Im a relatively new inpatient pharmacist and ive run into this situation twice that has made me pretty uncomfortable. Despite persistent expert recommendations urging its abandonment, the use of sliding scale insulin. 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. Sliding scale therapy approximates daily insulin requirements. This guideline is for intravenous sliding scale insulin, it is to be used in conjunction with the new 2 day intravenous sliding scale insulin prescription chart. Never share a novolog mix 7030 flexpen between patients, even if the needle is changed. Correction insulin sliding scale, supplemental, bolus. Can novolog insulin be used as a sliding scale before meals. Administer 14 units subcut, notify provider, and repeat poc blood sugar check in 30 minutes. Sliding scale regimens may include a bedtime high blood sugar correction. Stepwise dosing and titration of insulin for type 2 diabetes in the ambulatory setting update 52010. In most slidingscale insulin therapy regimens, your blood sugar is taken using a glucometer. Use this sliding scale as an example only adjust per patient weight and activity or disability delays insulin until hyperglycemia appears cover as units per glucose 50 mgdl over 150 mgdl renal failure insulin 50% renal excreted v.
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. Taking insulin or other diabetes medications is often part of dealing with diabetes in addition to healthy food choices and exercise, medicine can assist. The goal of insulin therapy is to keep your blood sugar levels within a target range. The term sliding scale refers to the progressive increase in premeal or nighttime insulin doses. If you have type 1 diabetes, inject within 15 minutes before you eat a meal. Slidingscale versus basalbolus insulin in the management of. Insulin pens appear similar to one another despite containing different insulins basal or bolus read each syringe carefully and note its color prior to each injection to prevent overdose errors. The bolus insulin is based on the blood sugar level before the meal or at bedtime premixed. Novolog insulin aspart sliding scale novolog insulin chart ppt inpatient hyperglycemia in non bolus basal versus sliding sliding scale novolog insulin chartnovolog insulin dosage chart images e993apidra sliding scale sensitive images e993sliding scale insulin aspart protocol plansliding scale for humalog kwikpen diabetestalksliding scale therapy diabetes educationnovolog dosing insulin.
You probably will find some beneficial info in this post, come have a glimpse. Guidelines for inpatient diabetes management these recommendations do not take into account individual patient situations, and do not substitute for clinical judgment. For the treatment of diabetes, insulin is the basic foundation. Stepwise dosing and titration of insulin for type 2.
Diabetes tracking chart printable diabetes tracking chart printable, blood sugar tracker printable for health medical prediabetes is a condition where the glucose level in the blood is elevated to a level higher than normal, but not high enough to be considered as diabetes. Jul 27, 2019 insulin therapy is a critical part of treatment for people with type 1 diabetes and also for many with type 2 diabetes. Getting started on novolog flexpen a discreet, prefilled, dialadose insulin pen please see additional important safety information on next page. It is not intended to be and should not be interpreted as medical advice or a diagnosis of any health or fitness problem, condition or disease. Novolog sliding scale chart type 1 best picture of chart. To work out the right dosage using a sliding scale, people should follow these steps. 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. Although its use is not recommended, sliding scale insulin therapy is still being used widely. Give supplemental insulin lispro following the sliding scale protocol 1d for blood glucose 140 mgdl. Lantus 20 units, subcut, every evening nph insulin 14 units, subcut before breakfast novolog mix 7030, 18 u, subcut before breakfast and dinner sliding scale insulin administration fallen out of favor with providers. When i worked the floor, our sliding scale protocol only covered hs cbgs 200 or was it 250.
Based on diabetes medications chart, oral medication pills for diabetes type 2 symptoms are classed in a number of categories depending their on type. 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. Stepwise dosing and titration of insulin for type 2 diabetes in the ambulatory setting last update 52010. Novolog sliding scale insulin chart insulin chart, diabetes. Use of a standardized protocol to decrease medication errors and adverse events related to sliding scale insulin a c donihi, m m dinardo, m a devita, and m t korytkowski a c donihi, m m dinardo, m a devita, m t korytkowski, university of pittsburgh medical center, pittsburgh, pa, usa.
Doctors give trusted answers on uses, effects, sideeffects, and cautions. 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. Use of a standardized protocol to decrease medication errors. Jun 10, 2014 a sliding scale is for what we call coverage. Compare common options for insulin therapy mayo clinic. Insulin protocols for hospital management of diabetes. Sliding scale for novolog aspart diabetes type 2 medhelp.
Glycemic control in hospitalized patients not in intensive. What is the sliding scale range for novolog insulin. These images are a random sampling from a bing search on the term insulin dosing in type 2 diabetes. If a patient is able and expected to eat all, give supplemental lispro insulin before each meal and at bedtime following the usual column. Sliding scale insulin ssi is commonly used to manage hospitalized patients with and without diabetes mellitus.
Novolog sliding scale is used to figure out the insulin needs in a diabetic patient. Find out how it works and learn about problems with this diabetes. Question about sliding scale insulin patient medications. 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. The proportions of rapidacting and longacting insulins are fixed and do not allow for basal nvolog prandial dose adjustments. What health clinics charge sliding scale of insulin per foods you eat. Insulin pens are supplied in boxes of 5 pens each containing 3 ml at 100 units insulin per ml.
Sliding scale insulin protocol follow ssi reference text medications medication sentences are per dose. Insulin types vary depending on how quickly they work, when they peak, and how long they last. The amount of insulin you get at mealtime is based on your blood sugar measurement. This is done about four times a day every five to six hours, or before meals and at bedtime.
Insulin aspart novolog slidding scale, very resistanthigh for blood glucose sliding scale comments 60149. Insulin sliding scale apidra insulin glulisine novolog insulin aspart rdna origin diabetes boot c cl 3 novolog insulin aspart injection sliding scale novolog insulin chartblood sugar sliding scale novolog images e993apidra sliding scale sensitive images e993novolog mix 70 30 dosing administration lines for hcpsstandard sliding scale insulin protocol for patients with. First described in 1934, what physicians typically refer to as sliding scale insulin ssi is fast or rapidacting insulin only, given subcutaneously, typically at meal times and sometimes bedtime, but only when blood glucose is above a threshold e. Jun 14, 2016 this pin was discovered by chervalia edwards. If you have type 2 diabetes, inject within 15 minutes before or after starting your meal. In most sliding scale insulin therapy regimens, your blood sugar is taken using a glucometer. I got on the floor at 330, checked his bs at 4, it was 141. Novolog dosing novolog insulin aspart injection 100 uml. Novolog insulin sliding scale chart best picture of. 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 and. Patients using novolog mix 7030 vials must never share needles or syringes with another person. Jul 11, 2011 see these well designed sliding scale insulin orders. Optimizing glucose management in hospitalized patients. Common questions and answers about novolog insulin sliding scale novolog what health clinics charge sliding scale of insulin per foods you eat.
Sliding scales contact provider if maximum glucose is exceeded. Call md if blood sugar is less than 60 or greater than 400. I found this one sliding scale online, listings of how much units to give depending on what his blood sugar level is. Taking insulin or other diabetes medications is often part of dealing with diabetes in addition to healthy food choices and exercise, medicine can assist you handle the disease. Nov 02, 2018 insulin sliding scale apidra insulin glulisine novolog insulin aspart rdna origin diabetes boot c cl 3 novolog insulin aspart injection sliding scale novolog insulin chartblood sugar sliding scale novolog images e993apidra sliding scale sensitive images e993novolog mix 70 30 dosing administration lines for hcpsstandard sliding scale insulin protocol for patients with diabetesnovolog dosing. Basal insulin is intended to keep blood glucose levels under control during periods of fasting or sleep. Jan 01, 2018 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 and. Dec 26, 2017 u and u, but do i have to take the sliding scale into account or not at this regularly scheduled. Sliding scale for humalog 7525 basalbolus vs sliding scale insulin in the hospital.
Historically, sliding scale regular insulin was the issue now rapid acting insulins are a concern. May 01, 2010 glycemic control in hospitalized patients who are not in intensive care remains unsatisfactory. According to the sliding scale it said to give none. Administer 12 units subcut, notify provider, and repeat poc blood sugar check in 1 hour. You need to talk with your doctor or see a specialist who deals with diabetes. 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. Sliding scale novolog question diabetes endocrine nursing.
Communication or other orders related to regular insulin sliding scale of blood sugar monitoring. Now my question is, i am looking at a novolog standardized sliding scale and it conflicts greatly. I am confused a bit about insulin control sliding scale. The content on this site is presented in a summary fashion, and is intended to be used for educational and entertainment purposes only.
Use of a standardized protocol to decrease medication. Aug 29, 2018 sliding scale chart, sliding scale chart for diabetes, sliding scale chart for humalog, sliding scale chart for novolog insulin sliding scale chart to see if you are eligible, find your family in the table below. In slidingscale insulin therapy, the dose is based on your blood sugar level. The general principles of sliding scale therapy are. Ive heard about sliding scale before but when i brought it up to his pharmacist she did not know much about it got me concerned. Click on the image or right click to open the source website in a new browser window. Jan 06, 2018 novolog mix 7030 is contraindicated during episodes of hypoglycemia and in patients hypersensitive to novolog mix 7030 or one of its excipients. Umc adult sliding scale insulin orders patient label here insulin sliding scale dose blood glucose mgdl low dose moderate dose high dose protocol initiate hypoglycemic protocol initiate hypoglycemic protocol 70 110 0 units 0 units 0 units 111 150 0 units 2 units subq 3 units subq. I have seen two orders for type 2 diabetic patients on novolog 7030 tidac with sliding scale parameters, including parameters for giving insulin when bg sliding scales.
An hs cbg of 185 would not have received a sliding scale dose. 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. Adult sliding scale for insulin aspart novolog fillable basal insulin involves longacting insulin injections that help keep insulin levels steady throughout the day. Novolog is a rapidacting insulin taken before starting your meal. Long acting insulin such as lantus would be a bit different, since they are supposed to be peakless. You take the same longacting insulin dose no matter what the blood glucose level. Novolog insulin aspart dosing, indications, interactions. Do not mix novolog mix 7030 with other insulin products or use in an insulin pump.
Adult sliding scale for insulin aspart novolog umc health system. Hello sliding scale really depends on you and your case and needs to be set by your doctor. Individualize and adjust the dosage of novolog based on route of administration, the individuals metabolic needs, blood glucose monitoring results and. Optimizing glucose management in hospitalized patients using. As sliding scale insulin therapy has fallen out of favor, many experts recommend using basal insulin with mealtime insulin added when needed. When using a sliding scale, eat the same amount of carbohydrate at each meal.
Based on insulin sensitivity estimate sensitivity using rule of 1800 bg change per unit insulin 1800total insulin daily. A sliding scale can be used on most patients when only using one insulin type, not two as in your fathers case. The amount of carbohydrate to be eaten at each meal is preset. The last doctor i was seeing he put me on novolog sliding scale with each meal and at bedtime, novolin n 10 units before meals, lantus 40 units twice daily, 2000 mg of glucophage, asa daily, lisinopril a day. Sep 02, 2014 sliding scale and basalbolus insulin regimens are two options available for the treatment of severe or acute hyperglycemia in type 2 diabetes mellitus patients. Sep 09, 2011 i am confused a bit about insulin control sliding scale. 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. Sliding scales contact provider if maximum glucose is exceeded very low schedule insulin sensitive bg 150199. The term sliding scale refers to the progressive increase in the premeal or nighttime insulin dose, based on predefined blood glucose ranges.
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