Published
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.
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
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 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:
HaleySVN06
6 Posts
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.
I know you will all know... :)