Why Is Regular Insulin Used For Sliding Scale?

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I understand the concept of the sliding scale for insulin. What I need to know is why regular insulin is used for the sliding scale? What are the benefits of using regular insulin as opposed to NPH?

Maybe its that my brain is tired from the finals, but for some reason I cant grasp this, and I cant seem to find an answer anywhere. :uhoh3: I know you will all know... :)

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It all boils down to the onset and peak time of the insulins. If you gave NPH or Lente the peak time (for hypoglycemic reactions) would not be until like 6-10 hours, posing a complication if they refused their afternoon meal for example. Just know your onset peaks and durations. Remember Reg. is the only insulin that you can give IV, IM, and via insulin pump for the same basic concept as I stated.

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Specializes in CCU, MICU, Tele, L&D.

Bolus Insulins (short onset and effect, Meal-time Insulin)

Traditional Insulins

Regular Insulin (Novolin R, Humulin R)

Onset: 30 to 60 minutes

Peak: 2.5 to 5 hours

Duration: 6 to 8 hours

Analogue Insulins (more consistent absorption)

Lispro (Humalog)

Onset: 10 to 15 minutes

Peak: 30 to 60 minutes

Duration: 2 to 4 hours

Aspart (Novolog)

Onset: 5 to 10 minutes

Peak: 1 to 3 hours

Duration: 3 to 5 hours

Regular Insulin Sliding Scale Standard Orders

Recommended indications:

As a supplement to a patient's usual diabetes medications to treat uncontrolled high blood sugars.

For short-term use (24-48 hours) in a patient admitted with an unknown insulin requirement.

Basal Insulins: (daily dose with long effect)

Traditional Insulins

NPH Insulin, Novolin R, Humulin R or Lente

Onset: 2-4 hours

Peak: 4-10 hours

Duration: 10 to 16 hours (Lente slightly longer)

Ultralente Insulin (extended insulin zinc suspension)

Onset: 6-10 hours

Peak: No peak

Duration: 18 to 24 hours

Regular is often thought of as "meal" Regular or "high blood sugar" Regular

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I disagree with some of that post, being a nurse and a diabetic, I have some experience with this. Nph wouldn't be used with a sliding scale because the purpose of a sliding scale is to treat a blood sugar right now, not in twelve hours when the NPH would kick in. NPH is long acting, used to keep your blood sugar at an even keel irregardless of the other factors, ie. food, exercise, etc. Also insulin pumps use Novolog, or Humalog because when you are on an insulin pump you are almost totally sliding scale.

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I disagree with some of that post, being a nurse and a diabetic, I have some experience with this. Nph wouldn't be used with a sliding scale because the purpose of a sliding scale is to treat a blood sugar right now, not in twelve hours when the NPH would kick in. NPH is long acting, used to keep your blood sugar at an even keel irregardless of the other factors, ie. food, exercise, etc. Also insulin pumps use Novolog, or Humalog because when you are on an insulin pump you are almost totally sliding scale.

I couldn't agree with you more. I use regular insulin when I am on steriods. I'm sure you are aware of their impact on our blood sugar. The primary reason for the use of regular insulin is to control the blood glucose level immeidately.

Grannynurse :balloons:

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Haley you got some info and a great answer from Kittie. As a student 2 months from graduation insulins are something you must commit to memory. My instructors have drilled this into my head daily!! good luck

Kris

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