Insulin Infusion Scale
This algorithm is not intended to be used for those individuals with diabetic ketoacidosis or hyperglycemic hyperosmolar states.
Target range for Glycemic Control: 140-180 mg/dL
1. STANDARD DRIP DILUTION: Humulin R 100 units in 100mL 0.9% NaCl 2. Start IV Insulin therapy when glucose is above the target range. 3. Insulin infusions should be discontinued when: a. Patient has no history of diabetes and is receiving less than 1 unit/hour. b. Patient receives 1st dose of SC basal + bridging dose of fast analog. 4. Bolus dose and initial infusion rate: * Divide initial CBS by 100, and then round to nearest 0.5 units for bolus AND initial infusion rate.
CBS ÷ 100 = ROUND OFF ANSWER TO NEAREST 0.5 units
Examples:
Initial glucose of 326mg/dL
326 mg/dL ÷100 = 3.26 round off to 3.5
IV bolus 3.5 units AND start infusion at 3.5 units/hour
Initial glucose of 174 mg/dL
174 ÷ 100 = 1.74 round to 1.5
IV bolus 1.5 units AND start infusion at 1.5 units/hour
5. Intravenous Fluids
If NPO, most patients will need 5-10 glucose per hour D5W or D5½NSS at 100-200 mL/hour. 6. Adjusting the Infusion according to CBS result: CBS Result (mg/dL) | Dosage (units/hour) | less than 70 | OFF | 70-109 | 0.2 | 110-119 | 0.5 | 120-149 | 1 | 150-179 | 1.5 | 180-209 | 2 | 210-239 | 2 | 240-269 | 3 | 270-299 | 3 | 300-329 | 4 | 330-359 | 4 | more than 360 | 6 |
31 August
Target range for Glycemic Control: 140-180 mg/dL
1. STANDARD DRIP DILUTION: Humulin R 100 units in 100mL 0.9% NaCl 2. Start IV Insulin therapy when glucose is above the target range. 3. Insulin infusions should be discontinued when: a. Patient has no history of diabetes and is receiving less than 1 unit/hour. b. Patient receives 1st dose of SC basal + bridging dose of fast analog. 4. Bolus dose and initial infusion rate: * Divide initial CBS by 100, and then round to nearest 0.5 units for bolus AND initial infusion rate.
CBS ÷ 100 = ROUND OFF ANSWER TO NEAREST 0.5 units
Examples:
Initial glucose of 326mg/dL
326 mg/dL ÷100 = 3.26 round off to 3.5
IV bolus 3.5 units AND start infusion at 3.5 units/hour
Initial glucose of 174 mg/dL
174 ÷ 100 = 1.74 round to 1.5
IV bolus 1.5 units AND start infusion at 1.5 units/hour
5. Intravenous Fluids
If NPO, most patients will need 5-10 glucose per hour D5W or D5½NSS at 100-200 mL/hour. 6. Adjusting the Infusion according to CBS result: CBS Result (mg/dL) | Dosage (units/hour) | less than 70 | OFF | 70-109 | 0.2 | 110-119 | 0.5 | 120-149 | 1 | 150-179 | 1.5 | 180-209 | 2 | 210-239 | 2 | 240-269 | 3 | 270-299 | 3 | 300-329 | 4 | 330-359 | 4 | more than 360 | 6 |
31 August