Is Sliding Scale insulin effective?

Despite persistent expert recommendations urging its abandonment, the use of sliding-scale insulin remains pervasive in U.S. hospitals. Evidence for the effectiveness of sliding-scale insulin is lacking after more than 40 years of use.

Is Sliding scale insulin recommended?

The American Diabetes Association (ADA) warn that using only sliding scale insulin for treatment is ineffective for most people. It can increase the risk of both high and low blood sugar and of complications if the person needs surgery. Most doctors advise against using this approach.

Is Sliding scale obsolete?

Still, this editorial will focus on the old concept of a sliding scale—a concept that is still alive and well throughout the United States. It is still used by many physicians, and it is still taught to many of our health care students and medical residents.

When do you use insulin sliding scale?

The cornerstone of insulin therapy should be an intermediate- or long-acting insulin accompanied by a rapid-acting insulin for meal coverage. Use the sliding scale only as a supplement to correct acute hyperglycemia.

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Is Sliding scale insulin fast acting?

In most sliding-scale insulin therapy regimens, your blood sugar is taken using a glucometer. This is done about four times a day (every 5 to 6 hours, or before meals and at bedtime). The amount of insulin you get at mealtime is based on your blood sugar measurement. In most cases, fast-acting insulin is used.

What does sliding scale mean for insulin?

A sliding scale varies the dose of insulin based on blood glucose level. The higher your blood glucose the more insulin you take. The Sliding Scale method is more precise than fixed dose insulin in that it takes account of the fact that people’s blood glucose is not always in the normal range before meals.

What is the sliding scale for diabetics?

The term “sliding scale” refers to the progressive increase in pre-meal or nighttime insulin doses. The term “sliding scale” refers to the progressive increase in the pre-meal or nighttime insulin dose, based on pre-defined blood glucose ranges. Sliding scale insulin regimens approximate daily insulin requirements.

What is the sliding scale for novolog insulin?

OGTT (oral glucose tolerance test): Plasma glucose > 200 mg/dL at 2 hours during a 75g OGTT.


Insulin Sliding Scale
Blood Glucose Novolog Insulin SQ
151-200 2 units
201-250 4 units
251-300 6 units

Should we prescribe sliding scale insulin alone for patients hospitalized with diabetes?

Should We Prescribe Sliding Scale Insulin Alone for Patients Hospitalized with Diabetes? A retrospective study and expert guidance suggest that many inpatients can be managed with sliding scale insulin alone.

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How do I calculate how much insulin I need?

Divide the total carbohydrates by the insulin to carbohydrate ratio. The result is the amount of insulin units needed. Visit for additional copies. 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 (Humalog/Novolog/Apidra).

How much glucose does 1 unit of insulin reduce?

Generally, to correct a high blood sugar, one unit of insulin is needed to drop the blood glucose by 50 mg/dl. This drop in blood sugar can range from 30-100 mg/dl or more, depending on individual insulin sensitivities, and other circumstances.

How many units of Lantus is normal?

The usual starting dose of Lantus for people with type 2 diabetes is 0.2 units/kg. (There are about 2.2 lb/kg.) The maximum starting dose of Lantus is 10 units a day. Lantus is typically taken once a day, not twice a day.

What is the maximum amount of insulin you can take?

When daily insulin doses exceed 200 units/day, the volume of U-100 insulin needed makes insulin delivery challenging. Available insulin syringes can deliver a maximum of 100 units, and insulin pen devices can deliver only 60–80 units per injection.

Can I take Lantus twice a day?

Using Lantus twice daily will double the costs compared to Humulin N, without an increased benefit. However, it’s important to remember that NPH insulin causes a peak in insulin whereas Lantus is “peakless.”

What blood sugar level requires insulin?

Insulin is usually recommended as the initial therapy for diabetes if a person’s HbA1c level at diagnosis is greater than 10% or if someone’s fasting blood glucose level is consistently above 250 mg/dl.

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