Aidan at 18:53, 19 October 2021

2021-10-19T18:53:55Z

← Older revision		Revision as of 18:53, 19 October 2021
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	== Gestational diabetes nomogram ==		== Gestational diabetes nomogram ==

			{\| class="wikitable"
	{\|
	! CBG		! CBG
	! Insulin Dose		! Insulin Dose
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	== Low dose nomogram (less than 40 u/d) ==		== Low dose nomogram (less than 40 u/d) ==

			{\| class="wikitable"
	{\|
	! CBG		! CBG
	! Insulin Dose		! Insulin Dose
Line 105:		Line 105:
	== High dose nomogram (greater than or equal to 60 u/d) ==		== High dose nomogram (greater than or equal to 60 u/d) ==

			{\| class="wikitable"
	{\|
	! CBG		! CBG
	! Insulin Dose		! Insulin Dose

Maintenance script: Imported from text file

2020-07-04T01:17:50Z

Imported from text file

New page

== IV insulin ==

* Monitor CBG q1h
* IV insulin
** Mix 25u Humulin R in 250 mL D5W
** D5W IV 50mL/h while on insulin IV
** if CBG > 7 x2h, notify Endo

== Gestational diabetes nomogram ==

{|
! CBG
! Insulin Dose
! Infusion Rate
|-
| Less than 3.8
| 0 and follow
| 0 and follow
|-
|
| hypoglycemia protocol
| hypoglycemia protocol
|-
| 3.8-6.9
| 0
| 0
|-
| 7-8.9
| 0.5
| 5
|-
| 9-10.9
| 0.7
| 7
|-
| 11 or greater
| 1 and notify Endo
| 10 and notify Endo
|}

== Low dose nomogram (less than 40 u/d) ==

{|
! CBG
! Insulin Dose
! Infusion Rate
|-
| Less than 3.8
| 0 and follow
| 0 and follow
|-
|
| hypoglycemia protocol
| hypoglycemia protocol
|-
| 3.8-6.9
| 0.5
| 5
|-
| 7-8.9
| 1
| 10
|-
| 9-10.9
| 1.5
| 15
|-
| 11 or greater
| 2 and notify Endo
| 20 and notify Endo
|}

== Medium dose nomogram (40-59 u/d) ==

{|
! CBG
! Insulin Dose
! Infusion Rate
|-
| Less than 3.8
| 0 and follow
| 0 and follow
|-
|
| hypoglycemia protocol
| hypoglycemia protocol
|-
| 3.8-6.9
| 1
| 10
|-
| 7.0-8.9
| 1.5
| 15
|-
| 9-10.9
| 2
| 20
|-
| 11 or greater
| 2.5 and notify Endo
| 25 and notify Endo
|}

== High dose nomogram (greater than or equal to 60 u/d) ==

{|
! CBG
! Insulin Dose
! Infusion Rate
|-
| Less than 3.8
| 0 and follow
| 0 and follow
|-
|
| hypoglycemia protocol
| hypoglycemia protocol
|-
| 3.8-6.9
| 1.5
| 15
|-
| 7-8.9
| 2
| 20
|-
| 9-10.9
| 2.5
| 25
|-
| 11 or greater
| 3 and notify Endo
| 30 and notify Endo
|}

== Hypoglycemia orders ==

* CBG 2.2-3.7
** Suspend insulin
** 175mL juice or add 25mL D50W to a 50mL D5W bag and give immediately (total volume 75mL)
** Check CBG in 15 minutes, notify Endo if still low
** When CBG ≥3.8, restart nomogram
* CBG < 2.2
** Suspend insulin
** Give 175mL juice or add 50mL D50W to a 50mL D5W bag and give immediately (total volume 100mL)
** Notify Endo
** When CBG ≥3.8, restart nomogram

== Post-procedure ==

* Continue IV insulin
* Once eating, start SC insulin
* Stop IV insulin and D5W 1h after first dose of SC short-acting insulin OR 4h after first dose of SC long-acting

[[Category:Perioperative medicine]]
[[Category:Endocrinology]]

Perioperative insulin management - Revision history

Aidan at 18:53, 19 October 2021

Maintenance script: Imported from text file