insulin regime

Gelofusin is weird - we always use N/Saline as the dilutent. If you find out what the rationale is I'd love to hear it

Was the patient hypotensive?

Even if they were, infusing Gelo at a rate of

the patient is not hypotensive, admit for adjusting insulin dose as poor DM control. When infusing Actrapid+Gelo, we ve to take Q2H h'stix to see the blood glucose level so as to adjust the dose of insulin of the Basal-bolus regime

but i just dont know why add to Gelo ?

I have never heard of either of these, p[lease explain.

Suni: when a patient is acutely unwell and has unstable blood sugar control (in ICU this covers a lot of patients, on the ward it's usually restricted to T1DM's or really unstable T2's), the patient is commenced on a short-acting (Actrapid, Novorapid) insulin infusion. The infusion rate is titrated to the BSL, which is monitored frequently (1/24 at my hospital, 2/24 at coffeekat's), to maintain tighter glycemic control.

Usually the insulin is diluted to 1 unit/ml in N/Saline. For some reason this infusion was made up in Gelofusine instead of N/S and coffeekat was wondering what the rationale was. So far the consensus is that none of us have any idea.

Incidentally, always make up the infusion in a syringe, not a flask, and use minimum volume tubing as the plastic absorbs insulin, reducing its effectiveness. I've received patients with Actrapid running at 16 units/hr via a flask, with BSL's rising, and switched to a syringe - an hour or two later, at 5 units/hr, the BSL's trending down to normal

Dear all,

I have asked some RNs about why added to Gelofusine, and they said that its because the insulin is being absored in the plastics tubing of IVset tubings as what talaxandra said. So Gelofusine is act like vehicle solution to enchance the effect of the insulin .

and i hve found a article which is similar to this situation . http://ndt.oxfordjournals.org/cgi/content/full/18/8/1677

I think I'd still rather use a syringe, though!

I know this is a little off subject, but have ya'll ever seen a pt with a glucose reading of 2500? another student in post reports said that her pt was in our facility from a 3 week coma due to hyperglycemia, could this reading be correct?

It's possible, but way high. The highest reading I've had on a patient of mine was 120.8mmol/L (2174.4mg/DL) - she had started to trend high and treated her thirst with flavoured milk and fruit juice, which is how her BSL could be so high without killing her: a chunk of that sugar was exogenous. The story on your patient would be fascinating.

It was not my pt so I don't know all the particulars, but I remeber the other student saying that the pt told her that all she remebered was falling down at home and waking up in the hospital a few weeks later! Thanks for the reply though.