What is the largest dose of insulin you have given a patient?

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Specializes in neuro/med surg, acute rehab.

Today I had a 60 yr old female patient with hx of DM who was taking large amounts of prednisone. I guess her BG levels had been running thru the roof. Imagine my surprise to look at the MAR and see 100 units of Lantus BID, standing order for 45 units of Novolog before each meal AND a really high SS (BG - 140 / 5). I ended up giving her (after double and triple checking the order, looking back at all of her other insulin doses, talking to my charge nurse AND PRAYING a bit lol) the 100 units of Lantus and a total of 59 units of log.

I was soooo worried all morning. . .checking on her. . .watching her for signs of hypoglycemia. . .

Then at lunchtime I checked her sugar with trepidation. . .and it was 197. Wow. And she complied with her 60 grams of carbs diet.

But that is nothing. . .the day before her BG was 387 and she was given a total of 90 units of Novolog (according to the MAR)!!!

How about you?

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Specializes in NICU, ICU, PICU, Academia.

As a PICU nurse and grandmother of a pre-teen with diabetes- all I can say is HOLY CANOLI THAT'S A LOT OF INSULIN!!!!!!

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Kinda sounds like my mom's regimen, though, she will drop to the fifty's when she decides to go no carb at lunch.

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I gave 100 units about a month ago. Me and another nurse checked the order 3x and even called the doctor just to verify. And it only brought her levels down to about 160. We were watching her like a hawk as that is just such a massive amount!

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Specializes in Critical care.

Oh, probably 130-ish units IV............per hour...........for my whole shift. Pt was a wee bit insulin resistant and the protocol was aggressive.

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Specializes in Geriatrics, Home Health.

One of my assisted living residents, a longtime diabetic, got 55 units of insulin in the morning and 65 units at bedtime.

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30 units of Novolog scheduled 30 min before meals. I called to clarify but still held the am dose since pt refused breakfast.

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Try having a insulin-resistant Type II on a sliding scale receiving ridiculous amounts of PO steroids as part as an oncology regimen.

By the end of that shift, I remember thinking that if I ever saw another insulin vial, it'd be too soon...

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