Glucose Level
The blood glucose level at which hyperglycemia is defined in hospitalized patients
140 mg/dL
The starting weight-based basal insulin dose in patients with A1C < 8%
0.1-0.2 units/kg
The key feature that distinguishes diabetic ketoacidosis (DKA) from hyperosmolar hyperglycemic syndrome (HHS)
Ketonuria and/or ketonemia
The way to convert from NPH insulin twice daily to insulin glargine
Reduction of daily dose by 20% given once daily
In hospitalized patients, the glucose level where the treatment for hyperglycemia is warranted
180 mg/dL
The starting weight-based basal insulin dose in patients with A1C > 8%
0.2-0.3 units/kg
The dose of insulin for treatment of DKA or HHS
IV bolus of regular insulin (0.1 units/kg body weight) followed within 5 minutes by a continuous infusion of regular insulin of 0.1 units/kg/hour (equivalent to 7 units/hour in a 70-kg patient)
The way to change premixed insulin 70/30 to glargine/aspart regimen
Glargine: 40% of TDD; Aspart: 60% of TDD TID
According to the 2018 American Diabetes Association's (ADA's) "Standards of Medical Care in Diabetes", target glucose level for hospitalized patients in the intensive care unit (ICU)
140-180 mg/dL
The weight-based total daily dose (TDD) when using prandial insulin
0.3-0.5 units/kg (50% basal; 50% prandial)
What should be done if serum potassium drops below 3.3 mEq/L in DKA?
Hold insulin and give 20 to 40 mEq potassium/hour until K > 3.3 mEq/L
The insulin which can be used in place of U-500 regular insulin in hospitalized patients that most closely mimics U-500
U-100 NPH insulin
According to the 2015 American Association of Clinical Endocrinologists (AACE) clinical practice guidelines (CPGs) for developing a diabetes mellitus (DM), the target glucose level for general medicine and surgery patients in non-ICU settings
Pre-meal: <140 mg/dL; Random: <180 mg/dL
The dose of correctional insulin (sliding scale) for blood glucose 150 mg/dL
Graded scale of 1 - 4 units for each increment of 50 mg/dL based on insulin sensitivity
What should be done when serum glucose reaches 200 mg/dL in DKA or 250 to 300 mg/dL in HHS?
Change IV fluids to 5% dextrose with 0.45% NaCl at 150 to 250 mL/hour
The way you calculate the U-500 insulin dose when using a U-100 insulin syringe
Divide prescribed Dose (actual units) by 5 = Unit markings in a U-100 insulin syringe
According to the 2018 ADA guidelines, the target glucose range for the perioperative period
80-180 mg/dL
The weight-based TDD of insulin in a pregnant patient during the 2nd trimester
0.8 units/kg
What 4 monitoring parameters indicate it is appropriate to switch from IV insulin infusion to subcutaneous insulin in DKA?
Blood glucose is <200 mg/dL
Serum anion gap <12 mEq/L
Serum bicarbonate ≥15 mEq/L
Venous pH >7.30
The time after administering Lantus before you can discontinue IV insulin infusion when switching to subcutaneous from IV insulin and the time after administering Lantus and rapid acting insulin that an IV insulin infusion can be discontinued.
If Lantus + rapid or regular: 60 mins after first dose; if only Lantus: 4 hours after dose