Dosing Insulin in Sick Adult Diabetic with Hyperglycemia

 

Target blood glucose: 300 mg/dL

 

Insulin to add: rapid-acting or regular insulin

 

Parameters:

(1) body weight

(2) ketones in urine

 

Parameter	Finding	Points
body weight	lean	0
	obese	1
ketones in urine	none	0
	trace or small amount	0
	moderate or large amount	1

 

insulin adjustment factor =

= SUM(points for 2 parameters) + 1

 

additional insulin units =

= 4 * (insulin adjustment factor)

 

Interpretation:

• The dose of additional insulin ranges from 4 to 12 units.

• The patient should also maintain a high intake of non-glucose containing fluids.

• The blood glucose should be monitored every 3 to 4 hours to determine the effectiveness of the therapy.

• The patient will need to contact his or her healthcare provider if unable to control the hyperglycemia, ketosis progresses or significant dehydration develops.