Lantus part II, oh how I want to scream!

[evans_c1]

So I had a pt last night that had just had a very minor procedure and was npo. Had a FS at 1800 and it was 80....lantus due at 2200 and 50 units.. my charge nurse wanted me to hold the lantus. I gave it. Honestly, who holds lantus for a normal gluc reading?? that is absurd. At 0600 the pt was like 78...what is this charge nurse's deal?? I am a new nurse and it just ticked me off bc she was like "well we will call you at 5am when her sugar is 40 something". The mentality of the nurse...she did a FS one hour after I gave the lantus...I tried to tell her that onset isn't until like 2-3 hours and she still did a FS (110 at that). How can I get it through her head lantus is a basal insulin...NOT a BOLUS! The patient had not even had novolog insulin since like 7 or 8 hours before all of this. Is this something to communicate with my supervisor? I mean if we have nurses holding lantus bc they think it is going to "bottom them out" that is a real problem

[dorimar, BSN, RN]

Very good post indy!

[lsyorke, RN]

Now, if a non NPO patient has lantus, and for some reason ran low BG's all day long, I'm gonna have a talk with the patient. Are they eating a sensible diet in hospital, when at home they normally eat a lot more? Re-confirm their home doses of what insulins, and what oral diabetics. Ask if any of these meds are relatively new to them or if they have changed doses recently before hospitalization.

Exactly! It's not a simple as "never hold lantus". Talk to your patients!!! There are no hard and fast rules for any insulin. Hubby takes lantus twice a day.. that's not a normal scenario, but it's working well for him.