Selected Important Safety Information
NovoLog® Mix 70/30 is contraindicated during episodes of hypoglycemia and in patients hypersensitive to NovoLog® Mix 70/30 or one of its excipients. Never Share a NovoLog® Mix 70/30 FlexPen® Between Patients, even if the needle is changed. Patients using NovoLog® Mix 70/30 vials must never share needles or syringes with another person. Sharing poses a risk for transmission of blood-borne pathogens. Changes in insulin strength, manufacturer, type, or method of administration may affect glycemic control and predispose to hypoglycemia or hyperglycemia. Changes should be made cautiously under close medical supervision and the frequency of blood glucose monitoring should be increased. NovoLog® Mix 70/30 (insulin aspart protamine and insulin aspart injectable suspension) 100 U/mL Indications and Usage NovoLog® Mix 70/30 (insulin aspart protamine and insulin aspart injectable suspension) 100 U/mL is a mixture of insulin aspart protamine and insulin aspart indicated to improve glycemic control in patients with diabetes mellitus. NovoLog® Mix 70/30 is not recommended for the treatment of diabetic ketoacidosis. The proportions of rapid-acting and long-acting insulins are fixed and do not allow for basal versus prandial dose adjustments. NovoLog® Mix 70/30 is contraindicated during episodes of hypoglycemia and in patients hypersensitive to NovoLog® Mix 70/30 or one of its excipients. Never Share a NovoLog® Mix 70/30 FlexPen® Between Patients, even if the needle is changed. Patients using NovoLog® Mix 70/30 vials must never share needles or syringes with another person. Sharing poses a risk for transmission of blood-borne pathogens. Changes in insulin strength, manufacturer, type, or method of administration may affect glycemic control and predispose to hypoglycemia or Continue reading >>
What Is Humulin 70/30 Kwikpen?
Before you receive DARZALEX®, tell your healthcare provider about all of your medical conditions, including if you: have a history of breathing problems have had shingles (herpes zoster) are pregnant or plan to become pregnant. DARZALEX® may harm your unborn baby. Females who are able to become pregnant should use an effective method of birth control during treatment and for at least 3 months after your final dose of DARZALEX®. Talk to your healthcare provider about birth control methods that you can use during this time. are breastfeeding or plan to breastfeed. It is not known if DARZALEX® passes into your breast milk. Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements. DARZALEX® may be given alone or together with other medicines used to treat multiple myeloma. Your healthcare provider will decide the time between doses as well as how many treatments you will receive. Your healthcare provider will give you medicines before each dose of DARZALEX® and on the first day after each dose of DARZALEX® to help reduce the risk of infusion reactions. If you miss any appointments, call your healthcare provider as soon as possible to reschedule your appointment. Infusion reactions. Infusion reactions are common with DARZALEX® and can be severe. Your healthcare provider may temporarily stop your infusion or completely stop treatment with DARZALEX® if you have infusion reactions. Tell your healthcare provider right away if you get any of the following symptoms: shortness of breath or trouble breathing dizziness or lightheadedness (hypotension) cough wheezing throat tightness runny or stuffy nose headache itching nausea vomiting chills fever Changes in blood tests. DARZALEX� Continue reading >>
Tips For Calculating A Total Daily Dose Of Insulin
You can use one of several methods to determine a safe, initial dose Published in the August 2007 issue of Today’s Hospitalist. Evidence keeps mounting that high blood sugars lead to worse outcomes in hospitalized patients “and that sliding scale regimens produce both more hyperglycemia and hypoglycemia. But as hospitalists switch from sliding scale to basal and bolus dosing, how do they calculate a safe total daily dose to start with? Experts say that physicians can use any of three different strategies, depending on whether patients have been using insulin as either an outpatient or in the ICU. ~ Deepak Asudani, MD Baystate Medical Center Any one of these approaches will produce a safe, conservative initial dose, but experts warn that none of the strategies by itself is a slam dunk. You still have to bring art to each approach, adjusting doses according to such factors as illness severity and eating status. Related article: Keeping it simple with insulin regimens, July 2013 Here’s a look at how two hospitalists use these strategies in their day-to-day practice. 1. Base total sub-Q dose on insulin infusion rates. When Deepak Asudani, MD, a hospitalist at Baystate Medical Center in Springfield, Mass., transitions patients from IV insulin in the ICU to sub-Q insulin on the wards, he uses the following formula: Take the average hourly insulin infusion rate over the past six hours and multiply that rate by 20. That gives you a number that should equal 80% of the daily infusion dose. “It’s a little correction to prevent any hypoglycemia,” says Dr. Asudani. Because patients’ insulin needs are tapering down a bit as they exit the ICU, he adds, you don’t need to supply the same daily dose. For patients eating substantial amounts of food, you can use that calcul Continue reading >>
- Calculating Insulin Dose
- Relative effectiveness of insulin pump treatment over multiple daily injections and structured education during flexible intensive insulin treatment for type 1 diabetes: cluster randomised trial (REPOSE)
- Relation of total sugars, fructose and sucrose with incident type 2 diabetes: a systematic review and meta-analysis of prospective cohort studies
Humulin 70-30
HUMULIN® 70/30 (70% human insulin isophane) Suspension and (30% human insulin) Injection, [rDNA origin] DESCRIPTION HUMULIN 70/30 (70% human insulin isophane suspension and 30% human insulin injection [rDNA origin]) is a human insulin suspension. Human insulin is produced by recombinant DNA technology utilizing a non-pathogenic laboratory strain of Escherichia coli. HUMULIN 70/30 is a suspension of crystals produced from combining human insulin and protamine sulfate under appropriate conditions for crystal formation and mixing with human insulin injection. The amino acid sequence of HUMULIN 70/30 is identical to human insulin and has the empirical formula C257H383N65O77S6 with a molecular weight of 5808. HUMULIN 70/30 is a sterile white suspension. Each milliliter of HUMULIN 70/30 contains 100 units of insulin human, 0.24 mg of protamine sulfate, 16 mg of glycerin, 3.78 mg of dibasic sodium phosphate, 1.6 mg of metacresol, 0.65 mg of phenol, zinc oxide content adjusted to provide 0.025 mg zinc ion, and Water for Injection. The pH is 7.0 to 7.8. Sodium hydroxide and/or hydrochloric acid may be added during manufacture to adjust the pH. For Consumers What are the possible side effects of insulin isophane and insulin regular? Get emergency medical help if you have any of these signs of insulin allergy: itching skin rash over the entire body, wheezing, trouble breathing, fast heart rate, sweating, or feeling like you might pass out. Hypoglycemia, or low blood sugar, is the most common side effect of insulin isophane and insulin regular. Symptoms of low blood sugar may include headache, nausea, hunger, confusion, drowsiness, weakness, dizziness, blurred vision, fast heartbeat, sweating, tremor, trouble concentrating, confusion, or seizure (convulsions). Watch for signs of l Continue reading >>
Weight-based Insulin Dosing Safe At Recommended Doses
Weight-based insulin doses up to 0.6 units per kilogram are associated with a low risk of hypoglycemia, according to a new report…. Dr. Daniel J. Rubin from Temple University School of Medicine in Philadelphia writes that, "Our study provides evidence for the safety of daily insulin doses up to 0.6 units/kg." "I hope this will encourage more physicians to be comfortable using weight-based insulin dosing." Dr. Rubin and colleagues investigated the relationship between insulin dose and hypoglycemia in a retrospective, case-control study of 1,990 diabetic patients admitted to hospital wards. The report appears online June 23 in Diabetes Care. The unadjusted odds of hypoglycemia increased with insulin doses above 0.2 units/kg, and patients who received insulin doses of 0.6 units/kg or more faced increased odds of hypoglycemia. The adjusted odds of hypoglycemia were not higher among patients who received 0.2 to 0.6 units/kg. The adjusted odds of hypoglycemia were 3 times higher among patients who didn’t receive sliding scale insulin than among those who did, and there was a trend toward higher odds among patients who received NPH compared with patients who received glargine or short-acting insulin. Hypoglycemia was not more common among patients given insulin with an oral diabetes medication than among those given insulin alone. "0.6 units/kg seems to be a threshold below which the odds of hypoglycemia are relatively low," the researchers note. "Some patients, however, require more than 0.6 units/kg to treat hyperglycemia and do not experience any hypoglycemia," Dr. Rubin said. "If there is any concern for hypoglycemia, it is reasonable to use doses <0.6 unit/kg. Insulin dosing for individual patients must be done on a case-by-case basis." "Our data are consistent with t Continue reading >>
Starting With Novolog® Mix 70/30
Do not share your NovoLog® Mix 70/30 FlexPen® with other people, even if the needle has been changed. You may give other people a serious infection, or get a serious infection from them. Who should not take NovoLog® Mix 70/30? Do not take NovoLog® Mix 70/30 if: your blood sugar is too low (hypoglycemia) or you are allergic to any of its ingredients. Before taking NovoLog® Mix 70/30, tell your healthcare provider about all your medical conditions including, if you are: pregnant, planning to become pregnant, or are breastfeeding. taking new prescription or over-the-counter medicines, including supplements. Talk to your health care provider about how to manage low blood sugar. How should I take NovoLog® Mix 70/30? Read the Instructions for Use and take exactly as directed. NovoLog® Mix 70/30 starts acting fast. If you have type 1 diabetes, inject within 15 minutes before you eat a meal. If you have type 2 diabetes, inject within 15 minutes before or after starting your meal. Do not mix NovoLog® Mix 70/30 with other insulin products or use in an insulin pump. Know the type and strength of your insulin. Do not change your insulin type unless your health care provider tells you to. Check your blood sugar levels. Ask your health care provider what your blood sugar levels should be and when you should check them. Do not reuse or share your needles or syringes with other people. You may give other people a serious infection, or get a serious infection from them. What should I avoid while taking NovoLog® Mix 70/30? Do not drive or operate heavy machinery, until you know how NovoLog® Mix 70/30 affects you. Do not drink alcohol or use medicines that contain alcohol. What are the possible side effects of NovoLog® Mix 70/30? Serious side effects can lead to death, includin Continue reading >>
Insulin 70/30 Mix Plus Metformin Versus Triple Oral Therapy In The Treatment Of Type 2 Diabetes After Failure Of Two Oral Drugs
Efficacy, safety, and cost analysis Abstract OBJECTIVE—Subjects (n = 188) with type 2 diabetes and inadequate response to two oral medications (A1C >8.0%) were randomly assigned to treatment with either a third oral medication or an insulin 70/30 mix b.i.d. plus metformin for a comparison of efficacy, safety, and cost. RESEARCH DESIGN AND METHODS—The protocol called for aggressive dose titration to achieve target values of fasting blood glucose (80–120 mg/dl), postprandial glucose (<160 mg/dl), and A1C (<7%). These efficacy parameters were evaluated at weeks 2, 6, 12, and 24 of therapy. If dose adjustments failed to achieve targeted glycemic control, subjects were switched to an alternate therapy. RESULTS—At the end of study (week 24 of therapy), A1C and fasting plasma glucose (FPG) values showed comparable decreases in the two treatment groups. Only 31% (oral therapy) and 32% (insulin plus metformin) of subjects achieved target values of A1C (<7%). A total of 10 of the 98 subjects randomized to triple oral therapy (10.2%) who failed to improve sufficiently were switched to insulin therapy. An additional four subjects dropped out of the oral treatment group due to adverse events felt to be potentially drug related. Only two of the subjects randomized to insulin plus metformin had to be switched to basal-bolus regimens (regular insulin and NPH insulin). Cost analysis determined that insulin plus metformin (mean cost $3.20/day) provided efficacy equal to that of a triple oral drug regimen ($10.40/day). CONCLUSIONS—Insulin 70/30 mix plus metformin was as effective as triple oral therapy in lowering A1C and FPG values. The triple oral regimen was not as cost effective, and a high percentage of subjects (total of 16.3%) did not complete this regimen due to lack of Continue reading >>
- Is It Time to Change the Type 2 Diabetes Treatment Paradigm? No! Metformin Should Remain the Foundation Therapy for Type 2 Diabetes
- Bariatric Surgery versus Intensive Medical Therapy for Diabetes — 5-Year Outcomes
- Relative effectiveness of insulin pump treatment over multiple daily injections and structured education during flexible intensive insulin treatment for type 1 diabetes: cluster randomised trial (REPOSE)
Combination Insulins
Rapid-Acting Analogues Short-Acting Insulins Intermediate-Acting Insulins Long-Acting Insulins Combination Insulins Novolin® 70/30 - Humulin® 70/30 Novolog® Mix 70/30 Humalog® Mix 75/25 SOLIQUA™ 100/33 (insulin glargine and lixisenatide injection) XULTOPHY® 100/3.6 (insulin degludec and liraglutide injection) --® Onset: 30-60 min Peak: 2-12 hours Duration: 18 - 24 hours Solution: Cloudy Comments: Mixture of 70% NPH, Human Insulin Isophane Suspension and 30% Regular, Human Insulin Injection. Recommended interval between dosing and meal initiation: 30 minutes. Mixing You should not attempt to change the ratio of this product by adding additional NPH or Regular insulin to the vial. If the physician has prescribed insulin mixed in a proportion other than 70% NPH and 30% Regular, you should use the separate insulin formulations (e.g. NPH and Regular insulin ) in the amounts recommended by the physician. All Unopened Novolin 70/30: • Keep all unopened Novolin 70/30 in the refrigerator between 36° to 46°F (2° to 8°C). • Do not freeze. Do not use Novolin 70/30 if it has been frozen. • If refrigeration is not possible, the unopened vial may be kept at room temperature for up to 6 weeks (42 days), as long as it is kept at or below 77°F (25°C). • Keep unopened Novolin 70/30 in the carton to protect from light. Novolin 70/30 in use: Vials • Keep at room temperature below 77°F (25°C) for up to 6 weeks (42 days). • Keep vials away from direct heat or light. • Throw away an opened vial after 6 weeks (42 days) of use, even if there is insulin left in the vial. • Unopened vials can be used until the expiration date on the Novolin 70/30 label, if the medicine has been stored in a refrigerator. Note: double mouse click to return to the top of the page Onset Continue reading >>
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 >>
Dosage Calculations C15 Insulin Administration
Is a group of metabolic diseases characterized by hyperglycemia that results from impaired pancreatic secretions of insulin and defects in the action of insulin inside cells. Is thought to be caused by an autoimmune process that destroys the beta cells in the pancreas. Persons with Type 1 diabetes are unable to produce endogenous insulin, so they must inject exogenous insulin to survive. The pancreas may still produce some insulin, but the insulin is not used effectively by the body's cells. Is the presence of diabetes during pregnancy and may be caused by hormonal changes and/or lack of insulin. Is managed with diet, exercise, and medications. Individuals with diabetes should eat a diet that balances protein, fat, and carbohydrate intake to manage blood glucose levels, cholesterol levels, and body weight. Is the hormone responsible for allowing the body to utilize and store glucose. Typically referred to as "human" insulin because its chemistry closely resembles the insulin produced by humans. Have different onset, peaks, and duration of action. -Insulin lispro protamine suspension/insulin lispro solutions (Humalog Mix 75/25, Humalog Mix 50/50) -Insulin aspar protamine suspension/insulin aspart solutions (NovoLog Mix 70/30) -NPH/regular insulin misture (Humalin 70/30, Novolin 70/30) Insulin may be ordered in a number of ways: Intermediate- and long-acting insulin (mixtures such as Humalog Mix 75/25, NovoLog Mix 70/30) are usually ordered on a routine basis. -Insulin glargine (Lantus) 20 units, subcut, every evening -NPH insulin 14 units, subcut, before breakfast -NPH insulin 25 units, subcut, before evening meal -NovoLog Mix 70/30, 18 units, subcut, before breakfast Patients inject rapid or short acting insulin just before their meals. Provide a burst of insulin that Continue reading >>
Humulin 70/30 Dosage
There is no standard dosage of Humulin 70/30 that will work for all people, so dosing must be individualized for each person. In order to help determine an appropriate dose, your healthcare provider may recommend carbohydrate counting and ask you to measure your blood sugar before and after meals. The medication is typically administered twice a day, about 30 minutes before meals. The dose of Humulin 70/30 (NPH insulin / regular insulin ) that your healthcare provider recommends will vary, depending on a number of factors, including: Your blood sugar goals (which can vary from person to person) Other medications you are taking, including other diabetes medications As is always the case, do not adjust your dosage unless your healthcare provider specifically instructs you to do so. Dosing for Humulin 70/30 must be individualized for each different person. There is no "standard" Humulin 70/30 dose that will work for all people or even for the same person in all situations. Humulin 70/30 is made up of two different insulins, 70 percent intermediate-acting (NPH insulin) and 30 percent short-acting (regular insulin). It is typically taken twice a day before meals (often about 30 minutes before eating). Your healthcare provider may ask you to measure your blood sugar before and after meals and may also recommend carbohydrate counting. Both of these things can help you and your healthcare provider know how to dose your Humulin 70/30. In some situations, you and your healthcare provider may prefer "aggressive" insulin dosing, which may help reduce the risk of long-term diabetes complications but increases the risk of dangerously low blood sugar (hypoglycemia). Some people may need more relaxed insulin dosing, especially if they live alone (making it difficult to adequately resp Continue reading >>
Humulin 70/30 U-100 Insulin Subcutaneous : Uses, Side Effects, Interactions, Pictures, Warnings & Dosing - Webmd
Combination isophane/regular insulin is used with a proper diet and exercise program to control high blood sugar in people with diabetes . Controlling high blood sugar helps prevent kidney damage, blindness, nerve problems, loss of limbs, and sexual function problems. Proper control of diabetes may also lessen your risk of a heart attack or stroke . This man-made insulin product is the same as human insulin . It replaces the insulin that your body would normally make. It is a mixture of 70% intermediate-acting insulin (isophane) and 30% short-acting insulin (regular). It starts to work as quickly as regular insulin but lasts longer. This insulin product works by helping blood sugar ( glucose ) get into cells so your body can use it for energy. This product may be used alone or with other oral diabetes drugs (such as metformin ). Read the Patient Information Leaflet provided by your pharmacist before you start using combination isophane/regular insulin and each time you get a refill. If you have any questions, ask your doctor, diabetes educator, or pharmacist. Learn all preparation and usage instructions from your health care professional and the product package. Before using, gently roll the vial or cartridge, turning it upside down and back 10 times to mix the medication . Do not shake the container. Check this product visually for particles or discoloration. If either is present, do not use the insulin . Combination isophane/regular insulin should look evenly cloudy/milky after mixing. Do not use if you see clumps of white material, a "frosty" appearance, or particles stuck to the sides of the vial or cartridge. Before injecting each dose, clean the injection site with rubbing alcohol. Change the injection site each time to lessen injury under the skin and to avoid d Continue reading >>
Novolin 70/30
Generic Name: 70% human insulin isophane and 30% regular insulin Dosage Form: injection, suspension Novolin® 70/30 , 70% NPH, Human Insulin Isophane Suspension and 30% Regular, Human Insulin Injection (recombinant DNA origin) PATIENT PACKAGE INSERT Patient Information for Novolin® 70/30 NOVOLIN® 70/30 (NO-voe-lin) 70% NPH, Human Insulin Isophane Suspension and 30% Regular, Human Insulin Injection (recombinant DNA origin) 100 units/mL Important: Know your insulin. Do not change the type of insulin you use unless told to do so by your healthcare provider. The amount of insulin you take as well as the best time for you to take your insulin may need to change if you take a different type of insulin. Make sure that you know the type and strength of insulin that is prescribed for you. Read the Patient Information leaflet that comes with Novolin 70/30 before you start taking it and each time you get a refill. There may be new information. This leaflet does not take the place of talking with your healthcare provider about your diabetes or your treatment. Make sure you know how to manage your diabetes. Ask your healthcare provider if you have any questions about managing your diabetes. What is Novolin 70/30? Novolin 70/30 is a man-made insulin (recombinant DNA origin) which is a mixture of 70% NPH, Human Insulin Isophane Suspension and 30% Regular, Human Insulin Injection that is structurally identical to the insulin produced by the human pancreas that is used to control high blood sugar in patients with diabetes mellitus. Who should not use Novolin 70/30? Do not take Novolin 70/30 if: Your blood sugar is too low (hypoglycemia). You are allergic to anything in Novolin 70/30. See the end of this leaflet for a complete list of ingredients in Novolin 70/30. Check with your healt Continue reading >>
Insulin Dosing In Type 1 Diabetes
Aka: Insulin Dosing in Type 1 Diabetes, Insulin Dosing in Type I Diabetes II. Dose: Initial Dosing with basal/Bolus Insulin Ketones moderate or less: 0.5 units/kg/day Divide total Insulin into basal and bolus dosing Basal Insulin (long-acting): 50% of total Insulin Regular Insulin may be used instead due to cost Adjust later for carb count variations at meals Example: 60 kg adult with moderate ketones Insulin Glargine ( Lantus ): 15 units at bedtime Insulin Lispro : 15 units total divided over meals III. Dose: Conversion from mixed Insulin (70/30 or 75/25) Hemoglobin A1C <9%: Decrease total Insulin by 20% Divide total Insulin into basal and bolus dosing Basal Insulin (long-acting): 50% of total Insulin Adjust later for carb count variations at meals See Insulin Dosing for adjustment regimen Images: Related links to external sites (from Bing) These images are a random sampling from a Bing search on the term "Insulin Dosing in Type 1 Diabetes." 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 A short-acting form of insulin. Regular insulin is obtained from animal or recombinant sources. The onset of action of regular insulin occurs at 30-90 minutes after injection; its effect lasts for 6 to 8 hours. Endogenous human insulin, a pancreatic hormone composed of two polypeptide chains, is important for the normal metabolism of carbohydrates, proteins and fats; it has anabolic effects on many types of tissues. (NCI04) Insulin (51 aa, ~6 kDa) is encoded by the human INS gene. This protein is involved in the direct regulation of glucose metabolism. protein hormone secreted by beta cells of the pancreas; insulin plays a major role in the regulation of Continue reading >>
- Texting Helps Low-Income Diabetes Patients Manage Insulin Dosing
- Relative contribution of type 1 and type 2 diabetes loci to the genetic etiology of adult-onset, non-insulin-requiring autoimmune diabetes
- Relative effectiveness of insulin pump treatment over multiple daily injections and structured education during flexible intensive insulin treatment for type 1 diabetes: cluster randomised trial (REPOSE)
8/12/2016
1 Inpatient Glycemic Management: How We Get Others To Follow Our Lead August 12th, 2016 San Diego, CA DNP MPH BC-ADM CDE CDTC FAAN FAADE Diabetes Nurse Practitioner Inpatient Glycemic Control Team NewYork-Presbyterian Hospital Weill Cornell Medicine New York, New York [email protected] Disclosure to Participants Disclosures: Advisory Board Meetings: Alliance (Boehringer-Ingelheim/Lilly) Bayer Diabetes Care Sanofi Diabetes Consulting: Johnson & Johnson Diabetes Institute TOPICS • Hardwiring in the EMR to promote safety & efficacy • Patient Education: Multi-media resources, generic skills instructions • Staff Education: Diabetes Champions, Clinical standards & pocket cards • Transitional Care & Preventing Readmissions Hardwiring Glycemic Control 8/12/2016 2 Why Hardwire Insulin Orders? • Reduces insulin dosing errors: Auto-calculate safe dose, can set dose limits • Simplifies and promotes weight based dosing: EX: Auto-populates weight into dosing algorithm • Reduces insulin type order errors: Basal, prandial & correction insulin orders separated • Reduces insulin delivery timing errors: Separate prandial & bedtime doses, Doses due are color coded 7 Step One Which Order Set Do I Choose? NYPH Basal/Bolus Insulin Order Sets Comprehensive Insulin Order Set at NYPH Type of Diabetes 11 Bedside BGM Defaults to ac & bedtime for prandial orders & q6 hrs for NPO Carb Controlled Meal Plan 12 Auto-select A1c if needed *Build Medical Logic Memory to auto-check if no A1C for >60 days Auto-Selects 60 gram Carb Controlled Meal Plan 8/12/2016 3 13 NPO: no auto-basal for type 2 Suggest .10 u/kg for T1DM Very Low Dose .10 u/kg Low Dose .15 u/kg Med Dose .20 u/kg High Dose .30 u/kg Insulin Titration Algorithm: Step 1 14 WHICH INSULIN NEEDS Continue reading >>
