What are the Portland Protocol Titration Guidelines for IV insulin therapy if the blood glucose level is 125-175 mg/dL?

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

Answer

Blood glucose level - 125-175 mg/dL

If higher than the last blood glucose level by more than 10 mg/dL, increase rate by 0.5 U/h

If lower than the last blood glucose level by more than 40 mg/dL, stop drip and recheck the blood glucose level again in 30 minutes. If the infusion is turned off, recheck the blood glucose in 30 minutes; when the blood glucose is more than 150 mg/dL, restart at 50% of previous rate.

If lower than the last blood glucose level by 21-40 mg/dL, decrease rate by half (50%) and recheck blood glucose levels in 30 minutes.

If lower than the last blood glucose level by 10-20 mg/dL, decrease rate by 0.5 U/h.

If within 10 mg/dL of last blood glucose level, remain at the same rate the blood glucose has consistently decreased each of last 4 measurements. Then, decrease rate by 0.3 U/h.

If the blood glucose has consistently increased each of last 4 measurements, increase rate by 0.2 U/h.


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