Insulin Correctional Scale

Posted on Jul 1, 2021 in Announcements | 0 comments

Glycemic control is important to prevent complications of diabetes, a common chronic condition. Uncontrolled diabetes can lead to fluctuations in blood glucose levels, which can result in unfavorable complications. Insulin correctional scales, which are insulin adjustments based on a set of criteria for insulin sensitive, average, or resistant patients, are strategies to target glycemic control in the setting of fluctuating blood glucose levels. Insulin correctional scales help ensure patients will receive an adequate dose of insulin based on their blood glucose levels. There is an increased risk of hypoglycemia with aggressive insulin strategies. Insulin correctional scales, in combination with long-acting/short-acting insulin, aim to provide adequate insulin coverage and minimize the risk of hypoglycemia.

At ABSMC, insulin correctional scales can be ordered through established ordersets in the EHR. Insulin correctional scale categories include insulin sensitive, average, and resistant scales.

  • Insulin Sensitive Patient (1 unit of Lispro will decrease blood glucose by ~50 mg/dL in ~3-4 hours)
    • Suggested starting point for patients with: BMI < 25, Patients >70 years of age, T1DM, Renal failure patients (CrCL < 30 mL/min), or those requiring <40 units of insulin/day
  • Insulin Average Patient (1 unit of Lispro will decrease blood glucose by ~25-30 mg/dL in ~3-4 hours)
    • Suggested starting point for patients with: BMI > 25, Daily dose of 40-100 units insulin/day
  • Insulin Resistant Patient (1 unit of Lispro will decrease blood glucose by ~16 mg/dL in ~3-4 hours)
    • Suggested starting point for patients with: BMI > 30, Sepsis diagnosis on anti-infective, Systemic steroids, Daily dose > 100 units of insulin/day

Joan Yim, PharmD, BCPS
Pharmacy Manager & Clinical Coordinator
Alta Bates Summit Medical Center – Alta Bates Campus
2450 Ashby Avenue, Berkeley, CA 94705
Office: (510) 204-1503

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