To make them look different, put a rubber band around one type of insulin. Every 4 hours and for patients on oral diet, fingersticks should be done every ac and hs therapy. Just want to chime in and say that in my opinion, while it is possible, the amount of work you have to put into it just makes it not worth it. Stepwise dosing and titration of insulin for type 2. Jan 31, 2010 diabetic,started the apidra sliding scale dosages. It starts working after several hours of injecting and works evenly for around 24 hours. You most likely will find some beneficial information in this short article, come have a glance. Injecting lantus insulin glargine injection 100 unitsml. But the fast acting insulins, like humalog or novolog act rapidly to bring blood glucose levels down, which is why they are given based on a sliding scale of what the blood glucose is. Insulin orders for patients with type 2 diabetes order set. Giving yourself an insulin injection with the lantus. Basalbolus versus slidingscale insulin therapy in the acute care hospital setting 4 patient population the sr5 included adult patients with type 1 or type 2 diabetes or newlydiagnosed hyperglycemia, admitted to a noncritical medical or surgical hospital ward, with various. May 01, 2010 in most sliding scale insulin regimens, the physician is only notified of extremes of hypoglycemia i. Sliding scale insulin administration flashcards quizlet.
Hba1c change from baseline was a secondary endpoint. Never share an apidra solostar pen between patients, even if the needle is changed. Dials doses in 1 unit increments and delivers a maximum dose of 80 units per injection. Administer 14 units subcut, notify provider, and repeat poc blood sugar check in 1 hour. Intensive insulin therapy diabetes education online. Lantus contains insulin glargine, an insulin analogue, and has a prolonged duration of action.
Always read the full instruction leaflet before you use the solostar readytouse injection pen for the first time. Lantus is an ultralente long acting analogue insulin the medical name for lantus, insulin glargine, is taken from how the dna of human insulin is modified to form the analogue. Taking insulin or other diabetes medicines is often part of treating diabetes together with healthy food options and exercise, medicine can assist you manage the disease. In most sliding scale insulin therapy regimens, your blood sugar is taken using a glucometer. Eventually the lantus scale is reduced to two rungs, and then possibly to one rung as the cat becomes better regulated. In many hospitals in developing countries, particularly in pakistan, a sliding scale is used to calculate the dose of insulin for the management of diabetes. Sliding scale insulin protocol follow ssi reference text medications medication sentences are per dose. A high blood sugar correction bolus insulin dose to bring your blood sugar back into the target range. Set it at the number of insulin units prescribed by your doctor, or as instructed on your sliding scale. Learn sliding scale insulin with free interactive flashcards.
If you have an acrobat question, ask questions and get help from one of our experts. You may need to monitor your sugars more frequently as directed by your endocrinologist. If changing from a treatment regimen with an intermediate or longacting insulin to lantus or basaglar, a. Similar glycemic control in the 2 treatment groups was desired in order. I took units of lantus yesterday and my blood glucose was 86 mgdl before lunch. We follow either tight regulation tr or start low go slow slgs the details of each can be found in the posts at the top of this forum. If lantus is diluted or mixed, the solution may become cloudy, and the pharmacokinetic pharmacodynamic profile e. Severe hypoglycemia is a lifethreatening emergency.
This type of insulin is often combined, when needed, with rapid or shortacting insulin. While im very much locked in on an insulintocarbohydrate ratio with my novolog, its a bit tricky to judge how much the longerlasting insulins affect your blood glucose. One of the only ways to treat diabetes type 1 and 2 are through insulin injections, like lantus insulin glargine, that help to control blood sugar. Lantus should be administered once daily at any time but at the same time each day. It is released over time and does not result in the instant gratification that is seen with all of the other insulin types. Unfortunately, doctors consistently report low levels of adherence to insulins, lantus. For example, lantus and apidra a rapidacting insulin are both clear medicines in elongated vials or insulin pens that look similar. But first, we need to convert 2000 units into ml we know that the ratio is 1 ml. Prior to initiation of lantus, train patients on proper use and injection technique. Lantus, toujeo insulin glargine dosing, indications. Page 3 18006331610 how to get ready for an injection how to do it what to do 1. Glargine lantus 1 to 2 hours 1 to 2 hours relatively flat relatively flat 12 to 20 hours 20 to 24 hours administered once to twice daily 12 hours apart, can be kept wo refrigeration up to 42 days usually administered once daily mixed multiple preparations nphregular mix humulin 7030 novolin 7030 aspart protamine aspart novolog mix 7030. Apidra insulin glulisine injection, for subcutaneous or.
Learn more about injecting lantus \insulin glargine injection\ 100 unitsml with a vial and syringe in this\r downloadable pdf. A recommended sliding scale is on the back of the nsw adult subcutaneous insulin prescribing chart. Metformin lowers the amount of glucose that your liver makes and helps your body use insulin better. In other words, if you currently take 20 units of a longacting insulin per day, your lantus dosage would be 20 units once daily or 10 units twice daily.
Patients using lantus vials must never reuse or share needles or syringes with another person. Asked 31 jan 2010 by publiceye updated 6 february 2010 topics apidra, diabetes, type 1, diabetes, type 2, metformin. As the nighttime scale only considers the amount of insulin required to drop your blood sugar level back into the target range, it should not be used to cover a bedtime snack. Unfortunately there is a big challenge to using lantus. Solostar quick reference guide for patients using the apidra andor the lantus solostar these instructions are supplied as a guide only. Capitals indicate lifethreatening, underlines indicate most frequent. Select initial sliding scale novolog insulin from the table below. Insulin orders for patients with type 2 diabetes order set action fill in required blanks and check appropriate boxes. If you dialed too many units, turn the dose selector counterclockwise to set the correct number of units. It was even in the american diabetes association ada position statement, crises in. We found that the lantus is running out by pm because its such a small dose, but its working very well. Lantus is a longacting human insulin analog indicated to improve glycemic control in adults and pediatric patients with type 1 diabetes mellitus and in adults with type 2 diabetes mellitus.
I just got an order on a patient who now takes 82 units lantus daily, plus sliding scale humalog. Mild hypoglycemia may be treated by ingestion of oral glucose. Find patient medical information for lantus u100 insulin subcutaneous on webmd including its uses, side effects and safety, interactions, pictures, warnings and user ratings. Do not use this solostar if the insulin is cloudy, colored or has particles.
Lantus glargine or levemir detemir or nph insulin a1c greater than 7% with optimal long acting basal insulin. Basalbolus versus sliding scale insulin therapy in the. In a typical day, between 2028 units multiple times a day. Oncedaily insulin glargine versus 6hour sliding scale regular insulin for control of hyperglycemia after a bariatric surgical procedure. Dec 18, 2014 i took units of lantus yesterday and my blood glucose was 86 mgdl before lunch. Lantus is a long acting insulin and needs to stay at a constant level in the body.
The content on this site is presented in a summary fashion, and is intended to be used for educational and entertainment purposes only. The recommended starting dose of lantus in patients with type 2 diabetes who are not currently treated with insulin is 0. The needle should remain in the skin for at least 10 seconds to ensure complete delivery of the insulin dose the patient should slowly count to 10. Your health professional has decided that solostar is appropriate for you, based on your ability to handle solostar. A bolus insulin dose to cover the sugar or carbohydrate in your food this will be presented as an insulin to carbohydrate ratio i. I been at this 34 years and have never seen a scale for lantus at 71 i might not take much either but we do tend to. If you have any questions, ask your healthcare professional. The lantus dose regimen dose and timing should be individually adjusted.
First, we must stop using slidingscale terminology. Carton of one 10 ml multipledose vial ndc 0088222033. Lantus is not recommended for the treatment of diabetic ketoacidosis. Highlights of prescribing information hyperglycemia or. For patients controlled on lantus insulin glargine, 100 unitsml expect that a higher daily dose of toujeo will be needed to maintain the same level of glycemic control. Choose from 45 different sets of sliding scale insulin flashcards on quizlet. The doc says titrate the lantus dose upward by 24 units q 5 days until fbg is 80160.
In glargines case, glycine and two arginines are part of the genetic recombination that helps to produce the insulin. A metabolism study in humans indicates that insulin glargine is partly metabolized at the carboxyl terminus of the b chain in the subcutaneous depot to form two active metabolites with in vitro lantus prescribing information similar to that of human insulin, m1 21 a glyinsulin and m2 21 a glydes b thrinsulin. Recovery from hypoglycemia may be delayed due to the prolonged effectofsubcutinsulinglargine. Most people with type 2 diabetes start medical treatment with metformin tablets.
Sliding scale regimens may include a bedtime high blood sugar correction. This drug may assist you lose a small amount of weight. Please see the terms and conditions this page was written by scott moses, md. Stepwise dosing and titration of insulin for type 2 diabetes.
Diabetes, type 2 i take lantus solostar pen1012 units. Lantus should be administered once a day at the same time every day. This is done about four times a day every five to six hours, or before meals and at bedtime. So, the box has 5 3 15 ml the doctor wants the pharmacist to dispense 2000 units. Hyperglycemia or hypoglycemia with changes in insulin regimen. Lantus is indicated to improve glycemic control in adults. Pdfadobe acrobat view as html sliding scale methodology dates to diabetes monitoring by urine glucose levels. Check the label on your solostar to make sure you have the correct insulin. If a patient is fasting, specify that the sliding scale is to be given q6h and not before meals.
I often wonder how much of an adjustment two units of lantus is. Chapter 21 adjusting the insulin dosage and thinking scales hours, the evening nph or lantus given at it is important to emphasize that sliding. Lantus insulin glargine injection is supplied as a clear solution containing 100 units per ml u100 of insulin glargine and is available in. Lantus is a longacting insulin that may look like a rapid or shortacting insulin.
I cant imagine your endocrinologist didnt give you one. If changing patients from twicedaily nph insulin to oncedaily lantus, the recommended initial lantus dosage is 80% of the total nph dose that is being discontinued. Oncedaily insulin glargine versus 6hour sliding scale. It is for most folks a 24 hour insulin dose and is not to be used to bring down an elevated bg in a short time period. You will need to calculate a total daily dose if needed. A controlled amount of carbs are provided with meals allowing pc rapidacting insulin analogue based on % meal intake eg. Other oral medicines act in various methods to lower blood glucose levels.
Optiset delivers insulin in increments of 2 units up to a maximum single dose of 40 units. Lantus solostar quick reference manual pdf download. Can lantus be used as a sliding scale with my current insulin of. Switching from intermediatetolongacting insulins to lantus. Is humalog maybe not the right choice if i need such high dosing. Tori marsh, mph, is on the research team at goodrx and is the resident expert on drug pricing and savings. Lantus insulin glargine, a longacting insulin is used for treating type 1 q. Lantus, the recommended initial lantus dose is 80% of the toujeo dose that is being discontinued.
Find out how it works and learn about problems with this diabetes. Continue to repeat 10 units subcut and poc blood until blood glucose is less than 300 mgdl, then resume normal poc blood sugar check and insulin regular sliding scale. Lantus is best given with consistent dosing at 12 hour intervals. Glycemic control in hospitalized patients not in intensive. Shortacting insulin dose humalog novorapid apidra fiasp blood sugar.
The lantus solostar is grey with a lilac injection button. Hi my name is rick type 2 since 2009 i looking for a lantus chart can anyone point me in the right direction. I asked about levimer, but the doc said she found out the same thing that it would run out at such a small dose so we didnt need to switch. Doctors give trusted answers on uses, effects, sideeffects, and cautions. In slidingscale insulin therapy, the dose is based on your blood sugar level. Lantus is not an insulin that you would use a sliding scale or an evening bg reading to help dose. Lantus must not be mixed with any other insulin or diluted with any other solution. Lantus is contraindicated during episodes of hypoglycemia and in patients hypersensitive to insulin glargine or one of its excipients. Mar 01, 2015 the problem with sliding scale insulinthe problem with sliding scale insulin time 0700 break fast 0800 1200 lunch 0 1700 dinner 1800 2100 blood glucose 275 350 400 250 sliding scale 6 units 10 units 12 units 6 units sliding scale insulin treats hyperglycemia with only shortrapid acting insulin without longacting basal insulin. Humalog is usually given on a sliding scale, and a certain amount units of the fast acting humalog is given at each increment of high blood sugars. Lantus is a longacting modified version of human insulin insulin analog used to control blood sugar in patients with type 1 and type 2 diabetes. Guidelines for insulin management for adult diabetics with. One may need to adjust the amount and timing of short or rapidacting insulins and dosages of any oral antidiabetic drugs. Sharing poses a risk for transmission of bloodborne pathogens.
The adobe acrobat user community is a global resource for users of acrobat and pdf, with free eseminars, tips, tutorials, videos and discussion forums. Lantus insulin glargine injection for subcutaneous. This dosage reduction will lower the likelihood of hypoglycemia see warnings and precautions 5. Cho tells you how many grams of carbohydrate can be covered by one unit of rapid acting insulin. When using a sliding scale, eat the same amount of carbohydrate at each meal. This dose reduction will lower the likelihood of hypoglycemia see warnings and precautions 5. Lantus insulin glargine dose, indications, adverse. Talk with your health professional about proper injection technique before using solostar. Dosing lantus insulin glargine injection 100 unitsml.
This page was last revised on 111220 and last published on 532020. Help need dosing sliding scale for,lantus feline diabetes. But if this is something you really must have, feel free to contact me privately and we can discuss it further. Before you get started insulin glargine lantus insulin. Lantus basalpr egimen indications and usage for lantus lantus is a longacting insulin analog indicated to improve glycemic control in adults and children 6 years and older with type 1 diabetes mellitus and in adults with type 2 diabetes mellitus. Basalbolus vs sliding scale insulin in the hospital rk. Administer 14 units subcut, notify provider, and repeat poc blood sugar check in 30 minutes. Quizlet flashcards, activities and games help you improve your grades. The following information is not intended to endorse any particular medication. It is not intended to be and should not be interpreted as medical advice or a diagnosis of any health or fitness problem, condition or disease.
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