[evans_c1]

Just wondering about the insulin Lantus.... It seems about 90% of the nurses on my unit would hold lantus if a blood glucose was ..say maybe 45? Were they not taught that Lantus is a basal insulin and you should NEVER hold it. I would give it if their glucose was 20! I was taught to never hold it and I hate to say anything bc I'm a fairly new nurse. Anyone ever heard of such a thing?

[TheCommuter]

Since Lantus is so slow-acting, I never hold it. If my patient's blood glucose is low, I will simply give them a sweet snack or some fruit juice. I have never had any problems with patients bottoming-out from Lantus.

[evans_c1]

Yes, that is what I was taught in nursing school. Thanks for the input!

[Fire Wolf]

Originally Posted by evans_c1

Just wondering about the insulin Lantus.... It seems about 90% of the nurses on my unit would hold lantus if a blood glucose was ..say maybe 45? Were they not taught that Lantus is a basal insulin and you should NEVER hold it. I would give it if their glucose was 20! I was taught to never hold it and I hate to say anything bc I'm a fairly new nurse. Anyone ever heard of such a thing?

If my patient's blood sugar is low, below normal but not critical, I hold insulin, any insulin, and call the doctor. Whether the insulin is long acting or short, a low blood sugar may require some changes in the amount the physician wants the patient to receive while he or she is an inpatient.

It is not just that the insulin is held, but that the insulin is held and the doctor notified so that he or she can make any changes that are needed.


Many people do not follow their ADA diets as religiously at home as they do when they are in the hospital and the food is sent to them from dietary.

Also, the disease process, infections, tests and procedures which require a patient to be NPO, and some medications will all affect the person's blood glucose level.

Often the normal dose that a patient takes at home is different from what they need when they are in the hospital. Most of our doctor's use a sliding scale regimen and have us do chem sticks ac/hs and at 0300 hours.

[jmgrn65]

Lantus is not to be held, no matter what thier Blood sugar is, it is not that it is slow or short acting it controls the sugar over the course of the day. It may need adjusting but it should NEVER be held. So you were right. It is harder for some of us older nurses to grasp that idea not to hold insulin when sugars are low. but holding the lantus will not effect it.

[Tweety]

I'm with FireWolf on this one. I would notify the MD of the blood glucose level and see if she/he wants to adjust the dose, especially if it's a high dose. Also one has to look at the other glucose levels throughout the day. Obviously the Lantus isn't going to affect the 45 and drop it, but you have to critically think "what's been going on the last 24 hours, and what will happen the next 24 hours?"

Nurses are not licensed to hold drugs without an MD or parameters. Obviously using good common sense we don't blindly give drugs either.

[jmgrn65]

yes call the MD but just don't hold it, the doc should be notified anyway if the sugar is low and tweety is right the trends need to be looked at also.

[Tweety]

Originally Posted by jmgrn65

yes call the MD but just don't hold it..........

Agreed, holding a diabetic's Lantus insulin is not an option. Those who hold it, treat the low blood sugar and then go about their business are committing an error.

[luvmy2angels]

Originally Posted by Tweety

I'm with FireWolf on this one. I would notify the MD of the blood glucose level and see if she/he wants to adjust the dose, especially if it's a high dose. Also one has to look at the other glucose levels throughout the day. Obviously the Lantus isn't going to affect the 45 and drop it, but you have to critically think "what's been going on the last 24 hours, and what will happen the next 24 hours?"

Nurses are not licensed to hold drugs without an MD or parameters. Obviously using good common sense we don't blindly give drugs either.

I totally agree Tweety!!

[jmgrn65]

Originally Posted by Tweety

Agreed, holding a diabetic's Lantus insulin is not an option. Those who hold it, treat the low blood sugar and then go about their business are committing an error.

yes exactly I think that was what the original poster was trying to say.