LEC 7: Insulin Order Sets

Question 1

Basal Insulin

Answer 1

Maintains normal glucose levels even when not eating. Insulin required to prevent unchecked high glucose levels.

• Long-acting or intermediate acting insulin
• Given once or twice daily

Question 2

What kind of insulin must insulin deficient patient always have?

Answer 2

Insulin deficient patients must always have basal insulin even when NPO; they should never receive only correction insulin

Question 3

What does basal insulin do?

Answer 3

Mimics the function of pancreas

Question 4

Prandial Insulin (Bolus/ Mealtime)

Answer 4

• Rapid-acting insulin given with meals or short-acting insulin given 30 minutes prior
• Given in anticipation of the spike in blood glucose due to ingestion of carbohydrate by eating or tube feed boluses
• Scheduled dose not dependent on BGM before meals

Question 5

What is prandial insulin given?

Answer 5

Given in anticipation of the spike in blood glucose due to ingestion of carbohydrate by eating or tube feed boluses

Question 6

Correction Insulin

Answer 6

Rapid or short-acting insulin used when blood glucose levels above target range

• May be added to prandial dose
• May be used as a sole insulin for newly diagnosed diabetics as a dose finding strategy
• Correction insulin is the same product as prandial
• Combine prandial and correction doses so patient receive only on injection

Question 7

When is correction insulin used?

Answer 7

Used in new diabetics as a guide to determine how much insulin is required

Question 8

Is the patients weight important when administering insulin?

Answer 8

The patient’s weight is important

Question 9

What do you want to do if blood glucose is grater then 22 mmol/L?

Answer 9

Want to call the physician if blood glucose is greater then 22 mmol/L

Question 10

When do you want to treat mild/ moderate hypoglycaemia?

Answer 10

Treat is blood glucose is less than 4-5 mmol/L

Question 11

What do you need to do to treat mild to moderate hypoglycaemia?

Answer 11

1. 1/ 4 tablets of glucose, 4 gram chewable or 3 tsp of sugar dissolved in water
   - No long treat with apple or orange juice
2. For tube fed patients, warm sugare (3 tsp on 120 mls of warm water)
3. Repeat every 15 minutes until GGM is greater than 4 mmol/L

Question 12

When do you want to treat severe hypoglycaemia?

Answer 12

Treat is blood glucose is less than 2.8 mmol/L

Question 13

What do you need to do to treat severe hypoglycaemia?

Answer 13

• 5 tables of glucose, 4gm chewable or 4 tsp of sugar dissolved in water
• Any episode or severe hypoglycaemia should prompt physician review of insulin, diet parental nutriotn, or tube feeding before next insulin dose

Question 14

Where do you document BGM or insulin administration?

Answer 14

On the BGM and Insulin administration record

- NEVER on the MAR