By vgreene, 20 February, 2018 Treat hyperglycemia (T1DM, T2DM, etc) w/ SC insulin. Distribute estimated total daily dose:5 50% long-acting basal (once daily) + 50% rapid-acting6 nutritional (divide equally pre-meal/bolus feed)
By vgreene, 20 February, 2018 D/C noninsulin antihyperglycemic agents, though certain T2DM pts4 may continue oral agents + only correctional insulin
By vgreene, 20 February, 2018 If admit BG >140 mg/dL, or if starting steroids3/TPN: Continue testing ≥24h-48h
By vgreene, 20 February, 2018 If BG is ≤99: Adjust insulin drip based on current BG (mg/dL), comparing average hourly rate of change10 since last BG as follows:
By vgreene, 20 February, 2018 If 75-99: Recheck BG q15min until ≥90; then recheck q1h; once ≥140 wait 30min, then restart insulin drip @75% of most recent rate
By vgreene, 20 February, 2018 If 50-74: Give ½ amp (12.5 g) D50 IV; recheck BG q15min until ≥90; then recheck q1h; once ≥140 wait 30min, then restart insulin drip @50% of most recent rate
By vgreene, 20 February, 2018 Adjust insulin drip based on current BG (mg/dL), comparing average hourly rate of change5 since last BG:
By vgreene, 20 February, 2018 <b>100-119.</b> Average the BG change per hour.5 If BG lower by >20/h, d/c insulin infusion, ✓BG in 15 min to ensure ≥90; then recheck q1h; once BG ≥140 wait 30 min, then restart insulin drip at 75% of most recent rate
