How is blood glucose testing performed according to the Portland IV insulin therapy protocol?

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

Answer

Test blood glucose by finger stick, arterial, or venous line drop samples. Frequency of testing is as follows:

  • Check blood glucose every 30 minutes when blood glucose is more than 200 mg/dL or less than 100 mg/dL; after drip is stopped or decreased more than 50%; after bolus intravenous insulin dose is given; or when rapidly titrating vasopressors (eg, epinephrine, norepinephrine).

  • Check blood glucose every hour when levels are 100-200 mg/dL.

  • Check blood glucose every two hours when levels are 125-175 mg/dL and blood glucose varies less than 15 mg/dL over 4 hours and the insulin rate remains unchanged for 4 hours. Note: If any change in blood glucose more than 15mg/dL occurs or any change in insulin rate more than 0.5 units occurs, return to checking blood glucose every hour.

  • During initiation of, rate change of, or cessation of any nutritional support or renal correction therapy, check blood glucose every 30 minutes (4 times).

    • Nutritional support (enteral or parenteral) includes tube feedings, total parenteral nutrition, and partial parenteral nutrition.

    • Renal correction therapy includes renal dialysis, continuous venovenous hemofiltration, continuous venovenous hemodialysis, and peritoneal dialysis.


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