How to Use Sliding Scale Insulin

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How To Use Sliding Scale Insulin
How To Use Sliding Scale Insulin

Diabetics using insulin frequently hear doctors using the term sliding scale insulin. What is sliding scale insulin and how does it work? Diabetics use insulin to better regulate and control their blood sugar levels. We know that when a diabetic's blood sugars are well controlled the likelihood of medical complications or physical symptoms is much lower than when blood sugars are too high. Conversely, if too much insulin is given blood sugars can drop dangerously low and cause serious side effects. The solution is to start with small amounts of daily insulin and gradually increase the dose based on the use of sliding scale insulin. The cliche "start low and go slow" is an appropriate description for sliding scale insulin.

Check blood sugars at set times every day. Usually one hour after breakfast, lunch and dinner are good times. These sugars are known as postprandial blood sugars and generally are a diabetic's highest daily readings.

Work with your doctor to develop a sliding scale insulin plan. This means injecting yourself with a variable amount of either short acting or ultra-short acting insulin each time you check your postprandial blood sugar.

Give yourself 2 units of insulin for blood sugars between 150 and 200 mg. Give yourself 4 units of insulin for blood sugars between 201 and 250 mg. Give yourself 6 units of insulin for blood sugars between 251 and 300 mg. This incremental increase in insulin dose can go as high as you and your doctor choose. Sliding scale insulin programs were developed to provide diabetics with flexibility. The insulin dose, blood sugar parameters and type of short acting insulin used can all be modified for each individual's needs.

Write down how much additional sliding scale insulin you're requiring on a daily basis. Try to be consistent with your meals, exercise program and daily activity. Look for patterns with your blood sugar levels.

Stick with the diabetic diet that your doctor and nutritionist helped create for you. Weight loss is the most important lifestyle factor for successfully lowering blood sugar levels.

Bring your sliding scale insulin data to your next doctor appointment. The amount of sliding scale insulin you're taking on a daily basis will be averaged over several weeks. Let's hypothetically say on average you're give yourself 2 units of insulin at breakfast, 3 units at lunch, and 5 units at dinner for a daily total of 10 units.

The daily total of sliding scale insulin is generally added to your current dose of long acting or extended release insulin which is typically given just once a day. As this process continues your once a day extended release insulin dose gradually, but safely, increases and your sliding scale insulin doses throughout the day decline reflecting your improving blood sugar levels.

Tips & Warnings

  • Most diabetic who require insulin use a combination of long acting extended release insulin and ultra-short acting insulin. This best mimics the body's natural release of insulin.

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