What are areas of variation in insulin protocols for IV insulin therapy?

Updated: Nov 06, 2018
  • Author: Guy W Soo Hoo, MD, MPH; Chief Editor: George T Griffing, MD  more...
  • Print
Answer

Answer

Areas of variation in insulin protocols are as follows:

  • Presence or absence of preexisting diabetes

  • Initial hyperglycemic threshold (>150-200 mg/dL)

  • Initial bolus insulin dose (calculated [formula] versus fixed [predetermined])

  • Subsequent bolus insulin

  • Change in insulin dose (calculated vs fixed dose)

    • Based on direction of change in glucose (decrease, no change, increase)

    • Velocity of change (30-50 mg/dL/h)

    • Dose adjustment for insulin resistance

    • Basis of change in insulin dose (rate, infusion)

    • Unit of change in insulin dose (fixed dose or calculated using a multiplier)

    • Number of steps required (1-3); some requiring calculations to change the dose (8 of 12)

  • Target glucose (80-180 mg/dL; with a wide range of acceptable values


Did this answer your question?
Additional feedback? (Optional)
Thank you for your feedback!