confused about insulin

[supervisorhatchet]

I just read a report from a recent survey, and one of the tags was that insulin was administered after the meal. Is this accurate?

I thought that FSBS was checked before the meal...the insulin could come any time (W/IN 30 MINUTES) of the meal...before or after.

please clarify....tell me which is right

and what are surveyors expecting me to do?

thanks

[JoanKayRNBSN]

Is the insulin given based on the amount of carbs eaten per meal? The hospitals where our students go has started to switch to this type of dosing. Add to this room service and host/hostesses who do not understand carb counting - and you have a perfect storm of inaccurate insulin dosing. When it works, it works well, but there are many stumbling blocks to make it even more difficult to explain to students.

[finchfamily4]

i'm a diabetic who carb counts & shoots - fast acting insulin.

so think of it this way: your pt has a pre meal glucose of 115. she's provided 50 carbs to eat. if you dose her before she eats she could bottom out if she doesn't eat.

the "old" way: my pt has a bs of 115 no insulin to be given. she eats 50 carbs. her sugar skyrockets to 300 and doesn't get tested again until before her next meal. very harmful to the organs. most hospitals are moving to the new standards of practice - not fast enough imo.

[conscientiousnurse]

I don't know what the state surveyors would say about this subject. But this is the way we did it when I worked in a school.: We gave the insulin based on the carb counts, but sometimes we could give it before the meal. If the student was very dependable on eating their whole meal, and we knew for sure how many carbs they would be getting (i.e., the student had brought their own lunch, or the kitchen was always dependable in having the meal on stock that was put in the menu). If it wasn't very dependable, the student would come to us with their tray and would get insulin after the meal. Hope this helps.