I would like to know when would be the appropriate time to give sliding scale insulin. One nurse at work checks this gentlemans blood sugar at 0800 and gives him insulin according to his reading at that time and a glass of milk to hold him over until he gets up at approx. 1030 or 1100 when he gets a snack just before lunch. I on the other hand wait until this gentleman gets up between 0900 and 0930, take his sugars, give him insulin according to his reading at that time and then follow up with breakfast. Which way is right and what are the ramifications? This gentleman has a BID order for sliding scale insulin as well as a standing order for Humulin N 10u BID.

Thanks for your reply

The right way is the way that keeps his blood sugars the most stable. There is no actual "rule book" for diabetes. You do what works and that is different for each individual. If your way yields better blood sugar results, then this should be discusses with his medical team and it should become the standard. If the other way results in more consistant and normal glucose readings, then that method should be adopted.

Sorry I couldn't give you a straight answer.

Cora

This is why I hate sliding scales- it assumes diet is the same each day.

"Officially" if you're a nurse (which is sounds like) the time for the shot should be within 1 hr of when it was ordered- but does the sliding scale account for food too, or just lowering the blood sugar?

A better way to handle it is to know how much insulin he needs for food and how much to lower the bg separately, so if he plans on eating right afterwards he can, otherwise he can just get the dose to lower the bg.

I doubt we'll see this happen any time soon, though, as diabetes care is health care settings is often antiqued at best.