Important safety information for lantus insulin glargine injection 100 unitsml contraindications lantus is contraindicated during episodes of hypoglycemia and in patients hypersensitive to insulin glargine or one of its excipients. When you understand how insulin therapy works in your body, you can more easily control your blood sugar. I often wonder how much of an adjustment two units of lantus is. Do not mix or dilute lantus with any other insulin or solution. Do not use sliding scale insulin for longterm diabetes management for individuals residing in. I found n to be too unpredictable so i was glad to switch to lantus when it came out.
Do not administer intravenously or via an insulin pump. Apr 05, 2020 lantus insulin glargine, a longacting insulin is used for treating type 1 q. How the sliding scale works the sliding scale is actually a chart of insulin dosages. Most doctors advise against the sliding scale approach. The lantus solostar prefilled pen dials in 1unit increments. Lantus compared with sliding scale insulin in patients who had bariatric surgery. Stepwise dosing and titration of insulin for type 2. Learn sliding scale insulin with free interactive flashcards. Lantus should be administered once a day at the same time every day. Based on weight or total daily insulin requirement ahrq 2012 sliding scale refers to a set amount of insulin administered for hyperglycemia without regard to the timing of food, presence or absence of preexisting. Ive been taking lantus at bedtime for about a month and i never seem to get any type of consistent morning blood sugar reading with the same dose. On day 4, patients were randomized to receive 80% of the previous days total insulin as either basal insulin glargine or insulin added to pn for a further 4 days. Lantusinsulin glargine injection rdna origin is a recombinant.
You cant hold lantus unless there are parameters there usually arent, because it shouldnt be held. Cat is currently on lantus will be home friday from shelter will do detox and then need a dosing scale using human glucometer. It will not work as intended, and you may lose blood sugar control. You need to talk with your doctor or see a specialist who deals with diabetes. Dosing lantus insulin glargine injection 100 unitsml. Its not sliding scale, you dont have permission to just withhold it without speaking to the md otherwise youre practicing medicine without. Dosing depends on the patients level of insulin resistance. Adult sliding scale for insulin aspart novolog page 1 of 1. Administer 12 units subcut, notify provider, and repeat poc blood sugar check in 1 hour.
Johnston, md u ncontrolled hyperglycemia in hospitalized patients with or without a previous diagnosis of diabetes is associated with adverse outcomes and longer lengths of stay. Highlights of prescribing information hyperglycemia or. The leeds assessment of neuropathic symptoms and signs lanss pain scale is based on analysis of sensory description and bedside examination of. Confirm any single dose of intermediatelong acting insulin over 50 units and any dose over 25 units of short acting insulin and document. Our solutions are written by chegg experts so you can be assured of the highest quality. In fact, the american diabetes association have pushed for this treatment method to no longer be used. Optimizing glucose management in hospitalized patients.
Started in 1995, this collection now contains 6767 interlinked topic pages divided into a tree of 31 specialty books and 732 chapters. Insulin pens are supplied in boxes of 5 pens each containing 3 ml at 100 units insulin per ml. Hello all, do any of you use a sliding scale for lantus dosing at bedtime. Over the last 20 years of intensive clinical research, we witnessed a remarkable move away from the old approach of using insulin per sliding scale due to its poor glycemic efficacy and potential harms in the management of inpatient diabetes. Dec 18, 2014 ive known for a while that my body is sensitive to insulin, but lately its been a little more sensitive than usual.
Stepwise dosing and titration of insulin for type 2 diabetes. Nursing mnemonics cheatsheet part ii nursing study guide. Humalog insulin sliding scale answers on healthtap. I thought that they still do because its their basal insulin or they get a reduced dosage. Find out how it works and learn about problems with this diabetes. Some patients may be able to self administer insulin as an inpatient. Veterinary practice guidelines 2018 aaha diabetes management guidelines for dogs and cats ellen behrend, vmd, phd, dacvim, amy holford, vmd, dacvimy, patty lathan, vmd, dacvim, renee rucinsky, dvm, dabvpy, rhonda schulman, dvm, dacvim abstract diabetes mellitus dm is a common disease en countered in canine and feline medicine. Doctors give trusted answers on uses, effects, sideeffects, and cautions. Lantus basalpr egimen indications and usage for lantus lantus is a longacting insulin analog indicated to improve glycemic control in adults and children 6 years and older with type 1 diabetes mellitus and in adults with type 2 diabetes mellitus. Humalog sliding scale insulin coverage blood sugar result humalog insulin coverage subq 60 124 no coverage 125 150 2 units of humalog insulin subq 151 200 4 units of humalog insulin subq 201 250 6 units of humalog insulin subq 251 300 8 units of humalog insulin subq 301 350 10 units of humalog insulin subq.
With the help of this nursing mnemonics you will memorize 30 most important topics related to nclex study. Lantus insulin glargine rdna origin injection, 100 uml fda. Sliding scale for insulin lantus blood sugar that is not well controlled in a pregnant woman with type 1 or type 2 diabetes could lead to problems for the woman and the baby. May 01, 2010 glycemic control in hospitalized patients who are not in intensive care remains unsatisfactory. Despite persistent expert recommendations urging its abandonment, the use of sliding scale insulin. Increase long acting basal insulin dose by 24 units at bedtime. The recommended starting dose of lantus in patients with type 2 diabetes who are not currently treated with insulin is 0.
With type 2 diabetes, the more common type, your body does not make or use insulin well. Administer 12 units subcut, notify provider, and repeat. A practical and evidencebased approach to management of. Sliding scale insulin involves checking the blood sugar and dosing the insulin typically rapid or shortacting based on the blood sugar value. Is humalog maybe not the right choice if i need such high dosing. Ask me anything information for nursing students and. Sliding scale regimens may include a bedtime high blood sugar correction. If i do use a sliding scale, i want them to have a low threshold to call me. Insulin therapy in the outpatient setting american college of.
Umc health system patient label here sliding scale insulin regular plan physician orders place an x in the orders column to designate orders of choice and an x in the specific order detail boxes where applicable. Lantus sliding scale pdf in sliding scale insulin therapy, the dose is based on your blood sugar level. If changing patients from twicedaily nph insulin to oncedaily lantus, the recommended initial lantus dosage is 80% of the total nph dose that is being discontinued. Use glargine usually once daily in am or at bedtime, nph at bedtime or am and. Lantus is best given with consistent dosing at 12 hour intervals. One may need to adjust the amount and timing of short or rapidacting insulins and dosages of any oral antidiabetic drugs. That being said, i tend to manage the glucose of my patients relatively tight. Insulintherapie bei typ2diabetes unter stationaren bedingungen. Administer 14 units subcut, notify provider, and repeat poc blood sugar check in 30 minutes. Should insulin be withheld when nothing by mouth is.
Patients with chf or esrd require individualized management. Lantus glargine or levemir detemir or nph insulin a1c greater than 8% on 2 or 3. When you have type 2 diabetes, and diet, exercise and other medications cannot control the blood sugar, or if you cannot use the medicines, it will be necessary to take insulin. Continue to repeat 10 units subcut and poc blood sugar checks every 30 minutes until blood glucose is less than 300 mgdl, then resume normal poc blood sugar check and insulin aspart sliding scale. Tillys diabetes homepage diabetes in cats lantus protocol. Definition medlineplus diabetes means your blood glucose, or blood sugar, levels are too high. Lantus and levemir should be given at the same time of day irrespective of meals. Optimizing glucose management in hospitalized patients using a.
Insulin drug chart for nursing printable sliding scale. I just wondered if a patient is npo, do they still receive their lantus insulin when they are on a sliding scale or just the sliding scale. If the piston is below the white line, replace the insulin cartridge with a new one, see pages 2021. I took units of lantus yesterday and my blood glucose was 86 mgdl before lunch. Addition of insulin to parenteral nutrition for control of. Product monograph lantus insulin glargine injection. Jul 04, 2019 lantus sliding scale pdf in slidingscale insulin therapy, the dose is based on your blood sugar level.
The example sliding scales are for regular insulin with blood glucose bg measured in mgdl. Insulin pens appear similar to one another despite containing different insulins basal or bolus read each syringe carefully and note its color prior to each injection to prevent overdose errors. If changing patients from oncedaily nph insulin to oncedaily lantus, the recommended initial lantus dose is the same as the dose of nph that is being discontinued. As the nighttime scale only considers the amount of insulin required to drop your blood sugar level back into the target range, it should not be used to cover a bedtime snack. Before you get started lantus insulin glargine injection. Use your hospitals preprinted order form or protocol in emr and. Determine the distribution of the tdd calculated above based on nutrition regimen. Lantus sliding scale pdf in sliding scale insulin therapy, the. Lantus insulin glargine, a longacting insulin is used for treating type 1 q. Inpatient hyperglycemia management of the nonpregnant adult consider a diabetes endocrine or medicine consult. Eliminate traditional monotherapy sliding scale dosing. I already know sliding scale wont last long with me. Each manufacturer has a program for free insulin for qualified individuals through a patient assistance program pap.
Attach a new needle 1 take a new needle, and tear off the paper tab. Type 2 diabetes adult outpatient insulin guidelines diabetes coalition of california. All patients received subcutaneous insulin by a correction sliding scale based on glucose readings. We follow either tight regulation tr or start low go slow slgs the details of each can be found in the posts at the top of this forum. Refrigerate unused unopened lantus vials and solostar prefilled pens.
Needymeds has free information on medication and healthcare costs savings programs including prescription assistance programs and medical and dental clinics. Can lantus be used as a sliding scale with my current insulin of. Umc health system patient label here sliding scale insulin. Get the recommended starting dose or use the dosing calculator for. Inpatient management of hyperglycemia and diabetes vasudev magaji, md, ms, and jann m. Teamingup for diabetes can help you move toward your overall diabetes management goals by providing you with tools and resources that can help you take charge. Jun 17, 2019 erasmus gbs outcome scale pdf june 17, 2019 guillainbarre syndrome gbs is an acute polyneuropathy with a variable degree of another prognostic model erasmus gbs outcome scale has been. Insulin sliding scale dose blood sugar low dose moderate dose high dose 60 110 no insulin no insulin no insulin 111 150 2 units 4 units 6 units 151 200 4 units 8 units 10 units 201 250 6 units 10 units 12 units 251 300 8 units 12 units 15 units 301 350 10 units 14 units 18 units. As a relatively new medication, there is limited experience in overdoses of lantus. Insulin dose calculation sliding scale diabetestalk. Lantus can be discontinued one to two days before surgery, and glucose levels can be stabilized with a regimen of intermediate insulin e. Download chart pdf first there are two kinds of diabetes both presenting with frequent type 1 diabetes.
Jan 31, 2020 lantus sliding scale pdf in slidingscale insulin therapy, the dose is based on your blood sugar level. Johns hopkins hospital glucose management committee. Find out how it works and learn about problems with this. Please see additional important safety information for lantus on the last page. Sliding scale for insulin lantus diabetes control view. Learn about the options for how to start appropriate t1dm and t2dm patients on lantus. Arbitrary sliding scale insulin should be avoided as it is not only ineffective but also potentially dangerous. Ive known for a while that my body is sensitive to insulin, but lately its been a little more sensitive than usual. Glycemic control in hospitalized patients not in intensive. Full text update on insulin treatment for dogs and cats. Stepwise dosing and titration of insulin for type 2 diabetes in the. Dec 26, 2017 the sliding scale is one way of working out how much insulin to take before each meal. Aug 29, 2019 the leeds assessment of neuropathic symptoms and signs lanss pain scale is an assessment tool used by the medical community to analyze and classify. Follow hypoglycemia treatment orders on page 3 and contact physician.
Use lantus solostar prefilled pen with caution in patients with visual impairment who may rely on audible clicks to dial their dose. Insulin is a hormone that helps glucose get into your cells to give them energy. I frequently use long acting insulins, usually lantus, for their basal insulin requirements, and then either a supplemental if i know theyre going to eat well or a sliding scale. Chapter 21 adjusting the insulin dosage and thinking scales hours, the evening nph or lantus given at it is important to emphasize that sliding. Find patient medical information for lantus u100 insulin subcutaneous on webmd including its uses, side effects and safety, interactions, pictures, warnings and user ratings. Should be customized to match insulin sensitivity for each patient. Access winninghams critical thinking cases in nursing 5th edition chapter 7.
Upon verification, the content of labeling in structured product labeling spl format for the package insert submitted march 14, 2007. It only shows approximately how much insulin is left in your pen. When using a sliding scale, eat the same amount of carbohydrate at each meal. Mar 31, 2018 the sliding scale is one way of working out how much insulin to take before each meal. Continue to repeat 10 units subcut and poc blood sugar checks every 1 hour until blood glucose is less than 300 mgdl, then resume normal poc blood sugar check and insulin regular sliding scale. They recruited a total of 67 pn episodes in 61 patients.
Sliding scale insulin refers to a treatment regimen that provides no basal insulin and provides only short. Choose from 45 different sets of sliding scale insulin flashcards on quizlet. In addition to the increasing prevalence of diabetes in the united states. The endo says i will probably need lantus daily, but i think it will take some time to figure out dosage given the rollercoaster my body is on, and hard to see how it could be a 7day consistent one. We present a case of a 37yearold male insulindependent diabetic presenting with refractory hypoglycemia secondary to an intentional overdose of lantus insulin to illustrate the varied management concerns in overdoses of longacting insulins. Inpatient diabetes management endotext ncbi bookshelf. Do not use the insulin scale on the cartridge holder to measure your dose. Help need dosing sliding scale for,lantus feline diabetes. Ask me anything information for nursing students and new nurses from the former dean of a nursing program in texas with years of nursing experience. Do not discontinue iv insulin during the acute or maintenance phase. Stepwise dosing and titration of insulin for type 2 diabetes in the ambulatory setting update 52010. Initiation of insulin glargine therapy in type 2 diabetes subjects suboptimally controlled on oral antidiabetic.
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