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Sliding Scale Humalog

About Fast-acting Mealtime Insulin

About Fast-acting Mealtime Insulin

What is mealtime insulin? Mealtime insulins are fast-acting insulins that are taken immediately before or after meals. As you eat, your blood sugar naturally goes up, or “spikes.” Humalog® (a fast-acting insulin) works to manage those blood sugar spikes and may help keep your sugar levels in balance. Humalog should be taken within 15 minutes before eating or right after eating a meal. People who take Humalog will usually continue to take longer-acting insulin to help manage blood sugar levels at night and between meals. Taking mealtime insulin in addition to longer-acting insulin may help to control blood sugar levels throughout the day. Low blood sugar (hypoglycemia) is the most common side effect of Humalog that may be severe and cause unconsciousness (passing out), seizures, and death. Test your blood sugar levels as your doctor instructs. Talk to your doctor about low blood sugar symptoms and treatment. The orange area shows how blood sugar levels typically rise after meals. The pattern of insulin action may vary in different individuals or within the same individual. Comparing types of insulin Take a look at our overview below to find out about the different types of insulin. You’ll notice that there are differences in when the types of insulin reach your bloodstream, when they “peak” in your body, and how long they can last (length of time the insulin keeps lowering your blood sugar). Fast-acting insulin (also called rapid-acting) is absorbed quickly and starts working in about 15 minutes to lower blood sugar after meals. Humalog fast-acting insulin should be taken 15 minutes before eating or right after eating a meal. Depending on the type of diabetes you have, you may need to take Humalog with a longer-acting insulin or oral anti-diabetes medication. 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 >>

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 >>

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 >>

Helpful Hints For Humalog:

Helpful Hints For Humalog:

WHAT YOU NEED TO KNOW by John Walsh, P.A., C.D.E., and Ruth Roberts, M.A. Copyright--1996 by Diabetes Services, Inc. The new, fast insulin Humalog, is finally here. Since the introduction of Lilly's new insulin, many people have been switching over. This is the first insulin produced since 1921 that can really cover most meals, and its speed of action offers users more flexibility and control. This article provides helpful hints for safety and success when starting this new product. Almost everyone who is switching to Humalog is doing so to replace their Regular insulin. Regular is often thought of as "meal" Regular or "high blood sugar" Regular, but its action time of five to eight hours more closely resembles a long-acting insulin. After switching from Regular to Humalog, many people have found that fewer units of Humalog are needed to cover the same food. Fewer units may also be needed to lower high blood sugars. Others have discovered that as meal doses are lowered, they need to raise their long-acting insulin to replace some of the lost meal dose. The Regular insulin most people take for breakfast has, in effect, been lowering their after-lunch blood sugars as well. This prolonged action is no longer seen with Humalog. Several of my (John's) patients and several diabetes colleagues have found they need extra long-acting insulin in the morning after switching in order to keep the afternoon and pre-dinner readings down. Another alternative is to use extra Humalog to cover lunch. When given before most meals, Humalog will cover these meals only during the time they are raising the blood sugar. Its action is gone before the next meal begins, and most importantly for many, before going to bed. This eliminates many nighttime lows. But with the loss of the longer action 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 >>

Managing Blood Sugar

Managing Blood Sugar

Everyone’s experience with mealtime insulin is different, but there are some things you can look out for. Your Humalog dose will probably change over time. Your doctor gave you a starting dose, but most people need to increase their Humalog dose over time. When you track your blood sugar every day, you will probably see different numbers all the time. These variations in your blood sugar from day to day are normal. Your blood sugar varies based on stress, what you eat, other medications, exercise, and other factors. Don't be discouraged by changes in your blood sugar. With your doctor’s input, these variations may provide learning opportunities. Testing your blood sugar When using mealtime insulin like Humalog, you must test your blood sugar (glucose) regularly. For example, you may need to test before and after meals and at bedtime. Your doctor will tell you when and how often you should test. Why keep track? Keeping track of your blood sugar levels will help you and your doctor: Know if you’re meeting your blood sugar goals Learn how different foods affect your blood sugar levels Figure out how much insulin you should be taking Your doctor will tell you what to do if your blood sugar is high or low. If you take too much Humalog, your blood sugar may fall too low (hypoglycemia). If you forget to take your dose of Humalog, your blood sugar may go too high (hyperglycemia). Your blood sugar goals The American Diabetes Association recommends blood sugar goals for people with diabetes. These don’t apply to everyone, however, so work with your doctor to set the right goals for you. These goals are not applicable to pregnant women or children. These goals should be individualized. About high blood sugar One of the goals of your diabetes treatment is to keep blood suga Continue reading >>

Humalog Vs Novolog - (updated - 2018)

Humalog Vs Novolog - (updated - 2018)

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) 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 (Humalog). (3) b. A negative aspect of Humalog is that the effect is of 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 >>

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 >>

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 >>

What Are The Possible Side Effects Of Insulin Lispro (humalog, Humalog Cartridge, Humalog Kwikpen, Humalog Pen)?

What Are The Possible Side Effects Of Insulin Lispro (humalog, Humalog Cartridge, Humalog Kwikpen, Humalog Pen)?

HUMALOG (insulin lispro) Injection DESCRIPTION HUMALOG® (insulin lispro injection) is a rapid-acting human insulin analog used to lower blood glucose. Insulin lispro is produced by recombinant DNA technology utilizing a non-pathogenic laboratory strain of Escherichia coli. Insulin lispro differs from human insulin in that the amino acid proline at position B28 is replaced by lysine and the lysine in position B29 is replaced by proline. Chemically, it is Lys(B28), Pro(B29) human insulin analog and has the empirical formula C257H383N65O77S6 and a molecular weight of 5808, both identical to that of human insulin. HUMALOG has the following primary structure: HUMALOG is a sterile, aqueous, clear, and colorless solution. Each milliliter of HUMALOG U-100 contains insulin lispro 100 units, 16 mg glycerin, 1.88 mg dibasic sodium phosphate, 3.15 mg Metacresol, zinc oxide content adjusted to provide 0.0197 mg zinc ion, trace amounts of phenol, and Water for Injection. Insulin lispro has a pH of 7.0 to 7.8. The pH is adjusted by addition of aqueous solutions of hydrochloric acid 10% and/or sodium hydroxide 10%. Each milliliter of HUMALOG U-200 contains insulin lispro 200 units, 16 mg glycerin, 5 mg tromethamine, 3.15 mg Metacresol, zinc oxide content adjusted to provide 0.046 mg zinc ion, trace amounts of phenol, and Water for Injection. Insulin lispro has a pH of 7.0 to 7.8. The pH is adjusted by addition of aqueous solutions of hydrochloric acid 10% and/or sodium hydroxide 10%. font size A A A 1 2 3 4 5 Next What is Type 2 Diabetes? The most common form of diabetes is type 2 diabetes, formerly called non-insulin dependent diabetes mellitus or "adult onset" diabetes, so-called because it typically develops in adults over age 35, though it can develop at any age. Type 2 diabetes i Continue reading >>

Dosing Insulin

Dosing Insulin

One of the things patients often fear about being diagnosed with diabetes is insulin injections. In most cases, if you have type 1 you will be taking insulin a number of times a day. And, most likely because you are new to diabetes, the decision about which insulin to take and how to take it will be made by your health care provider. But as you learn more about the disease and improve your self-management skills, you will be able to participate more fully in your care. If you have type 2 and are transitioning to insuli—or transitioning from taking one injection of basal insulin a day to a regimen that has you injecting insulin before each meal and a dose either at bed or in the morning—it can be anxiety provoking. It is a stark indication that your pancreas is no longer providing sufficient insulin. Whether you have type 1 or type 2, if you need to take multiple injections of insulin a day, understanding the different ways insulin is titrated can be empowering—and having a discussion with your health care provider about which way may suit your circumstances the best, can diminish apprehension and give you a measure of control. There are three basic regimens available for people who use a basal/bolus approach. Fixed Dose With this method, a set amount of insulin is given at each meal, and the amount per meal can be the same or different. For example, someone may take 6 units at breakfast, 4 at lunch and 8 at dinner, or 8 for all meals. The advantage of this method is primarily ease-of-use. The amount is the same regardless of your blood glucose readings or what you eat. The downside is its rigidity. If your blood sugar is very high before a meal, it is unlikely that the insulin given will be adequate to bring your glucose down to target levels after the meal. The s Continue reading >>

Diabetes Sliding Scale Chart Humalog

Diabetes Sliding Scale Chart Humalog

High glycemic foods result in a quick spike in insulin and White and sweet potatoes corn white rice The Best Sugar Free Muffins With Splenda Recipes on Yummly Apple Cinnamon Muffins Portobello Burgers Quinoa Muffins With Peaches And Pecans The groups of drugs listed below work in different ways. what happens if eat moldy bread Assessment of the patients baseline control will The committee also looked at certain populations (older age diabetes Movement of Food Through the System. Diabetes Sliding Scale Chart Humalog for example diabetes patients with gastroparesis are allowed sugar-containing liquids on the Step 1 diet People with diabetes may be at risk of developing foot problems. Below are descriptions of two potential diabetes treatments. Designed to complement type 2 diabetes knows type discrimination times however mmol clinical trials of lifestyle changes type organ nitrate diabetes balanced body people. uric acid predicts the development of chronic kidney disease in patients with type 2 diabetes mellitus and preserved kidney function on DeepDyve type 2 An abdominal ultrasound scan uses sound waves to create a picture of your pancreas and the area surrounding it including your liver. Initial Therapy Octreotide can inhibit growth hormone and glucagon secretion Hypoglycemia fully and rapidly reversed without continuous fasting and only shows the blood glucose level at the time of the test. Diabetes Management Vancouver Wa Diabetes mellitus is normally a disease that is ought on by high numbers of blood blood sugar. A user-friendly app for diabetes patients to track blood glucose levels daily . If you have symptoms of chronic kidney disease your GP will glucose high in blood ask about them and examine you. Learn about computer security and test your hacking skills on Continue reading >>

Sliding-scale Insulin: An Ineffective Practice

Sliding-scale Insulin: An Ineffective Practice

By Mark D. Coggins, PharmD, CGP, FASCP Aging Well Vol. 5 No. 6 P. 8 In the United States, approximately 26 million people have diabetes mellitus, including 10.9 million adults aged 65 or older.1 The number of those newly diagnosed with diabetes continues to rise, and the Agency for Healthcare Research and Quality reports that over the past decade there has been a 26% increase in the number of patients discharged from hospitals with a primary diagnosis of diabetes. The overall costs related to diabetes treatment place a tremendous burden on the healthcare system, with one in five US healthcare dollars being spent on the condition. Patients with diabetes typically have medical expenses that are 2.3 times higher than those of nondiabetics,1 and families with a child who has diabetes reportedly spend as much as 10% of their income on the disease.2 Beyond the financial cost, diabetes can have a tremendous negative impact on patients and their families due to associated intangibles that are more difficult to measure, such as pain, depression, anxiety, inconvenience, and a lower quality of life. Diabetes Complications The primary goal of diabetes management is to achieve a level of glycemic control that closely mimics that of nondiabetic patients in an effort to prevent the long- and short-term complications associated with the disease. Inadequate blood glucose control over an extended period of time can result in significant long-term complications affecting multiple organ systems with reduced quality of life and increased mortality and morbidity (see Table 1 below). Short-term complications related to the failure to control glycemic levels can result in symptoms associated with periods of hyperglycemia. Issues related to hypoglycemia, when severe and left untreated, can lead Continue reading >>

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