novolog 70/30 as coverage?

nelcoy4 · Jul 26, 2008

I never gave this as a coverage

november17, ASN, RN · Jul 26, 2008

If the patient is insulin dependent and uses 70/30 at home as coverage, then yes I do give it as coverage. Generally we give regular if they are diet or orally controlled.

Xbox Live Addict · Jul 26, 2008

When I was in school, I had thought that only regular insulin was given per sliding scale. I have seen a number of extremely insulin-resistant patients given Humalog/Novolog (very quick-acting insulin) per SS.

70/30 is a mix of either 70% regular, 30% NPH (intermediate acting cloudy insulin), or the other way around. Can't remember, I haven't dealt with insulin in about a year and a half. and I have never heard of that being given per SS. Typically, that was given BID.

NursKris82 · Jul 26, 2008

We use Regular for converage, I do have one resident on Humalog and one with one of those pens, but we have never used 70/30 for sliding scale coverage, only for long lasting. We rarely use it though. Most of the residents use Lantus for this.

pagandeva2000, LPN · Jul 26, 2008

I never heard of it, either. I look forward to more responses...maybe some doctors would order it for coverage, but that is a new one on me!

wonderbee, BSN, RN · Jul 26, 2008

Yes, I've seen it given as coverage when nothing else seemed to work to control the numbers.

psalm51 · Jul 26, 2008

novolog is not regular insulin.

novolog (aspart) is rapid acting insulin - with an immediate onset.

novolog is the "other" coverage. it is appropriate for "peakers" -- that is, for those whose blood glucose level peaks (a sudden sharp rise) following meals.

most of us are use to covering with regular insulin for diabetics whose blood glucose level rises gradually to a sustained high level.

i've not given the 70/30 as coverage -- but i could see how some diabetics would benefit.

mpccrn, BSN, RN · Jul 26, 2008

never heard of that....we use novolog or regular insulins for our sliding scales. :no:

Sunflowerinsc, ADN, RN · Jul 26, 2008

do any of you ever give patients novolog 70/30 insulin for sliding scale coverage? i thought either novolog is a short acting insulin like regular insulin. i thought only regular insulins are used for sliding scale coverage and the mixtures like 70/30 are given scheduled.

novolog 70/30 is a mix of slow (nph 70%) and 30% faster acting (30% regular.) we don't use much mixed insulin anymore or regular. regular is fast acting compared to nph but still takes 30 or more min to work and should be given that long before a meal. lantus is a 24 hr lasting insulin (altho some for people it doesn't last that long) humalog is a rapid onset insulin that starts working 15 min and should in most cases not be given until you see the food in front of the pt. we don't do much sliding scale anymore. base the before meal humalog on how many carbs pt is going to eat. and adjust the lantus as needed.

and let the ones with a insulin pump adjust as they need to.

suzanne4, RN · Jul 26, 2008

In all of my years as being an RN, which are too many too count; have never once used 70/30 for coverage. If they are requiring something like that, it means that they need to have their dosing adjusted as a start and perhaps a different regimen.

Coverage is supposed to be short-acting. Longer coverage insulin should not be used as coverage. It just may need to be ordered like two times per day, but not before each meal and at bedtime.

Have never seen an endocrinologist order like this either for the combination for coverage either.

And if you think of what the coverage is supposed to be doing, the NPH part of it would not have even kicked in by that time.

Either regular insulin or one of the faster acting ones such as novolog is all that I ever see ordered and all that you even see on pre-printed coverage sheets as well.

If someone is ordering the mixture, would most definitely ask them why, and also surprised that the pharmacist would not contact them over this as well.