulin doses based on the patients blood glucose bg level. These earlier studies used urine glucose for sliding scale, but with demonstration of inaccuracy of urine glucose 3, blood glucose replaced urine glucose for sliding scale. Some people on insulin use a sliding scale, while others have set doses each day. The first is for a younger child, and the second is for an older child. Stepwise dosing and titration of insulin for type 2 diabetes in the ambulatory setting update 52010. Patient instructed humalog insulin lispro is a fastacting insulin that starts to work about 15 minutes after injection, peaks in about 1 hour, and keeps working for 2 to 4 hours.

If patient unable to do multiple daily injections, consider switching to mixed insulin instead of adding prandial insulin. Patients in a mixed medicalsurgical icu were compared during two 9 month periods. Apr 12, 2020 spanish, low literacy pdf very low literacy pdf general diabetes patient education handouts through a partnership with home diagnostics, a producer of glucometers, the acu has created new patient education materials focused on diabetes for a low literate and multicultural population. All insulin available in the united states is manufactured in a laboratory, but animal insulin can still be imported for personal use. Jul 16, 2012 adapted from guide to starting and adjusting insulin for type 2 diabetes, 2008 international diabetes center, minneapolis, mn. National subcutaneous insulin charts and resources national subcutaneous insulin chart for acute hospitals. This is done about four times a day every five to six hours, or before meals and at bedtime. Patient was educated on slidingscale insulin therapy as follows. Patients treated with slidingscale insulin alone had blood glucose levels. Divide the total carbohydrates by the insulin to carbohydrate ratio. The provider or staff performing the teaching should check off each item as it is completed to document teaching. In most sliding scale insulin therapy regimens, your blood sugar is taken using a glucometer. Reviews diabetic complications both ones that develop rapidly acutely or slowly chronically how to recognize them, and what to do if they occur.

Slidingscale insulin therapy home health patient education. Developed by the diabetes coalition of california, october 2010 see web site. Insulin sliding scale dose blood sugar low dose moderate dose high dose. Although its use is not recommended, sliding scale insulin. If you are on a sliding scale, results of your blood sugar check tells you how much insulin to take. Basal insulin is best starting insulin choice for most patients if fasting glucose above goal. Guide to starting and adjusting insulin for type 2 diabetes.

Patient information and handouts for use are attached. A nomogram for intravenous insulin infusion in critically ill patients was evaluated in a retrospective beforeafter cohort study. Oct 7, 2014 insulin drug chart for nursing printable sliding scale insulin chart stay safe and healthy. Sliding scale and basalbolus insulin regimens are two options available for the treatment of severe or acute hyperglycemia in type 2 diabetes mellitus patients.

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