INSULIN SLIDING SCALE- AMENDED

• only soluble insulin can be used

• do not put insulin in litre bags
• give 10 U soluble insulin IV stat
• thereafter: give IV insulin according to sliding scale 2 hourly
• check glucose 2 hourly

Blood glucose IV insulin dose type of IV fluid

HHH very high 10 N Saline
>400mg/dl (22 mmol/l) 10 N Saline
300-399 mg/dl (16.5-22) 10 N Saline
200-299 mg/dl (11-16.5) 5 N Saline
54-200 mg/dl (3-11) 5 5% dextrose

After 3 doses (6 hrs) if the blood glucose is not responding give

15u insulin at the next dose

It is not advisable to withhold insulin administration unless

glucose <54 mg/dl (3 mmol / L); otherwise the next glucose
reading can be expected to be high.
SICK DAY RULES

Advice to patient / family

• When you are sick your blood glucose may rise above normal
even if you are not able to eat your normal meals or drink
anything, so NEVER STOP TAKING YOUR INSULIN.

• administer insulin in reduced (half) dose if unwell even if not

eating
• seek medical help early
• prompt diagnosis and treatment for any fever

if unable to eat normal diet, replace food with small frequent

amounts of the following:

 100 ml (1/2 a cup) of natural unsweetened fruit juice.

 100 ml (1/2 a cup) ordinary (not light) Coke or Fanta.
 200 ml / 1 cup of milk (plain dairibord).

 To prevent dehydration try to drink 4-6 pints water per

day. This is approximately one glass every hour.

Theresa Allain 30th November 2010