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Discussion

Is this common?

Okay have a 64yom, with qid accuchecks.. s/s 151-199 1 unit novalog.. He also recieved 10units of lantus @ 9p.

Sent Res. out to hospital for altered mental status, came back yesterday with lantus DCd, replaced with metformin q/hs, his s/s is now 100-120 2 units on novalog, 121-150 4 units, and 151-170 6 units.... Is it common to give insulin when the range is 100-120? Most of my Res. start at 130 to 180.

If this is common, can someone please tell me the rational behind it. I can perhaps see, if it was only before meals, but at bedtime Im not sure I get it.

Thanks so much

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    At our facility SS starts at 200. Our medical director wants everyone on the same scale to help rule out insulin errors. However there are a few who have special orders.

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    i have a pt right now whose sliding scale starts at 70 (70-100, 2 units).

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    NP came back in on Friday and after much encouragement agreed to change his s/s back the the 150-199 1unit, started him back on his lantus, but kept the metformin and yes she left it @ hs..... So who knows, at times I fell like I just work there!!! But I am very happy that she finally agreed to go back to his origional s/s

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    NP came back in on Friday and after much encouragement agreed to change his s/s back the the 150-199 1unit, started him back on his lantus, but kept the metformin and yes she left it @ hs..... So who knows, at times I fell like I just work there!!! But I am very happy that she finally agreed to go back to his origional s/s

    i was more concerned about the metformin at HS than the sliding scale, look it up in your drug handbook, "with meals" i think is what it will say.....if he is not low in the am, perhaps the metformin is NOT DOING ANYTHING.

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    NP came back in on Friday and after much encouragement agreed to change his s/s back the the 150-199 1unit, started him back on his lantus, but kept the metformin and yes she left it @ hs..... So who knows, at times I fell like I just work there!!! But I am very happy that she finally agreed to go back to his origional s/s

    i was more concerned about the metformin at HS...what was her rationale for that?

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