Many diabetics require the use of subcutaneous insulin therapy to regulate elevated blood glucose. Tight blood glucose control may lower the risk of complications associated with diabetes in both acute inpatient hospital stays and the outpatient clinical setting. Many types of insulin regimens are available to control blood glucose and you should work with a qualified health care provider to create a regimen that is individualized to you. When appropriate, sliding scale insulin may be included in the dosing schedule.
Insulin
Insulin is a hormone that is normally produced by the pancreas in response to elevated blood glucose levels. Cells and tissues respond to insulin by absorbing glucose from the bloodstream for use as energy. Diabetes is a metabolic disorder that is typically caused by either low insulin production or poor insulin sensitivity by cells and tissues. In either case, glucose accumulates within the bloodstream. Many diabetics may require the use of insulin therapy through subcutaneous injections to maintain blood glucose control.
Rapid and Short Acting Insulins
There are many types of insulins, each with unique properties that include onset and duration of action. Rapid and short-acting insulins are designed to produce insulin levels that are seen in normal healthy individuals after they consume a meal. These insulins have a quick onset and produce definitive peak insulin levels. In addition, they have a very short duration of action, lasting only a few hours. Rapid acting insulin includes insulin lispro and insulin aspart. Short-acting insulin usually consists of insulin regular.
Sliding Scale Insulin
In certain situations, sliding scale insulin may be used as part of an insulin dosing regimen. Appropriate situations in which sliding scale insulin may be considered include inpatient hospital settings where blood glucose is regularly monitored. In rare cases, patients who are determined to be medically competent and have received training from their health care provider can monitor their blood sugars and administer insulin based on a sliding scale at home. Sliding scale insulin is generally defined as a dosing schedule that is based on a particular blood sugar value or range of values. The insulin dose to be administered becomes greater when blood sugar readings are higher. Each sliding scale needs to be tailored to the individual, as each patient has unique circumstances and different insulin requirements.
Significance
Scale insulin is typically calibrated based on blood glucose readings immediately before meals and/or at bedtime. Rapid and short-acting insulins are generally the types of insulin that are used in a sliding scale regimen. Sliding scale insulin may be used alone or in conjunction with scheduled insulin doses. Since sliding scale insulin carries the risk of inappropriate dosing and hypoglycemia, it should only be used in situations where blood glucose can be closely monitored and the person administrating insulin has been properly trained on the use of sliding scale. Sliding scale insulin is not to be confused with carb-counting regimens in which the insulin dose is based on the carbohydrate content of a meal rather than a blood sugar reading. You should speak with a physician if you have any concerns regarding the use of sliding scale insulin.
