What are the initial orders of the Georgia Hospital Association protocol for IV insulin therapy?

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

Answer

This has also been referred to as the Davidson or Glucommander Protocol. The intravenous infusion protocol is for a target of 140-180 mg/dL.

Initial orders are as follows:

  • Discontinue previous diabetes medications.

  • Obtain basic metabolic profile (repeat in 6 h and then daily)

  • Record intravenous fluid (ie, normal saline, dextrose 5% in 1/2 normal saline, dextrose 5% in 1/2 normal saline/20 meq K+). If the patient is NPO and is not receiving total parenteral nutrition or continuous enteral feedings and has a blood glucose level of less than 250 mg/dL, the intravenous fluid selected and the rate of infusion should have a glucose source of 5 g/h or more.


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