CLINICAL QUERIES: When should I use an insulin sliding scale?
Joan E. King RN,C, ACNP, ANP, PhD
Kathleen Wolff FNP, BC-ADM, MSN

November 2004 
Volume 34  Number 11
Pages 73 - 73
  PDF Version Available!



    Our hospital uses a sliding scale for insulin administration, but I recently read that this approach isn't always the best. What are the pros and cons of using a sliding scale? —R.O., GA.

    Joan E. King, RN,C, ACNP, ANP, PhD, and Kathleen Wolff, FNP, BC-ADM, MSN, reply: Insulin therapy aims to stabilize a patient's serum glucose levels with respect to future carbohydrate intake, rather than retrospectively treating an increase in serum glucose. Using a sliding scale to correct a high glucose level creates a greater risk of peaks and valleys in the patient's serum glucose, so it shouldn't be the sole form of insulin therapy. Although you can use a sliding scale dose to bring down an elevated glucose level, it may not do so for several hours—and it may increase the risk of hypoglycemia.

    The American Diabetes Association recommends that a patient's blood glucose level be less than 180 mg/dl ...

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