INSULIN
Standard Prescription
Type 1 Diabetes:
Insulin {type}__ units (___ units / kg) __ frequency SC
Diabetic Ketoacidosis:
Regular Insulin __ units/kg/hr IV
Hyperkalemia:
Regular Insulin __ units/kg/ with dextrose __% __ml IV over __ minsDosages
Type 1 Diabetes:
Given subcutaneous in divided doses, as a combination of basal and bolus insulins. Dosage is individualized based on degree of blood glucose control.
Usual initial dose: 0.2 - 0.6 unit/kg/day.
Usual maintenance dose: 0.5 - 1 unit/kg/day.
Diabetic Ketoacidosis: Regular insulin 0.05-0.1 unit/kg/hr.
Given subcutaneous in divided doses, as a combination of basal and bolus insulins. Dosage is individualized based on degree of blood glucose control.
Usual initial dose: 0.2 - 0.6 unit/kg/day.
Usual maintenance dose: 0.5 - 1 unit/kg/day.
Diabetic Ketoacidosis: Regular insulin 0.05-0.1 unit/kg/hr.
Hyperkalemia: Regular insulin 0.1 unit/kg/dose (maximum 10 Units/dose) IV over 30 minutes (given with dextrose 0.5 grams/kg/dose (5 mL/kg of dextrose 10%); maximum 25 grams/dose of dextrose)
** see Forms Supplied for Insulin types **
Mechanism of Action
Analogue of Human Insulin, a peptide hormone produced by beta cells of the pancreatic islet cells, that promotes absorption of glucose from the blood into cells, lowering blood sugar. It stimulates sodium-potassium ATPase, shifting potassium into cells and lowering serum potassium.
Forms Supplied
BOLUS INSULINS (very rapid to rapid acting)
Insulin aspart (NOVORAPID); onset: 0.25-0.5 hours; administered: Pre-meals.
Insulin lispro (HUMALOG, ADMELOG (non-formulary)); onset: 0.25-0.5 hours; administered: Pre-meals.
Insulin glulisine (APIDRA); onset: 0.25-0.5 hours; administered: Pre-meals,
Insulin regular (HUMULIN-R, NOVOLIN-ge, TORONTO); onset: 0.5-1 hours; administered: Pre-meals.
BASAL INSULINS (intermediate to long acting)
Insulin NPH (isophane) (HUMULIN-N, NOVOLIN-ge, NPH); onset: 1-2 hours; administered: HS or BID.
Insulin glargine (BASAGLAR, LANTUS (non-formulary), TOUJEO (non-formulary)); onset: 3-4 hours; administered: Once daily.
Insulin NPH (isophane) (HUMULIN-N, NOVOLIN-ge, NPH); onset: 1-2 hours; administered: HS or BID.
Insulin glargine (BASAGLAR, LANTUS (non-formulary), TOUJEO (non-formulary)); onset: 3-4 hours; administered: Once daily.
Insulin detemir (LEVEMIR); onset: 3-4 hours; administered: Once daily or BID.
Insulin degludec (TRESIBA (non-formulary)); onset: 1-4 hours; administered: Once daily
**different types/ brands of insulin are not interchangeable
Comments
Only insulin regular is to be given intravenously.
Refer to BCCH Diabetic Ketoacidosis Protocol Toolkit.
Lipohypertrophy or -dystrophy may occur at subcutaneous injection sites. Injection sites should be routinely rotated.
monitor glucose levels closely. When treating hyperkalemia, consider checking blood glucose Q30-60 minutes.
Refer to BCCH Diabetic Ketoacidosis Protocol Toolkit.
Lipohypertrophy or -dystrophy may occur at subcutaneous injection sites. Injection sites should be routinely rotated.
monitor glucose levels closely. When treating hyperkalemia, consider checking blood glucose Q30-60 minutes.
References
44, 353, 354
Last Edited
2022-07-03 18:43:56