Non dka insulin protocol

The most common cause is diabetic ketoacidosis. If patient will begin eating give.

- 50 units soluble insulin Actrapid in 495ml 09 sodium chloride - administer at 01 unitskg bodyweighthr intravenously Continue any long acting insulins at normal dose Lantusglargine or Levemirdetemir YES NO YES IDENTIFY TREAT CAUSES - infection often pneumonia or UTI - missed insulin dosespoorly controlled DM.

Non dka insulin protocol. ICU Not for DKA Management Goal. Maintain blood glucose level between 140-180 mgdL. This protocol is NOT to be used for patients in Diabetic Ketoacidosis DKA.

Glucose levels will be evaluated by finger stick testing or blood testing 2. Intravenous Insulin Prescription and Fluid Protocol FOR DIABETIC KETO-ACIDOSIS DKA For use for ALL ADULT over 18 years patients with a diagnosis of DKA NOT FOR USE IN CHILDREN NEVER use an IV syringe to draw up insulin ALWAYS draw up insulin using an insulin syringe ALWAYS continue subcutaneous intermediate or basal insulin Hospital Number. Treat Diabetes Non-DKA Use ED Diabetes Non-DKA order set If hyperglycemia with ketosis BOHB 06 mmolL or MODERATE to LARGE urine ketones in consultation with endocrinologist consider ordering one-time insulin for sick day - dose following Sick Day Management Pathway.

To compare the efficacy and safety of two non-ICU approaches for the care of DKA with that of usual ICU care 2. To compare direct cost related to the management of non-complicated DKA of mild to moderate severity resulting from each of three approaches. General ward protocol with every 2 hour SC insulin aspart.

The genesis of ketone bodies by organisms is a protective mechanism. This metabolic process helps organisms to survive acute metabolic derangements in times of nutrient deficiency. When prolonged ketogenesis leads to ketoacidosis which is a potentially life-threatening metabolic disorder due to the accumulation of keto-acids in the body.

The most common cause is diabetic ketoacidosis. Check insulin dose correct and Consider sepsis Consider re-starting protocol IV therapy Change to sodium chloride 09 glucose 5 with potassium chloride 20 mmol500ml Discuss with Consultant DO NOT STOP INSULIN Clinical signs Assess dehydration Deep sighing respiration Kussmaul Lethargydrowsiness - vomiting Elevated blood glucose 11. - 50 units soluble insulin Actrapid in 495ml 09 sodium chloride - administer at 01 unitskg bodyweighthr intravenously Continue any long acting insulins at normal dose Lantusglargine or Levemirdetemir YES NO YES IDENTIFY TREAT CAUSES - infection often pneumonia or UTI - missed insulin dosespoorly controlled DM.

First dose SQ insulin includes basal insulin bridging dose aspart glulisine lispro or R x 1 1. If patient will begin eating give. Half TDD as basal glargine detemir or NPH Plus Bridging insulin 10 of basal insulin dose Stop IV insulin Continue primary IV.

If patient will continue NPO TPN or tube feeding give. Diabetic ketoacidosis DKA is a complex disordered metabolic state characterised by hyperglycaemia acidosis and ketonaemia. DKA usually occurs as a consequence of absolute or relative insulin deficiency that is accompanied by an increase in counter-regulatory hormones ie glucagon cortisol growth hormone epinephrine.

This type of hormonal. Our insulin treatment protocol. It should not be given until BG is less than 15mmolL and it can be given as a five per cent dextroseglucose infusion.

Insulin therapy for DKA patients. There is no clearly superior protocol for insulin therapy. A general rule is to pick an insulin protocol that suits your practice.

Use of intravenous insulin aspart for treatment of naturally occurring diabetic ketoacidosis in dogs. 26379102 Insulin aspart is a short-acting insulin used as a CRI. 22Ukg into 240mL 09 NaCl later 045 saline with dextrose and start at 10cch same as the regular insulin CRI described by Macintire.

Draw up 50 units human soluble Actrapid insulin in 495mL sodium chloride 09 to give 1 unit mL solution pre-made solution available from pharmacy. Use a non-return device to administer. Commence fixed rate IV insulin at 01 unitkghour based on actual or estimated weight.

The table below can be. Give initial insulin bolus IV Push ONE TIME per Table 1. Insulin should NOT be initiated if serum potassium is less than 35 mEqL TABLE 1.

Round to nearest WHOLE number IV Push ONE TIME 40 91 Initiate Insulin Infusion per Table 2. 100 units Insulin Regular in 100 ml Normal Saline 1 unitmL. IV insulin is the drug of choice for optimal glycemic management in many patients.

Safe administration of IV insulin is a complex task. The Jefferson Hospital Insulin Infusion Protocol JIIP applies to all adult patients requiring IV insulin but ONLY if the JIIP is ordered. RESOLUTION OF DKA Resolution of DKA is defined as pH73 and blood ketones.

If DKA has resolved and the patient is eating and drinking switch to SC insulin refer to TG team or DKA guideline on intranet 2. If DKA has resolved but the patient cannot eat OR has another indication for IV insulin severe sepsisMI-. Diabetic ketoacidosis DKA and hyperosmolar hyperglycemic state HHS also known as hyperosmotic hyperglycemic nonketotic state HHNK are two of the most serious acute complications of diabetes.

They are part of the spectrum of hyperglycemia and each represents an extreme in the spectrum. The median time to normalization of ketoacidosis was 9 hours IQR 5-12 and 9 hours IQR 65-13 for protocol and non-protocol groups respectively p 014. The median duration of IV insulin therapy was 169 hours IQR 137-215 vs.

21 hours IQR 153-26 for protocol and non-protocol groups p 003. 1 Patient can be transitioned off insulin gtt between 9a-12pm o Use. NPH isophane for transition o When can the insulin gtt be stopped.

4 hours AFTER subq NPH insulin administration o Then start mealtime aspart TIDAC and bedtime lantus 2 Patient can be transitioned off insulin gtt between 1p-6pm o Use. Regular insulin to transition.