Novolog sliding scale question & dr update

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Novolog sliding scale question & dr update


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Old 06-15-2010, 04:52   #1
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Location: Dallas, TX USA
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Unhappy Novolog sliding scale question & dr update

Well, let's see. I talked to my doctor again today (no surprise, he calls me every day, getting a bit annoying actually). He put me on a sliding scale for the insulin as follows:

BGL up to 200 - no insulin
BGL 200 to 300 - 2 units
BGL 300 to 400 - 8 units
BGL 400 to 550 - 15 units
BGL 550 and above - go directly to the ER, do not pass GO, do not collect $200 (even though that would help with my copay at the ER).

Now my question is, I am looking at a Novolog standardized sliding scale and it conflicts greatly. It says it should be:

BGL to 60 - initiate hypoglycemia protocol
61 to 150 - no insulin
151 to 200 - 3 units
201 to 250 - 5 units
251 to 300 - 8 units
301 to 350 - 10 units
351 to 400 - 12 units
401 and above - 15 units & call DR.

I used the 8 units as prescribed by dr today and my sugar levels haven't moved. Ok, that's not true, they went up 30 points, then down 7. He also diagnosed me with type 1 diabetes, when originally it was believed I was type 2. Can diabetes change like that? I had been so excited earlier today when I took my BGL after breakfast this morning and it was 163. After lunch it was back to 367. I just can't seem to get my numbers steady. It's so frustrating too, since I have a job interview on Wednesday that I think I have an excellent chance at getting and just feel like something the dog dragged in.

Also, I have been forewarned that if I continue to not improve & can't start eating, that I will be hospitalized. He is now very worried about complications, since it has been SO long with my sugar levels above 300 and refusing to budge.

So that was my Monday. Lovely, wasn't it? At least the weather was nice here!

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Rechelle

Diagnosed:
Pre Diabetic March 2007
Diabetic May 2010

Meds:
NovoLog sliding scale
NovoLog Mix 70/30 70mg/day
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Old 06-15-2010, 05:02   #2
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Location: Ohio, USA
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Quote:
Originally Posted by dallasrechelle View Post
Well, let's see. I talked to my doctor again today (no surprise, he calls me every day, getting a bit annoying actually). He put me on a sliding scale for the insulin as follows:

BGL up to 200 - no insulin
BGL 200 to 300 - 2 units
BGL 300 to 400 - 8 units
BGL 400 to 550 - 15 units
BGL 550 and above - go directly to the ER, do not pass GO, do not collect $200 (even though that would help with my copay at the ER).

Now my question is, I am looking at a Novolog standardized sliding scale and it conflicts greatly. It says it should be:

BGL to 60 - initiate hypoglycemia protocol
61 to 150 - no insulin
151 to 200 - 3 units
201 to 250 - 5 units
251 to 300 - 8 units
301 to 350 - 10 units
351 to 400 - 12 units
401 and above - 15 units & call DR.

I used the 8 units as prescribed by dr today and my sugar levels haven't moved. Ok, that's not true, they went up 30 points, then down 7. He also diagnosed me with type 1 diabetes, when originally it was believed I was type 2. Can diabetes change like that? I had been so excited earlier today when I took my BGL after breakfast this morning and it was 163. After lunch it was back to 367. I just can't seem to get my numbers steady. It's so frustrating too, since I have a job interview on Wednesday that I think I have an excellent chance at getting and just feel like something the dog dragged in.

Also, I have been forewarned that if I continue to not improve & can't start eating, that I will be hospitalized. He is now very worried about complications, since it has been SO long with my sugar levels above 300 and refusing to budge.

So that was my Monday. Lovely, wasn't it? At least the weather was nice here!
I never liked a sliding scale, it just is not personalized enough. But now that you are T1, that changes alot in my opinion. If you are type 1, you really need to count carbs and take into account what your pre-meal blood sugar is. I would just stick to the endo's schedule for now. Hopefully, a T1 will come along and help you out. Hang in there, this has to be very stressful for you.

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Breezeonby {Female}
Medications: Metformin ER, Lantus, Novolog
Zofran for Gastroparesis
Gabapentin-Neuropathy
Zocor 40MG, Fish Oil 4000MG
A1C/5.2% April 14, 2010
A1C/5.5% June 1, 2010
A1C/5.2% October 6, 2010
A1C/5.0% February 7, 2011
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