Insulin Sliding Scale
All About The Insulin Sliding Scale
The insulin sliding scale method is a controversial way for diabetes patients to help control their blood glucose levels. Many doctors have been against this method for quite a long time. They believe that this is an older and inaccurate way to control the glucose levels, and that it has been buried in the techniques of the past. They feel that it does not have a place in today's contemporary treatment methods.
The reason many are against this old method is that it seems to “chase” the blood glucose levels, rather than managing them. A person's dosage of insulin is not reactive, but rather proactive, in its nature. Although the insulin sliding scale was once the main treatment measurement method, there are now many more modern means available to maintain proper blood glucose levels.
So far, there has not been much evidence provided that says this practice is wrong, but to many doctors, it simply doesn't make sense anymore. The same control level can be achieved now by the use of basal insulin for the shorter procedures, and IV insulin for procedures that are more prolonged
Patients in hospitals are often put on the insulin sliding scale method, staff believe, just so that the consulting physician doesn't have to be bothered with making constant adjustments to insulin levels. If they use the scale, then the nurse will be making the necessary adjustments. The method is easy to use, but its usage sometimes leads to patient deterioration.
Many affiliates of proper nursing care believe that insulin sliding scale therapy is designed to stabilize someone's serum glucose levels, instead of treating an increase that has already occurred. Using the sliding scale creates more of a risk of valleys and peaks in the blood glucose level, so it's not proper to use as the only form of insulin therapy. A sliding scale approach can bring down a high glucose level, but it does it slowly, and can result in hypoglycemia.
The American Diabetes Association has recommended that any patient's glucose level in the blood should be no higher than 180 when tested two hours after a meal. They believe that insulin therapy should utilize long-acting insulin as the main course of treatment, supplemented by quick-acting insulin for coverage at meal times. They advise to only use the insulin sliding scale as a supplemental therapy, only when the patient needs to correct acute hyperglycemia.
To make the correct dose adjustments, it is necessary to focus on trends in blood glucose, and identify any patterns that emerge. Then you can adjust insulin doses to counter the trends, and to allow for tighter control of glycemic levels.
IV insulin is another option when diabetes patients are hospitalized. High glucose can be quickly treated and the IV medication provides a predictable and consistent insulin level. This is much more effective, and healthier for the patient, than using the insulin sliding scale method.