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Humalog Dose Sliding Scale

Insulin (medication)

Insulin (medication)

"Insulin therapy" redirects here. For the psychiatric treatment, see Insulin shock therapy. Insulin is used as a medication to treat high blood sugar.[3] This includes in diabetes mellitus type 1, diabetes mellitus type 2, gestational diabetes, and complications of diabetes such as diabetic ketoacidosis and hyperosmolar hyperglycemic states.[3] It is also used along with glucose to treat high blood potassium levels.[4] Typically it is given by injection under the skin, but some forms may also be used by injection into a vein or muscle.[3] The common side effect is low blood sugar.[3] Other side effects may include pain or skin changes at the sites of injection, low blood potassium, and allergic reactions.[3] Use during pregnancy is relatively safe for the baby.[3] Insulin can be made from the pancreas of pigs or cows.[5] Human versions can be made either by modifying pig versions or recombinant technology.[5] It comes in three main types short–acting (such as regular insulin), intermediate–acting (such as NPH insulin), and longer-acting (such as insulin glargine).[5] Insulin was first used as a medication in Canada by Charles Best and Frederick Banting in 1922.[6] It is on the World Health Organization's List of Essential Medicines, the most effective and safe medicines needed in a health system.[7] The wholesale cost in the developing world is about US$2.39 to $10.61 per 1,000 iu of regular insulin and $2.23 to $10.35 per 1,000 iu of NPH insulin.[8][9] In the United Kingdom 1,000 iu of regular or NPH insulin costs the NHS 7.48 pounds, while this amount of insulin glargine costs 30.68 pounds.[5] Medical uses[edit] Giving insulin with an insulin pen. Insulin is used to treat a number of diseases including diabetes and its acute complications such as diabetic ketoacid Continue reading >>

Sliding Scale Insulin Therapy

Sliding Scale Insulin Therapy

Insulin is the foundation of treatment for many people with diabetes. If you’re a diabetic, your body either can’t produce enough insulin or can’t use insulin efficiently. People with type 1 diabetes, and some with type 2 diabetes, have to take several injections of insulin per day. The insulin keeps blood sugar in a normal range and prevents high blood sugar levels. This can help prevent complications. The amount of insulin you should take can be determined in several different ways: Fixed-Dose Insulin With this method, you take a certain set amount of insulin units at each meal. For example, you may take 6 units at breakfast and 8 at dinner. The numbers don’t change based on your blood sugar readings or the amount of food you eat. While this may be easier for people just starting insulin, it doesn’t account for pre-meal blood sugar levels. It also doesn’t factor in the varying amounts of carbohydrates in a given meal. Carbohydrate to Insulin Ratio In this method, you take a certain amount of insulin for a certain amount of carbohydrates. For example, if your breakfast carb to insulin ratio is 10:1 and you eat 30 grams of carbohydrates, you would take 3 units before breakfast to cover your meal. This method also includes a “correction factor” that accounts for your pre-meal blood sugar. For example, let’s say you want your blood sugar to be under 150 mg/dL before meals, but it’s at 170. If you’ve been told to take 1 unit of insulin for every 50 you’re over, you would take 1 additional unit of insulin before your meal. While this takes a lot of practice and knowledge, people who can manage this method can keep better control of their post-meal blood sugar levels. Sliding-Scale Insulin Therapy (SSI) In the sliding-scale method, the dose is based o Continue reading >>

Humalog Side Effects

Humalog Side Effects

Generic Name: insulin lispro (IN soo lin LISS pro) Brand Names: HumaLOG, HumaLOG Cartridge, HumaLOG KwikPen, HumaLOG KwikPen (Concentrated) What is Humalog? Humalog (insulin lispro) is a fast-acting insulin that starts to work about 15 minutes after injection, peaks in about 1 hour, and keeps working for 2 to 4 hours. Insulin is a hormone that works by lowering levels of glucose (sugar) in the blood. Humalog is used to improve blood sugar control in adults and children with diabetes mellitus. Humalog is used to treat type 2 diabetes in adults. Humalog is also used to treat type 1 diabetes in adults and children who are at least 3 years old. Important information Humalog is a fast-acting insulin that begins to work very quickly. If you use this medication with meal, use it within 15 minutes before or just after you eat. Never share an injection pen, cartridge, or syringe with another person, even if the needle has been changed. You should not use Humalog if you are having an episode of hypoglycemia (low blood sugar). Humalog is only part of a complete program of treatment that may also include diet, exercise, weight control, foot care, eye care, dental care, and testing your blood sugar. Follow your diet, medication, and exercise routines very closely. Changing any of these factors can affect your blood sugar levels. Before taking this medicine You should not use Humalog if you are allergic to insulin, or if you are having an episode of hypoglycemia (low blood sugar). Humalog should not be given to a child younger than 3 years old. Humalog should not be used to treat type 2 diabetes in a child of any age. To make sure Humalog is safe for you, tell your doctor if you have: liver or kidney disease; or low levels of potassium in your blood (hypokalemia). Tell your doctor if Continue reading >>

Insulin Dosing Made Simple

Insulin Dosing Made Simple

I have found, in my years of practicing correctional medicine, that few practitioners who come to corrections are comfortable with insulin dosing. In my experience, this is especially true for physician assistants and nurse practitioners, but many physicians have problems, too. Insulin dosing can be complicated and tricky at times, but for most patients, 10 simple rules will get you to where you need to be. We first need to cover some groundwork and some terms. Insulin terminology can be confusing. First, it is very important to remember that this discussion applies to type 1 diabetics only. Type 2 diabetics sometimes use insulin, but that’s a “whole ‘nother ballgame.” There are two types of insulin used for two very different purposes when treating type 1 diabetics. The first is basal insulin, which is used to replace the insulin that the normal pancreas releases constantly—whether we eat or not. Long-acting insulin is used to provide coverage for the basal metabolic needs of type 1 diabetics. Examples are insulin glargine (Lantus) and insulin detemir (Levemir). The most commonly used long-acting insulin is Lantus, so I am going to use that name in this article. (I have no financial ties to the maker of Lantus—I use that name because it is the name most commonly used by patients). The second type of insulin that type 1 diabetics need is short-acting insulin, which is given to cover the carbohydrates in the food they eat. Short-acting insulins are given just before a meal or snack and, ideally, the dose should vary depending on how many carbohydrates are in the food. Examples of short acting insulins are insulin regular, insulin aspart (Novolog) and insulin lispro (Humalog). Again, I will use the term Humalog in this article because it is the term most often Continue reading >>

Humalog Vs Novolog

Humalog Vs Novolog

Introduction: Diabetic patients take various forms of insulin on a regular basis. One of these forms is called rapid acting insulin. This type of insulin takes its effect within minutes. Currently, the two of the forms available on the market are Lispro (Humalog) and Aspart (NovoLog). These can be used for both Type I and Type II diabetic patients. Patients must always be aware of their need for proper diet and exercise for increased function in treatment. Also, appropriate meal times and promotions are extremely important when receiving regular insulin. Unlike oral medications, these insulins provide rapid relief of high glucose levels. They are usually prescribed on a sliding scale meaning the dosage depends on the current insulin levels. These sliding scales differ from patient to patient depending on weight, activity level, and age. Regular insulin usually lasts for 2-4 hours and reaches their peak after one hour. It is important to check glucose levels before and after administering this type of insulin. These levels, as well as the dosage, applied, should be kept in a record by the patient. (5) It is very important that the patient realizes that regular insulins will need to be used in combination with various other treatments including and not limited to Oral medication, diet, exercise, and long lasting insulin. (1-10) Difference between Humalog and Novolog Humalog (Lispro) Below is the image of a vial of Humalog insulin. Patients should pay close attention to the markings and read the insulin vial before administering to help prevent administration errors. a. Humalog was introduced in 1996 and has been proven safe for use when used correctly. It allows for mealtime injection and close regularization of glucose levels. This image shows the structure of Lispro (Hu Continue reading >>

Understanding The Sliding Scale In Diabetes Care

Understanding The Sliding Scale In Diabetes Care

One of the tools physicians use to help people who take insulin keep their blood glucose in control is a sliding scale. There are many reasons your health care provider may prescribe this type of insulin regimen for you but foremost it has to do with how much involvement you are able to have and want to have in figuring out your insulin needs. Some people want to spend as little time and effort as possible with their insulin and are willing to follow a structured, time-bound meal plan. For these folks a fixed dose (taking the same amount of insulin at each meal regardless of their blood glucose level or the type or amount of food they are eating) is a good choice. On the other end of the spectrum is matching insulin to carbohydrate. This requires a strong commitment to carb counting and following a mathematical algorithm at meals. The sliding scale falls smack in the middle. No math to do, meal timing isn’t as important but carbohydrate content at meals does need to be standardized. When people hear the term “sliding scale,” they might picture a balance scale with weights tumbling off one end. Now there is no physical object to slide; rather it is a chart that tells you how much insulin to give yourself at meals based on your blood glucose levels The chart is divided into a series of columns. The column farthest to the left lists blood glucose ranges starting from below 70mg/dl to 400mg/dl or more, increasing in increments of anywhere from 20 mg to 50 mg/dl. The other columns correspond to breakfast, lunch and dinner, and, if necessary, bedtime. The columns may have you take different amounts of insulin at different times of the day at the same blood glucose level. This may be because your sensitivity to insulin changes throughout the day or because your meals ten Continue reading >>

Glycemic Control With Regular Versus Lispro Insulin Sliding Scales In Hospitalized Type 2 Diabetics.

Glycemic Control With Regular Versus Lispro Insulin Sliding Scales In Hospitalized Type 2 Diabetics.

Abstract PURPOSE: The aim of this study was to compare glycemic control with either regular or lispro insulin sliding scales in hospitalized Type 2 diabetics who were not using insulin as outpatients. METHODS: Forty-three patients with Type 2 diabetes, who were taking oral agents only, were admitted to a medical inpatient service and randomized to receive either regular or lispro insulin sliding scale. Oral agents for diabetes were held upon admission and patients were followed throughout their hospital stay. RESULTS: There was no significant difference (P>.05) between the average finger-stick blood glucose (FSBG) in the regular insulin group (157.78+/-40.16 mg/dl) and the lispro insulin group (152.04+/-27.71 mg/dl). No significant difference was found between the daily dose of insulin (regular, 5.83+/-5.01 units; lispro, 4.27+/-3.40 units), total amount of insulin used during hospitalization (regular, 11.87+/-10.78 units; lispro, 12.77+/-14.39 units), glucose excursion (regular, 110.13+/-25.86 mg/dl; lispro, 106.77+/-52.65 mg/dl), or length of hospital stay (regular, 2.33+/-1.23 days; lispro, 2.69+/-1.59 days). CONCLUSION: No significant difference in glycemic control was found in hospitalized Type 2 diabetic patients who received either regular or lispro insulin sliding scales. Both insulin sliding scales used in this study are inadequate to achieve current recommended glycemic targets in this patient population, when used as the only inpatient treatment for diabetes. Continue reading >>

Sliding Scale Therapy

Sliding Scale Therapy

Sliding scale therapy approximates daily insulin requirements. The term "sliding scale" refers to the progressive increase in pre-meal or nighttime insulin doses. The term “sliding scale” refers to the progressive increase in the pre-meal or nighttime insulin dose, based on pre-defined blood glucose ranges. Sliding scale insulin regimens approximate daily insulin requirements. Common sliding scale regimens: Long-acting insulin (glargine/detemir or NPH), once or twice a day with short acting insulin (aspart, glulisine, lispro, Regular) before meals and at bedtime Long-acting insulin (glargine/detemir or NPH), given once a day Regular and NPH, given twice a day Pre-mixed, or short-acting insulin analogs or Regular and NPH, given twice a day The general principles of sliding scale therapy are: The amount of carbohydrate to be eaten at each meal is pre-set. The basal (background) insulin dose doesn’t change. You take the same long-acting insulin dose no matter what the blood glucose level. The bolus insulin is based on the blood sugar level before the meal or at bedtime Pre-mixed insulin doses are based on the blood sugar level before the meal The sliding scale method does not accommodate changes in insulin needs related to snacks or to stress and activity. You still need to count carbohydrates. Sliding scales are less effective in covering a pre-meal high blood sugar, because the high blood glucose correction and food bolus cannot be split. Points To Remember! Sliding scale regimens may include a bedtime high blood sugar correction. 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. When using a sliding scale, eat the same amount of carbohydrat Continue reading >>

Insulin Sliding Scale

Insulin Sliding Scale

Use this sliding scale as an example only Adjust per patient weight and activity or Disability Delays Insulin until Hyperglycemia appears Cover as units per Glucose 50 mg/dl over 150 mg/dl Renal Failure ( Insulin 50% renal excreted) V. Protocol 1: Based on Insulin sensitivity Estimate sensitivity using "rule of 1800" BG change per unit Insulin = 1800/total Insulin daily Example of 60 units/day: 1 unit drops BG 30 mg/dl Protocol (uses rapid acting Insulin , e.g. Lispro ) Using sensitivity, how many units to drop 50 mg/dl For example above, ~1 unit to drop BG 50 mg/dl BG 150-199: 1 unit Bolus Insulin (regular or RA) Based on per carbohydrate when Glucose >60 mg/dl Use for Type I Diabetes , consider for Type II Example: For 3 carbohydrate meal, add 3 units VI. Protocols: Sliding Scales (contact provider if maximum Glucose is exceeded) BG 150-199: 0.5 unit Bolus Insulin (regular or rapid-acting) Schnipper (2009) J Hosp Med 4(1): 16-27 [PubMed] Images: Related links to external sites (from Bing) These images are a random sampling from a Bing search on the term "Insulin Sliding Scale." Click on the image (or right click) to open the source website in a new browser window. Search Bing for all related images Related Studies (from Trip Database) Open in New Window Therapeutic or Preventive Procedure (T061) esquema de insulina con escala variable (rgimen/tratamiento), esquema de insulina con escala variable (rgimen/terapia), Sliding scale insulin regime, Sliding scale insulin regime (regime/therapy), esquema de insulina con escala variable Derived from the NIH UMLS ( Unified Medical Language System ) FPnotebook.com is a rapid access, point-of-care medical reference for primary care and emergency clinicians. Started in 1995, this collection now contains 6546 interlinked topic pag Continue reading >>

Sliding Scale: Low Dose Sliding Scale Humalog

Sliding Scale: Low Dose Sliding Scale Humalog

Basal/Bolus Subcutaneous Insulin Therapy: A Hospital Practice Medical Care in Diabetes and the AACE recommend using Basal-Bolus insulin therapy in treating adult hospitalized (Humalog), Aspart (Novolog), Glulisine insulin coverage at glucose levels of 150 mg/dl on the low dose) It is not sliding scale and should not be implemented or used as such ... Document Retrieval Insulin Pump - Wikipedia, The Free Encyclopedia This shape provides a large dose of insulin up front, In the Minimed 640G insulin pump series, low glucose suspend mode can also be entered based on predicted hypoglycemia. These insulins are absorbed more quickly than the currently available Humalog, Novolog, ... Read Article Guidelines For Caring For Brittany Walkers - Insulin Pumpers She will then take a shot of Humalog insulin right before she goes to eat. Sliding Scale FSBS checks over 200. I feel low especially if during or after exercise. What to do based on her blood sugar reading. ... Fetch Document What Is Rapid-Acting Insulin? - About.com Health Rapid-acting Insulins: The first is generically referred to as lispro but is marketed under the name Humalog and manufactured by Eli Lilly. High and Low Blood Sugar - Managing The Ups and Downs; What is a Hemoglobin A1c Test? Advertisement. ... Read Article Mealtime Insulin Management - Amazon Web Services Mealtime insulin management What is mealtime insulin? Insulin keeps blood glucose in providers may add a dose of mealtime insulin to your treatment plan, taken at breakfast, lunch and You may need to learn how to use a sliding scale plan, or an insulin-to-carbohydrate ratio, ... Access Doc SWARNA VARMA, M.D. & ASSOCIATES (Attachment 2B) Endocrinology ... BEDTIME SLIDING SCALE NO HUMALOG UNLESS BEDTIME SLIDING SCALE BASELINE 100-120 Breakfast Humalog Dos Continue reading >>

Insulin Dosing Worksheet €“ Sliding Scale Insulin To Carbohydrate Ratio

Insulin Dosing Worksheet €“ Sliding Scale Insulin To Carbohydrate Ratio

Sliding scale to correct a high blood sugar This is the amount of insulin needed to correct high blood sugar. Blood sugar at meals: Blood sugar at bedtime: _____ to _____ = _____ _____ to _____ = _____ _____ to _____ = _____ _____ to _____ = _____ Over _____ = _____ Over _____ = _____ = units of insulin needed 1 unit : _________ grams carbohydrate Sliding scale If pre-meal blood sugar is over ________, use sliding scale. Calculate insulin dose for food • Add up all the carbohydrates in your meal. • Divide the total carbohydrates by the insulin to carbohydrate ratio. • The result is the amount of insulin units needed. Total carbs ÷ insulin to carb ratio = units of insulin needed Visit choa.org/diabetes for additional copies. Time Correction insulinInsulin for food Total insulin (units) Meal Breakfast Morning snack Afternoon snack Lunch Dinner Bedtime Time Food + correction insulin (units) BS*: *BS required BS*: *BS required BS*: *BS required BS*: *BS required Blood sugar (BS) level Sliding scale correction insulin calculated (units) Total carbohydrates (g) Food formula (carb count/ carb ratio) Food insulin calculated (units) or set dose -------- -------- -------- -------- -------- -------- Daily plan: Calculate total insulin dose • Add the number of units needed for food to the number of units needed to correct blood sugar to get your total dose of insulin (Humalog/Novolog/Apidra). Food insulin + correction insulin = total insulin ©2016 Children’s Healthcare of Atlanta Inc. All rights reserved. MED 965480.kc.08/16 1. Wash and dry hands thoroughly. 2. Set lancet by cocking into position. 3. Put test strip into meter. 4. Prick side of finger and apply pressure to draw blood. 5. Wait for finger prompt on meter and then take blood. 6. Tou Continue reading >>

The Abcs Of Insulin

The Abcs Of Insulin

Insulin is a naturally occurring hormone produced by the pancreas. Insulin is required to move sugar from the blood into the body’s cells, where it can be used for energy. For the symptoms of high blood sugar and low blood sugar, see Tables 1 and 2. Type 1 diabetes (T1D) is a chronic condition in which the pancreas produces little or no insulin. Only 5% of patients with diabetes have this form of the disease, according to the American Diabetes Association. Type 2 diabetes (T2D) is much more common; the risk factors are listed in online table 3. Individuals with T2D make insulin, but their bodies don’t respond well to it, a condition known as insulin resistance. Treatment of T2D usually begins with dietary and lifestyle changes, as well as oral medications. Over time, as the pancreas struggles to make an adequate amount of insulin to overcome insulin resistance, patients may require insulin supplementation. Insulin therapy must be individualized and balanced with meal planning and exercise. When a patient begins using insulin to manage diabetes, the initial dose is just a starting point. Over time, insulin requirements are affected by factors such as weight gain or loss, changes in eating habits, and the addition of other medications. The need for insulin often increases, and the dose must be readjusted to meet the new requirements. Insulin is injected subcutaneously, meaning not very deep under the skin. Common injection sites include the stomach, buttocks, thighs, and upper arms. By rotating the site of injection, patients can avoid lipohypertrophy, a slight increase in the growth or size of fat cells under the skin. When lipohypertrophy occurs, a soft pillowy growth may form at the repeated-use injection site. Therefore, for reliable absorption rates and cosmetic Continue reading >>

Lantus Insulin / Humalog Insulin

Lantus Insulin / Humalog Insulin

I bought five of the Star Solo Pens of the Lantus insulin today; the cost was $227.30, but my insurance co-pay was only $45.00, saving me $182.30. I also bought five of the Humalog Kwik-Pens for a total cost of $346.99, with an insurance co-pay also of $45.00, thus saving me $301.99. I am retired and I live on a fixed income. What do people do who do not have insurance or help from family members? My blood glucose levels run in the 200 range and I test five times a day. I take 50 units of the Lantus insulin in the morning; and then I take the Humalog insulin on a sliding scale depending on my blood sugar levels. My biggest complaint is the constant, never-ending pain in both my feet from the diabetic peripheral neuropathy. Ive wondered the same thing. Those of us with good healthcare are so fortunate. I, for one, cannot imagine dealing with the costs of diabetes on my own - I would be broke. But there are non-profit charity care programs that qualifying diabetics can access. Also, some clinics will give out free insulin samples from the pharmaceutical (sp?) reps. Are there any meds you can take to help with the peripheral neuropathy in your feet? I am taking Gabapentin (the generic of Neurontin); I take six (6) 600-mg. tablets per day; two tablets at a time, three times a day; and I also take 1000 Units of vitamin E and 1000 units of vitamin D. It helps a little, but not very much. I was on Cymbalta at one time and then the doctor prescribed Ultracet; and the pharmacist caught the error - that combination can cause death as a side effect. I have also been on Hydrocodone but that did not help at all. I have tried topical ointments but nothing helps. I was on Lyrica at one time and that did not help. I am thinking of looking into electrical appliances as an alternative. Continue reading >>

Calculating Insulin Dose

Calculating Insulin Dose

You'll need to calculate some of your insulin doses. You'll also need to know some basic things about insulin. For example, 40-50% of the total daily insulin dose is to replace insulin overnight. Your provider will prescribe an insulin dose regimen for you; however, you still need to calculate some of your insulin doses. Your insulin dose regimen provides formulas that allow you to calculate how much bolus insulin to take at meals and snacks, or to correct high blood sugars. In this section, you will find: First, some basic things to know about insulin: Approximately 40-50% of the total daily insulin dose is to replace insulin overnight, when you are fasting and between meals. This is called background or basal insulin replacement. The basal or background insulin dose usually is constant from day to day. The other 50-60% of the total daily insulin dose is for carbohydrate coverage (food) and high blood sugar correction. This is called the bolus insulin replacement. Bolus – Carbohydrate coverage The bolus dose for food coverage is prescribed as an insulin to carbohydrate ratio. The insulin to carbohydrate ratio represents how many grams of carbohydrate are covered or disposed of by 1 unit of insulin. Generally, one unit of rapid-acting insulin will dispose of 12-15 grams of carbohydrate. This range can vary from 6-30 grams or more of carbohydrate depending on an individual’s sensitivity to insulin. Insulin sensitivity can vary according to the time of day, from person to person, and is affected by physical activity and stress. Bolus – High blood sugar correction (also known as insulin sensitivity factor) The bolus dose for high blood sugar correction is defined as how much one unit of rapid-acting insulin will drop the blood sugar. Generally, to correct a high bloo Continue reading >>

Pre Meal Sliding Scale Humalog

Pre Meal Sliding Scale Humalog

Im a newly diagnosed LADA diabetic, less than a month. The endocrinologist cant see me until June so Im trying to figure a lot out on my own with the help of my primary care doctor. After finding myself in the ICU in ketoacidosis, I was discharged less than 48 hours later with instructions to eat ~60g of carbs a meal, to inject 9 units of lantus in the morning and 3 units before every meal. My numbers were quite high that whole first week until I saw my primary care doctor who gave me the pre meal sliding scale. Ive modified it a bit and Im having much better numbers. My biggest issue/question is that I am now testing in the no coverage range often at mealtimes, but I know if I dont take any insulin that it will spike at the next check, yet I dont want to take it if I dont need to or if it will end up lowering my BG too much, late night its been falling low enough (65-85) that I get concerned about going to sleep and I have to have a small snack. Ive started taking 2 units anyway when its in the 100-150 range, but I dont really know what Im doing, just going on instinct with a bit of an educational guess. Any advice or tips based on your experiences. Are you keeping a log? I think its the best way to learn how your glucose metabolism works. Itll help to track insulin dose size and type, when given, what you eat and blood glucose numbers with their times. I think you should make a goal to learn how to eventually adjust your insulin doses on your own. You need to be able to make many decisions every day. Doctors can help you but they are seriously limited in their availability. You wont need to keep these records forever but can accelerate your understanding of how insulin works for you. I also suggest that you start reading about how insulin works and the basics of a ba Continue reading >>

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