On day three after his admission Bob has a large hospital meal, plus a large box of chocolates, despite the nurses previously giving him some dietary advice. The next routine BM stix shows his glucose to be even higher at 16mmol/l. The doctors decide that this needs to be better controlled and decide to start Bob on an insulin sliding scale.
Example of a Diabetic Control Table. NB: These will vary so please refer to your local charts.
Patient name: |
Bob Ferguson |
DOB: 23/03/62 |
Consultant: |
Dr Ross |
|
| Date | 21/11/2020 | 21/11/2020 | 21/11/2020 | 21/11/2020 | 21/11/2020 |
| Time | 07:30 | 09:30 | 11:30 | 13:30 | 15.30 |
| Insulin Name and Units | |||||
| Actrapid | |||||
| as per BM | 4 | 3 | 3 | 2 | 2 |
| Signature: D. Ross | D Ross | D Ross | D Ross | D Ross | D Ross |
| BM results (mmol/L | 16.0 | 13.8 | 12.2 | 10.7 | 10.2 |
| Ketones | |||||
Insulin sliding scale prescription
| Drug/Dose
Actrapid 100units in 100ml 0.9% Saline |
BM result
(mmol/L) |
Insulin rate
(ml/hr) |
|
| 0 – 4 | 0 | ||
| ROUTE Intravenous | 5 – 7 | 1 | |
| 8 – 10 | 2 | ||
| Start Date
21/11/2020 |
Doctors Signature
Doug Ross |
11 – 15 | 3 |
| 16 – 20 | 4 | ||
| Disc. Date | Doctors Signature | 21 – 28 | 6 |
| >28 | Inform Dr | ||
An insulin sliding scale is a temporary measure to control glucose levels in acute stroke patient with very high blood glucose (>15 mmol/L). It involves intravenous administration of a standard insulin to tightly regulate blood glucose levels. Blood glucose levels are monitored using bedside, finger-prick capillary glucose monitoring machines. The rate of infusion of insulin is titrated according to the glucose which is ideally monitored every 1-2 hours. Insulin given intravenously has a short half-life of a few minutes.
Page last reviewed: 04 Feb 2021
