Dosing depends on the patients level of insulin resistance. With the help of this nursing mnemonics you will memorize 30 most important topics related to nclex study. Important safety information for lantus insulin glargine injection 100 unitsml contraindications lantus is contraindicated during episodes of hypoglycemia and in patients hypersensitive to insulin glargine or one of its excipients. I already know sliding scale wont last long with me. Follow hypoglycemia treatment orders on page 3 and contact physician. It will not work as intended, and you may lose blood sugar control. Find patient medical information for lantus u100 insulin subcutaneous on webmd including its uses, side effects and safety, interactions, pictures, warnings and user ratings. Do not administer intravenously or via an insulin pump. Lantus should be administered once a day at the same time every day. Ive been taking lantus at bedtime for about a month and i never seem to get any type of consistent morning blood sugar reading with the same dose. With type 2 diabetes, the more common type, your body does not make or use insulin well. Most doctors advise against the sliding scale approach. How the sliding scale works the sliding scale is actually a chart of insulin dosages.
If i do use a sliding scale, i want them to have a low threshold to call me. 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. Stepwise dosing and titration of insulin for type 2 diabetes. Stepwise dosing and titration of insulin for type 2 diabetes in the. Stepwise dosing and titration of insulin for type 2 diabetes in the ambulatory setting update 52010. Sliding scale for insulin lantus diabetes control view. Dosing lantus insulin glargine injection 100 unitsml. You cant hold lantus unless there are parameters there usually arent, because it shouldnt be held. Doctors give trusted answers on uses, effects, sideeffects, and cautions. Before you get started lantus insulin glargine injection. A basalprandial dosing option for nonintensive care. Do not mix or dilute lantus with any other insulin or solution. The leeds assessment of neuropathic symptoms and signs lanss pain scale is based on analysis of sensory description and bedside examination of.
Administer 12 units subcut, notify provider, and repeat poc blood sugar check in 1 hour. Patients with chf or esrd require individualized management. Discussion in lantus basaglar glargine and levemir detemir started by cbiscuit, nov 12, 2015. Ive known for a while that my body is sensitive to insulin, but lately its been a little more sensitive than usual. In a typical day, between 2028 units multiple times a day.
Adult sliding scale for insulin aspart novolog page 1 of 1. Started in 1995, this collection now contains 6767 interlinked topic pages divided into a tree of 31 specialty books and 732 chapters. Jul 18, 2019 lantus sliding scale pdf in slidingscale insulin therapy, the dose is based on your blood sugar level. Insulin drug chart for nursing printable sliding scale. Do not use the insulin scale on the cartridge holder to measure your dose. Sliding scale for insulin lantus blood sugar that is not well controlled in a pregnant woman with type 1 or type 2 diabetes could lead to problems for the woman and the baby. Our solutions are written by chegg experts so you can be assured of the highest quality. Initiation of insulin glargine therapy in type 2 diabetes subjects suboptimally controlled on oral antidiabetic. Johns hopkins hospital glucose management committee.
Learn sliding scale insulin with free interactive flashcards. Umc health system patient label here sliding scale insulin regular plan physician orders place an x in the orders column to designate orders of choice and an x in the specific order detail boxes where applicable. Cat is currently on lantus will be home friday from shelter will do detox and then need a dosing scale using human glucometer. Lantus can be discontinued one to two days before surgery, and glucose levels can be stabilized with a regimen of intermediate insulin e. Do not discontinue iv insulin during the acute or maintenance phase. Jul 04, 2019 lantus sliding scale pdf in slidingscale insulin therapy, the dose is based on your blood sugar level. Tillys diabetes homepage diabetes in cats lantus protocol.
Insulintherapie bei typ2diabetes unter stationaren bedingungen. When you understand how insulin therapy works in your body, you can more easily control your blood sugar. Highlights of prescribing information hyperglycemia or. Access winninghams critical thinking cases in nursing 5th edition chapter 7. Download chart pdf first there are two kinds of diabetes both presenting with frequent type 1 diabetes. Teamingup for diabetes can help you move toward your overall diabetes management goals by providing you with tools and resources that can help you take charge. Lantus is best given with consistent dosing at 12 hour intervals.
Insulin is a hormone that helps glucose get into your cells to give them energy. Subcutaneous insulin order set this order is not to be. Ask me anything information for nursing students and new nurses from the former dean of a nursing program in texas with years of nursing experience. Lantus insulin glargine, a longacting insulin is used for treating type 1 q. Inpatient diabetes management endotext ncbi bookshelf. Type 2 diabetes adult outpatient insulin guidelines diabetes coalition of california. Determine the distribution of the tdd calculated above based on nutrition regimen. Insulin pens are supplied in boxes of 5 pens each containing 3 ml at 100 units insulin per ml. The lantus solostar prefilled pen dials in 1unit increments. Its not sliding scale, you dont have permission to just withhold it without speaking to the md otherwise youre practicing medicine without. Administer 12 units subcut, notify provider, and repeat. Sliding scale regimens may include a bedtime high blood sugar correction.
Is humalog maybe not the right choice if i need such high dosing. Apr 05, 2020 lantus insulin glargine, a longacting insulin is used for treating type 1 q. Lantus sliding scale pdf in sliding scale insulin therapy, the dose is based on your blood sugar level. Arbitrary sliding scale insulin should be avoided as it is not only ineffective but also potentially dangerous. Needymeds has free information on medication and healthcare costs savings programs including prescription assistance programs and medical and dental clinics. Please see additional important safety information for lantus on the last page.
Do not use sliding scale insulin for longterm diabetes management for individuals residing in. Nursing mnemonics cheatsheet part ii nursing study guide. Lantus glargine or levemir detemir or nph insulin a1c greater than 8% on 2 or 3. Eliminate traditional monotherapy sliding scale dosing. Attach a new needle 1 take a new needle, and tear off the paper tab. Refrigerate unused unopened lantus vials and solostar prefilled pens. Can lantus be used as a sliding scale with my current insulin of. Lantus insulin glargine rdna origin injection, 100 uml fda.
Despite persistent expert recommendations urging its abandonment, the use of sliding scale insulin. Aug 29, 2019 the leeds assessment of neuropathic symptoms and signs lanss pain scale is an assessment tool used by the medical community to analyze and classify. Help need dosing sliding scale for,lantus feline diabetes. Lantus sliding scale pdf in sliding scale insulin therapy, the. The example sliding scales are for regular insulin with blood glucose bg measured in mgdl. Based on weight or total daily insulin requirement ahrq 2012 sliding scale refers to a set amount of insulin administered for hyperglycemia without regard to the timing of food, presence or absence of preexisting. If changing patients from twicedaily nph insulin to oncedaily lantus, the recommended initial lantus dosage is 80% of the total nph dose that is being discontinued. Sliding scale insulin refers to a treatment regimen that provides no basal insulin and provides only short.
Inpatient hyperglycemia management of the nonpregnant adult consider a diabetes endocrine or medicine consult. Upon verification, the content of labeling in structured product labeling spl format for the package insert submitted march 14, 2007. Each manufacturer has a program for free insulin for qualified individuals through a patient assistance program pap. Confirm any single dose of intermediatelong acting insulin over 50 units and any dose over 25 units of short acting insulin and document. They recruited a total of 67 pn episodes in 61 patients.
Hello all, do any of you use a sliding scale for lantus dosing at bedtime. Sliding scale insulin refers to a treatment regimen that provides no basal. Jan 31, 2020 lantus sliding scale pdf in slidingscale insulin therapy, the dose is based on your blood sugar level. In addition to the increasing prevalence of diabetes in the united states.
A practical and evidencebased approach to management of. Dec 26, 2017 the sliding scale is one way of working out how much insulin to take before each meal. Developed by the diabetes coalition of california, october 2010 see web site. Insulin dose calculation sliding scale diabetestalk. Full text update on insulin treatment for dogs and cats.
Inpatient management of hyperglycemia and diabetes vasudev magaji, md, ms, and jann m. Use lantus solostar prefilled pen with caution in patients with visual impairment who may rely on audible clicks to dial their dose. We present a case of a 37yearold male insulindependent diabetic presenting with refractory hypoglycemia secondary to an intentional overdose of lantus insulin to illustrate the varied management concerns in overdoses of longacting insulins. Optimizing glucose management in hospitalized patients using a. Sliding scale insulin involves checking the blood sugar and dosing the insulin typically rapid or shortacting based on the blood sugar value. Lantus compared with sliding scale insulin in patients who had bariatric surgery. Product monograph lantus insulin glargine injection. Lantusinsulin glargine injection rdna origin is a recombinant. Use your hospitals preprinted order form or protocol in emr and. Definition medlineplus diabetes means your blood glucose, or blood sugar, levels are too high. The endo says i will probably need lantus daily, but i think it will take some time to figure out dosage given the rollercoaster my body is on, and hard to see how it could be a 7day consistent one. Learn about the options for how to start appropriate t1dm and t2dm patients on lantus. We follow either tight regulation tr or start low go slow slgs the details of each can be found in the posts at the top of this forum.
When using a sliding scale, eat the same amount of carbohydrate at each meal. Glycemic control in hospitalized patients not in intensive. As a relatively new medication, there is limited experience in overdoses of lantus. Administer 14 units subcut, notify provider, and repeat poc blood sugar check in 30 minutes. Over the last 20 years of intensive clinical research, we witnessed a remarkable move away from the old approach of using insulin per sliding scale due to its poor glycemic efficacy and potential harms in the management of inpatient diabetes. Some patients may be able to self administer insulin as an inpatient.
I just wondered if a patient is npo, do they still receive their lantus insulin when they are on a sliding scale or just the sliding scale. Choose from 45 different sets of sliding scale insulin flashcards on quizlet. 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. Insulin therapy in the outpatient setting american college of. You need to talk with your doctor or see a specialist who deals with diabetes. Ask me anything information for nursing students and. Addition of insulin to parenteral nutrition for control of. 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. Should insulin be withheld when nothing by mouth is. All patients received subcutaneous insulin by a correction sliding scale based on glucose readings. Use glargine usually once daily in am or at bedtime, nph at bedtime or am and.
Dec 18, 2014 ive known for a while that my body is sensitive to insulin, but lately its been a little more sensitive than usual. I often wonder how much of an adjustment two units of lantus is. 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. When you have type 2 diabetes, and diet, exercise and other medications cannot control the blood sugar, or if you cannot use the medicines, it will be necessary to take insulin. Mar 31, 2018 the sliding scale is one way of working out how much insulin to take before each meal. 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. Optimizing glucose management in hospitalized patients. I found n to be too unpredictable so i was glad to switch to lantus when it came out. Should be customized to match insulin sensitivity for each patient.
Lantus basalpr egimen indications and usage for lantus lantus is a longacting insulin analog indicated to improve glycemic control in adults and children 6 years and older with type 1 diabetes mellitus and in adults with type 2 diabetes mellitus. Find out how it works and learn about problems with this diabetes. In fact, the american diabetes association have pushed for this treatment method to no longer be used. 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. Do not use it if it is cloudy or if you see particles. I took units of lantus yesterday and my blood glucose was 86 mgdl before lunch. That being said, i tend to manage the glucose of my patients relatively tight. Increase long acting basal insulin dose by 24 units at bedtime. 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. Jun 17, 2019 erasmus gbs outcome scale pdf june 17, 2019 guillainbarre syndrome gbs is an acute polyneuropathy with a variable degree of another prognostic model erasmus gbs outcome scale has been.
Stepwise dosing and titration of insulin for type 2. Humalog insulin sliding scale answers on healthtap. One may need to adjust the amount and timing of short or rapidacting insulins and dosages of any oral antidiabetic drugs. Umc health system patient label here sliding scale insulin. Doctors use a number of different regimens depending on the patient and their sensitivity to insulin. Find out how it works and learn about problems with this. I thought that they still do because its their basal insulin or they get a reduced dosage. If changing patients from oncedaily nph insulin to oncedaily lantus, the recommended initial lantus dose is the same as the dose of nph that is being discontinued. Lantus and levemir should be given at the same time of day irrespective of meals. It only shows approximately how much insulin is left in your pen. When you have diabetes, you may need to take insulin. May 01, 2010 glycemic control in hospitalized patients who are not in intensive care remains unsatisfactory.
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