Do you cover a high glucose AFTER a meal?

[holdensjane1]

If a patient is ACCUCHECK TID with sliding scale and has been coming up 150s with minimal coverage for breakfast and lunch, but is 350 at dinner and you find out he already ate an hour ago but didn't call for coverage. What do you do? I don't want to cover a false high because he already ate, but its been an hour already. But I don't want to not cover him if he needs it.

What would you do in this case?

[enuf_already]

If a patient is ACCUCHECK TID with sliding scale and has been coming up 150s with minimal coverage for breakfast and lunch, but is 350 at dinner and you find out he already ate an hour ago but didn't call for coverage. What do you do? I don't want to cover a false high because he already ate, but its been an hour already. But I don't want to not cover him if he needs it.

What would you do in this case?

Call the physician for guidelines informing him of the facts (patient ate an hour ago). I would make him aware of the patient's blood sugar trends and insulin coverage for the past several days.

I would not cover with the sliding scale orders based on the current blood sugar because your sliding scale orders are for blood sugars collected before meals.

[MrChicagoRN, RN]

More information is needed.

Is that the only medication given to control diabetes? What is the pts typical before dinner reading.

you need to contact the doctor, tell him/her the situation, recent values, and list all relevant meds and doses.

the doctor may prescribe a smaller one time coverage dose.