What is the duration of the Portland 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

Protocol duration is as follows:

  • All diabetic patients and nondiabetic patients who remain hyperglycemic should continue on the protocol throughout their ICU stay.

  • Nondiabetic, euglycemic patients may stop protocol when the target range is maintained with less than 0.5 U/h. Check blood glucose levels every 2 hours (6 times) and then before meals, 2 hours after meals, and at bedtime for 24 hours. If all blood glucose levels remain less than 150 mg/dL, monitoring can be stopped; if any blood glucose levels are more than 150 mg/dL, resume the protocol.

  • If the need for insulin continues in patients without diabetes after transfer 3 days after surgery and admission HgbA1c level is greater than 6%, ask the physician to consult with an endocrinologist for diabetes workup and further follow-up orders.


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