What are examples of IV insulin therapy protocols?

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

Answer

Two archetypal approaches are presented in more detail: the Georgia Hospital Association Protocol [12] , also referred to as the Davidson or Glucommander Protocol, and the Portland Protocol©. [13]

The Georgia Hospital Association Research and Education Foundation developed their own guidelines in 2002 for inpatient diabetes care throughout the state’s hospitals; this standardized approach to manage hyperglycemia has also been referred to as the Davidson or Glucommander Protocol, and authors of this protocol are also involved in the construct of the latest protocol. Although calculations are involved in determining insulin dose, the protocol has also been published in a columnar dosing form to eliminate the need for these calculations.

In 1992, the Providence Heart and Vascular Institute developed the Portland Protocol© from data extrapolated from diabetic patients who underwent cardiac surgery. It has undergone multiple modifications since its inception and takes into account many of the nuances previously identified. Both protocols are available from the respective websites and have been modified with glucose targets than are less stringent the previous 80-110 mg/dL and closer to the 140-180 mg/dL range. These changes should also reduce the incidence of hypoglycemia that was associated with earlier protocols.


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