When do you hold insulin if no parameters?

Is the novolog scaled/dosed to the amount of carbs he's eating? If it is, the easy answer is to hold it if he's not eating. Is he on a steady-state/once a day insulin as well? It still might be a good idea to give the on-call a heads' up and get any one time orders you need. It's better to call "early" at a decent hour than have to wake somebody up with a problem that you saw coming in the beginning of the shift.

yes its scheduled, 3 times a day 5 units. He's eating now and got a big meal, so I rechecked and its still 110. I gave the insulin because he was going to eat.

Was that the wrong thing to do?

With novolog when should it be held?

Novolog is a fast acting insulin. It should typically be given within 15 minutes of eating because it onsets in 15 minutes.

Is this patient a type 1 or type 2 diabetic? If type 1 that doesn't sound like a great management plan.

If a type 1 diabetic has a blood sugar of 110 mg/dL and is about to eat, in my world he'd get insulin to cover the carbs he's going to eat but (most likely) nothing to correct his blood sugar. My diabetic 5 year old patient has a target blood glucose of 150 mg/dL and a correction factor of 100 so he doesn't get any correction until his blood sugar is 200 mg/dL (0.5 units then).

He's type 2, just wondering if I was right to give it because of it being 110. normal is 75-110 right?

Sorry if i'm not making sense.

I plan on rechecking tonight, to see how's he doing. He gets 22 units of levermir.

I also just rechecked his insulin it's 113.

He has levemir for 22 units in another hour.

Giving humalog/novalog to cover carbs when starting with an initial patient glucose of 110 is fine...

Jedrnurse when would you held this? He's now at 113 and has 22 unit of levemir scheduled. He's kinda worried but he's having no ssx.

Levemir is long acting insulin. What would the reason to hold it be? The Novolog he got at 5pm is worn off by now.

Finally, I would just like to share my concern that you are at work and depending on this forum to make clinical decisions. That is not appropriate in my opinion. If you are not working in an environment with appropriate supports for you and your level of experience, perhaps you should begin to look elsewhere. And you should never hesitate to call the on-call physician to clarify orders over the cost of the consult.

Definitely not holding Levemir. But trust and believe I've talked to them about the no support during my shift. Something is supposed to be done about it. But has yet to. I can make decisions but don't trust my decisions if that makes sense.

If he has the capacity to make his own decisions and does not want insulin, then it's moot.

Also, the other example, when you called the doc and he wanted to hold the insulin? The doctor is ordering the insulin. If he gives you an order to hold insulin and there is no reason for you to question said order, forget your darn charge nurse.

I gave him that choice, I told him he had to be eating taking the insulin that's when he told me he didn't want to because he wasn't going to eat at the moment hen he came right back less than 10 mins.

What I was trying to elaborate on is if BS ranges from