HUMALOG SLIDING SCALE INSULIN COVERAGE Blood Sugar Result Humalog Insulin Coverage SubQ 60 - 124 No Coverage 125 - 150 2 units of Humalog Insulin subq 151 - 200 4 units of Humalog Insulin subq 201 - 250 6 units of Humalog Insulin subq 251 - 300 8 units of Humalog Insulin subq 301 - 350 10 units of Humalog Insulin subq. Correction Insulin Correction insulin is meant to “correct” or lower high blood sugars before meals. It is often given in addition to the usual dose that you take to cover your meal. Some people also take it if blood sugars are high at bedtime. Types of Correction Insulin Short-acting or rapid-acting insulin can be used. Examples include.
.Chemical and physical data5793.5999 g/mol1.09 g/cm 3233 °C (451 °F)Insulin is a that is used as a to treat. This includes in, and complications of such as. It is also used along with to treat. Typically it is given by, but some forms may also be used by or.The common side effect is. Other side effects may include pain or skin changes at the sites of injection,. Use during is relatively safe for the baby.
Insulin can be made from the of pigs or cows. Human versions can be made either by modifying pig versions. It comes in three main types short–acting (such as ), intermediate–acting (such as (NPH) insulin), and longer-acting (such as ).Insulin was first used as a medication in by and in 1922. It is on the, the most effective and safe medicines needed in a. The wholesale cost in the is about US$2.39 to $10.61 per 1,000 (34.7 mg) of regular insulin and $2.23 to $10.35 per 1,000 iu of NPH insulin. In the United Kingdom 1,000 iu of regular or NPH insulin costs the £7.48, while this amount of insulin glargine costs £30.68. Giving insulin with an.Insulin is used to treat a number of diseases including and its acute complications such as.
It is also used along with to treat. Insulin was formerly used in a psychiatric treatment called. Side effects If too much insulin is delivered or the person eats less than he or she dosed for, there may be hypoglycemia. On the other hand, if too little insulin is delivered, there will be hyperglycemia. Both can be life-threatening.
Allergy Allergy to Insulin products is rare with a prevalence of about 2%, of which most reactions are not due to the insulin itself but to preservatives added to insulin such as zinc,. Most reactions are reactions and rarely cause. A suspected allergy to insulin can be confirmed by, and occasionally. First line therapy against insulin hypersensitivity reactions include symptomatic therapy with antihistamines. The affected persons are then switched to a preparation that does not contain the specific agent they are reacting to or undergo.
Principles. The idealised diagram shows the fluctuation of (red) and the sugar-lowering hormone insulin (blue) in humans during the course of a day containing three meals. In addition, the effect of a -rich versus a -rich meal is highlighted.
See also:Includes the insulin analogues,. These begin to work within 5 to 15 minutes and are active for 3 to 4 hours.
Most insulins form, which delay entry into the blood in active form; these analog insulins do not but have normal insulin activity. Newer varieties are now pending regulatory approval in the U.S. Which are designed to work rapidly, but retain the same genetic structure as.
Short-acting Includes, which begins working within 30 minutes and is active about 5 to 8 hours.Intermediate-acting Includes, which begins working in 1 to 3 hours and is active for 16 to 24 hours.Long-acting Includes the analogues U100 and, each of which begins working within 1 to 2 hours and continues to be active, without major peaks or dips, for about 24 hours, although this varies in many individuals.Ultra-long acting Includes the analogues U300 and, which begin working within 30 to 90 minutes and continues to be active for greater than 24 hours. Combination insulin products Includes a combination of either fast-acting or short-acting insulin with a longer acting insulin, typically an. The combination products begin to work with the shorter acting insulin (5–15 minutes for fast-acting, and 30 minutes for short acting), and remain active for 16 to 24 hours. There are several variations with different proportions of the mixed insulins (e.g. Contains 70% aspart protamine akin to NPH, and 30% aspart.)Methods of administration. Insulin delivery devicesUnlike many medicines, insulin cannot be taken orally at the present time.
Like nearly all other proteins introduced into the, it is reduced to fragments (single amino acid components), whereupon all activity is lost. There has been some research into ways to protect insulin from the digestive tract, so that it can be administered in a pill. So far this is entirely experimental.Subcutaneous Insulin is usually taken as by single-use with, an, or by repeated-use with needles. Patients who wish to reduce repeated skin puncture of insulin injections often use an in conjunction with syringes.Administration schedules often attempt to mimic the physiologic secretion of insulin by the pancreas. Hence, both a long-acting insulin and a short-acting insulin are typically used.Insulin pump. Main article:are a reasonable solution for some.
Advantages to the patient are better control over background or 'basal' insulin dosage, bolus doses calculated to fractions of a unit, and calculators in the pump that may help with determining 'bolus' infusion dosages. The limitations are cost, the potential for hypoglycemic and hyperglycemic episodes, catheter problems, and no 'closed loop' means of controlling insulin delivery based on current blood glucose levels.Insulin pumps may be like 'electrical injectors' attached to a temporarily implanted.
Some who cannot achieve adequate glucose control by conventional (or jet) injection are able to do so with the appropriate pump.Indwelling catheters pose the risk of infection and ulceration, and some patients may also develop due to the infusion sets. These risks can often be minimized by keeping infusion sites clean. Insulin pumps require care and effort to use correctly.Dosage and timing. See also: and Dosage units One of insulin (1 IU) is defined as the 'biological equivalent' of 34.7 pure crystalline insulin.The first definition of a unit of insulin was the amount required to induce in a rabbit. This was set by at the University of Toronto in 1922. Of course, this was dependent on the size and diet of the rabbits. The unit of insulin was set by the insulin committee at the University of Toronto.
The unit evolved eventually tothe old insulin unit, where one unit (U) of insulin was set equal to the amount of insulin required to reduce the concentration of in a to 45 / (2.5 /). Once the chemical structure and mass of insulin was known, the unit of insulin was defined by the mass of pure crystalline insulin required to obtain the USP unit.The used in insulin therapy is not part of the (abbreviated SI) which is the modern form of the. Instead the (IU) is defined by the. Potential complications. Main article:In 2006 the U.S.
Approved the use of, the first inhalable insulin. It was withdrawn from the market by its maker as of third quarter 2007, due to lack of acceptance.Inhaled insulin claimed to have similar efficacy to injected insulin, both in terms of controlling glucose levels and blood half-life. Currently, inhaled insulin is short acting and is typically taken before meals; an injection of long-acting insulin at night is often still required. When patients were switched from injected to inhaled insulin, no significant difference was observed in Hb A1c levels over three months. Main article:Another improvement would be a of the pancreas or beta cell to avoid periodic insulin administration. This would result in a self-regulating insulin source. Transplantation of an entire pancreas (as an individual ) is difficult and relatively uncommon.
It is often performed in conjunction with or transplant, although it can be done by itself. It is also possible to do a transplantation of only the pancreatic beta cells. However, islet transplants had been highly experimental for many years, but some researchers in, have developed techniques with a high initial success rate (about 90% in one group). Nearly half of those who got an islet cell transplant were insulin-free one year after the operation; by the end of the second year that number drops to about one in seven.
However, researchers at the University of Illinois at Chicago (UIC) have slightly modified the Edmonton Protocol procedure for islet cell transplantation and achieved insulin independence in diabetes patients with fewer but better-functioning pancreatic islet cells. Longer-term studies are needed to validate whether it improves the rate of insulin-independence.Beta cell transplant may become practical in the near future. Additionally, some researchers have explored the possibility of transplanting non-beta cells to secrete insulin. Clinically testable results are far from realization at this time. Several other non-transplant methods of automatic insulin delivery are being developed in research labs, but none is close to clinical approval.References.
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We may share your information with third-party partners for marketing purposes. To learn more and make choices about data use, visit our. By clicking “Accept and Continue” below, (1) you consent to these activities unless and until you withdraw your consent using our rights request form, and (2) you consent to allow your data to be transferred, processed, and stored in the United States.In people with diabetes, insulin does not work properly or the body does not produce enough of it. A person may have to use supplemental insulin to stay healthy.therapy aims to keep blood sugar levels as close to healthy levels as possible, to prevent symptoms and the risk of complications.The sliding scale is one way of working out how much insulin to take before each meal. Doctors developed it several decades ago as a guide to insulin dosage, but few healthcare professionals now use it.The warn that using only sliding scale insulin for treatment is ineffective for most people. It can increase the risk of both high and low blood sugar and of complications if the person needs surgery.Most doctors advise against using this approach.As long ago as 2001, the author of an article published in described the sliding scale as 'arbitrary,' and a 'historical artifact.' How the sliding scale works.
Sliding scale insulin therapy involves creating and following an individual chart.The sliding scale is a chart of insulin dosages.A doctor creates this chart with the individual. They base it on how the person's body responds to insulin, their daily activity, and a intake that they will agree on.Insulin dosage will vary, depending on two factors:Pre-meal blood glucose level: This usually appears on the left-hand side on the chart, from low to high, with higher doses of insulin toward the bottom of the chart.
The more blood sugar a person has, the more insulin they will need to deal with it.Mealtime: This usually appears along the chart's top row. This row will show breakfast, then lunch, then dinner.Throughout the day, the dose will change. This is because insulin sensitivity — the way the body responds to insulin — can change as the day progresses.The composition of meals can also change through the day, and the doctor may take that into consideration. Find the matching blood glucose value along the chart's left-hand column.3. Slide horizontally along that value's row until they reach the current meal.4. Take a dosage that matches the number where the two values meet.The person should test their blood sugar levels before mealtimes, depending on the type of insulin they use.Different types of insulin work over different periods of time. If a person uses a, they may need to take their insulin 15–30 minutes before a meal.Along with these mealtime rapid-acting doses, people often take a long-acting insulin dose once or twice a day.The aim of this is to set a stable baseline blood glucose level for the body to work around.Blood glucose monitors are available for.
Benefits and disadvantagesThe sliding scale method requires very few daily calculations. People with diabetes may feel more comfortable following a pre-determined plan. However, these factors also make sliding scale treatment very inflexible.
Inflexible routine. The sliding scale needs a regimented diet and exercise program to succeed.Carbohydrates: The person must consume the same number of carbs with each meal because the chart's calculations depend on a single carb value. This number should not change from day to day.Meal timing: The person needs to eat their meals around the same time each day. If not, their insulin sensitivity may not match the ones the chart uses to work out the dosage for a specific meal.Exercise: People should not vary the amount that they exercise much from day to day. Changes in activity and also affect blood glucose levels in a way that the sliding scale cannot account for.However, it is difficult for most people to follow these meal and activity restrictions completely because the scale does not allow for changes in carb intake, the timing of meals, and exercise.As a result, large changes in blood glucose levels can happen throughout the day.Medical professionals also worry that the sliding scale poses a risk of continuous high blood glucose levels.
A published in 2015 found that the use of the sliding scale did not improve glucose control, but it did lead to more frequent high blood sugar, or hyperglycemia. Low blood sugarThe doses that a sliding scale chart requires might also be excessive if a person skips meals or is more sensitive to insulin on a given day.As these doses build up throughout the day, they could lead to a dangerous drop in blood glucose levels. This can rapidly become a life-threatening emergency, leading to and possibly death.A published in 2012 notes that sliding scale insulin therapy can lead to 'poor and erratic control with unpredictable.'
Surgery complicationsHigh blood glucose levels increase the risk of complications during and after general surgery.In 2018, of a report published in Anesthesiology noted that, 'use of a sliding scale insulin alone is not acceptable as the single regimen in patients' around the time of surgery, as it can lead to high or low blood sugar levels. This can result in further complications. AlternativesIn place of the sliding scale model, the ADA recommend other ways of taking insulin. Conventional insulin therapyThis treatment involves injections of the following:Short-term insulin: The person takes 2–3 doses of insulin each day, and they must co-ordinate their meals with the injections' peak activity times.
The doses are the same each day and do not depend on pre-meal blood glucose levels.Long-acting insulin: One dose each day. For this method to be effective, the person must take their meals at the same time each day, or unwanted fluctuations in blood glucose may result.
Insulin pensAlternatively, the person may use an to inject insulin. The pens are adjustable, to allow for different doses.The pen is easier to use than a syringe. It comes as a prefilled or refillable device. This content requires JavaScript to be enabled.7. Diabetes technology: Standards of Medical Care in Diabetes — 2019.
(2019).American Diabetes Association. Standards of medical care in diabetes – 2013.Duggan, E. Perioperative hyperglycemia management: An update.Insulin basics. (2019).Insulin pumps. (2018).Lee, Y. Sliding-scale insulin used for blood glucose control: a meta-analysis of randomized controlled trials.Lorber, D. Sliding scale insulin.McCall.
Insulin therapy and hypoglycemia.