Would you give Lantus without BG check?

Sparrowhawk · May 22, 2011

I wouldn;t administer any insluing long or short w/o doing a BG check first...but most doctors don't want to hold Lantus anyway , so I can see why some don't check first.

RNGrammie · May 22, 2011

do some research on lantus. while you should check bg levels while on insulin, it really isn't necessary to check prior to giving lantus. yes i would give it without doing a bg check.

carolmaccas66, BSN, RN · May 22, 2011

No, never, and I would argue that point with anyone.

And BTW, I don't need an order to check BGLs/BSLs. I would do this off my own back as a RN, despite what anyone else thinks. I have to be responsible for my onw practice. You have to think like a professional nurse and do tasks/procedures as warranted. Plus it's legal and must be documented (in Oz I'm talking about).

jmqphd · May 22, 2011

Wouldn't you care as much or more about how well the patient is eating? If my diabetic patient is NPO or been throwing up for a half a day... that would concern me more than a spot check of the BG.

Don't jump on me. Not saying BG isn't important. Just that BG is not the end-all and be-all when you give Lantus.

Prettybrowngirl · May 22, 2011

Wouldn't you care as much or more about how well the patient is eating? If my diabetic patient is NPO or been throwing up for a half a day... that would concern me more than a spot check of the BG.
Don't jump on me. Not saying BG isn't important. Just that BG is not the end-all and be-all when you give Lantus.

I'm not going to jump on anyone because I did ask for opinions. I know what I would more than likely do. In response to your post, though, I was only told pt. "eats well." There wasn't good doc on what/how much. Also, when I checked H&P part of the problem previously had been really low BGs (which wasn't passed on in report). So it was a little more to it in this case.

NurseKatie08, MSN · May 22, 2011

Yes and no.

For me, it depends on the patient and how well I know their baseline. I work in sub-acute rehab, so I get to know my diabetics really well. I currently have one patient on Lantus QHS with Humalog sliding scale coverage before breakfast & dinner (scheduled fingersticks ordered at breakfast & dinner as well). She is a good eater & always takes her bedtime snack. As of late, I've not been checking her bedtime fingerstick & she's been doing just fine. However though, depending on her dinnertime fingerstick, I will recheck her at bedtime if I'm concerned that something might be off. She runs really well (of late has not been needing sliding scale coverage much) and has never bottomed out on us. Were it someone a bit more fragile, you bet your booty I'd be checking their BG whenever I saw fit. It's just a matter of nursing judgement--do what your gut tells you.

Caffeine_IV · May 22, 2011

In most cases yes I check BS before giving any type of insulin. There have been a few times (1 or 2 patients) when I've had a long termer type patient who is stable on their dose and I don't check. I always make sure they have a snack.

3dayRN · May 22, 2011

I was always taught never to hold Lantus and I know some doctors don't necessarily order glucose check but I always do a check. I'm probably just being overly cautious. So, I do not think a person that does not check one is wrong.

stoberto · May 22, 2011

I am a 3rd shift nurse in LTC and I have issues every now and then with Lantus being given w/o a snack or blood sugar checks that get changed to 1x/wk because they have been stable for a while...then I get stuck with the person being lethargic or worse unconscious on me because of being hypoglycemic. If it is reported to me that the person didn't have a snack or they do have BS check and I see it was fairly low, I always give a snack to stop it from happening, but if there's no BS check and I'm not told, there's nothing I can really do...it is very very frustrating.

So I guess what I'm saying is, I would prefer that everyone have a BS check and nurses were better about following up on bedtime snacks. I understand why you still give Lantus, but please please tell me or give them something to eat.

jmqphd · May 22, 2011

I'm not going to jump on anyone because I did ask for opinions. I know what I would more than likely do. In response to your post, though, I was only told pt. "eats well." There wasn't good doc on what/how much. Also, when I checked H&P part of the problem previously had been really low BGs (which wasn't passed on in report). So it was a little more to it in this case.

Exactly. Giving Lantus or any insulin requires more than just a number on a flow sheet.

hecallsmeDuchess · May 22, 2011

I've always thought that blood sugar needs to be checked before any type of insulin administration and that is how I practice. If my pt's blood sugar levels are low and they are supposed to get Lantus, I'll call the doc and let them know in case they want to reduce the dose. I have never ever given any type of insulin without checking the pt's current blood sugar.