What are the Portland Protocol Titration Guidelines for IV insulin therapy if the blood glucose level is 250-300 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 – 250-300 mg/dL

  • If lower than the last blood glucose level by more than 100 mg/dL, decrease rate by half (50%).

  • If lower than the last blood glucose level by 50-100 mg/dL, continue same rate.

  • If lower than the last blood glucose level by less than 50 mg/dL or higher than the last blood glucose level, bolus with 6 U of regular insulin intravenously and increase the insulin rate by 2 U/h.

  • If the blood glucose remains higher than 250 mg/dL and has not decreased after 3 consecutive increases in insulin, administer double the previous intravenous bolus dose up to a maximum of 24 U double the insulin drip rate up to a maximum of 20 U/h. If on 20 U/h and no response is seen after 4 maximum boluses, call physician for further orders

  • Recheck blood glucose level in 30 minutes and repeat every 30 minutes until less than 200 mg/dL.


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