Appendix 5 Table 1 Appropriate action depending on blood glucose level
Test | Blood glucose result (mg/dl) | Action |
|---|---|---|
A: Measure blood glucose on entry to ICU | >220 | Start insulin at a dose of 2–4 IU/h. Continue as per test B |
|  | 220–110 | Start insulin at a dose of 1–2 IU/h. Continue as per test B |
| Â | <110 | Do not start insulin but continue blood glucose monitoring every 4 h. Continue as per test A |
B: Measure glucose every 1–2 h until in normal range | >140 | Increase insulin dose by 1–2 IU/h |
|  | 110–140 | Increase insulin dose by 0.5–1 IU/h |
|  | Approaching normal range | Adjust insulin dose by 0.1–0.5 IU/h. Continue as per test C |
C: Measure glucose every 4 h | Approaching normal range | Adjust insulin dose by 0.1–0.5 IU/h |
| Â | Normal | Leave insulin dose unchanged |
|  | Falling steeply | Reduce insulin dose by half and check every 1–2 h |
|  | 60–80 | Reduce insulin dose and check blood glucose within 1 h |
|  | 40–60 | Stop insulin infusion, assure adequate baseline glucose intake and check blood glucose within 1 h |
| Â | <40 | Stop insulin infusion, assure adequate baseline glucose intake, administer glucose per 10 g IV boluses and check blood glucose within 1 h |