Insulin Sliding Scale Guideline Malaysia

Add prandial insulin to basal insulin if post meal blood glucose levels are above goal 6 7 8 start one of the prandial insulins listed above.

Insulin sliding scale guideline malaysia. Regular human insulin or structurally modifi ed i e. Continue basal insulin may need to re adjust dose 6 7 8 rapid acting insulins should be just before meal. Per hospital guideline and restart iv insulin within 20 minutes 1 2 life of iv insulin is 7 8 minutes. Insulin medication errors hyperglycemia practice guidelines sliding scale insulin ssi is commonly used to manage hospitalized patients with and without diabetes mellitus 1 2 3 monotherapy with ssi often leads to erratic fluctuations of glucose control because it tries to retrospectively treat hyperglycemia rather than prospectively prevent it 1 4 5 6 7 8 9 10 in the.

Long or intermediate acting insulins are used to mimic the steady background release of insulin and should be continued even when the patient isn t eating. Step down to the next scale when the vriii is restarted i e. Short acting insulin. Disadvantages of the sliding scale regimen.

Sliding scale insulin regime sliding scale insulin regime regime therapy sliding scale insulin regime procedure. Insulin medication errors hyperglycemia practice guidelines sliding scale insulin ssi is commonly used to manage hospitalized patients with and without diabetes mellitus 1 2 3 monotherapy with ssi often leads to erratic fluctuations of glucose control because it tries to retrospectively treat hyperglycemia rather than prospectively prevent it 1 4 5 6 7 8 9 10 in the. 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. It is a very useful tool when used in the right context and has been shown to improve outcomes.

The insulin currently used in malaysia is recombinant human insulin either directly derived from the native human insulin i e. Variable rate intravenous insulin infusion vriii formerly known as sliding scale insulin has been used for decades to achieve normoglycaemia in hospitals. Section 19 covers gkis and iv insulin infusions. The adult inpatient diabetes guidelines can be accessed here.

You still need to count carbohydrates. Esquema de insulina con escala variable régimen tratamiento esquema de insulina con escala variable régimen terapia sliding scale insulin regime sliding scale insulin regime regime therapy esquema de insulina con escala variable english. Obtain venous blood sample for u e s to include potassium and. The sliding scale method does not accommodate changes in insulin needs related to snacks or to stress and activity.

6 7 when adding prandial insulin. 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. However when used incorrectly it can result in morbidity from hypoglycaemia excess. Prior to commencing vriii.

If using standard vriii then step down to reduced vriii scale.