By nzingha Latest Reply 2012-02-18 13:43:34 -0600
Started 2012-02-13 05:04:10 -0600

' i have just seen this…A sliding scale is usually anything over 201 to 250 - 2 units of novolog, 251-300 - 4 units, 301-350- 6 units, 351-400 - 8 units as per my diabetic specialist'.

does this apply to everyone or is it specific to one person. i know or have learnt that with this diabetic disease, there is no one size fits all… but I am curious as to how this sliding scale works and would like to experiment with it. what are your thoughts or your own experiences? Sometimes i believe i'm being overdosed with insulin…!

6 replies

red flower lady
red flower lady 2012-02-18 13:43:34 -0600 Report

No, the scale can be lower then what you wrote depending on what type of insulins you use. Fast acting, regular, 24, hr brand, etc. The scale needs to be for you and your numbers and how you react to your insulin. This is why we need to keep good track of bg, food, amount of meds in order for our drs to make needed adjustments. If you feel like you are taking to much, then ask your dr about it and see if he feels sliding scale is right for you. If you don't like his answers then change drs until you find one you can work with. It is a team effort to control your diabetes, so you have to have drs, nutritionist and so on that you feel good about.

p@trick 2012-02-13 08:58:36 -0600 Report

I use a sliding scale every time my bg are off, and at every meal…because I count carbs. But everyone's body processes food and insulin at different speeds/sensitivies, so it really is something that a healthcare provider would advise you best on.

jayabee52 2012-02-13 08:42:13 -0600 Report

I have never needed to use a sliding scale for my own care, but I was intimately involved with my bride Jem's sliding scales

Actually she had 2 sliding scales one for her Novolog R. and one for Novolin "Aspart". She got these from her Endo not long after he took on her diabetes care. The sliding scales changed over time according to her condition.

One of Jem's "medical challenges" was Lupis (Systemic Lupis Erithramosis — or SLE)
another was Rhumetoid arthritus (RA). There were meds supposededly to help her combat those very painful conditions, but she could not take them. She was allergic to them all. The only medications to which she was not allergic was a cortisone shot, and prednisone. Of course these two medications were steroids and her Blood Glucose (BG) readings skyrocketed when she was on those meds.

She routinely went into 300 + territory when she was on those steroids. All we could do was wean her off the steroids ASAP and then use the sliding scales to bring down her BGs below the 200 mark.

Since she was totally blind I took on the task of reading her BG meter and recording it in her sheet for the month, and then twice a week, emailing the readings to her endo.

Then I drew her insulin up according to the instructions in the sliding scales and what was happening to her BG levels and the time of day. She was to use the Novolog NPH (about 60 U) and if her BG was over 160 (if memory serves) Novolog R the first thing in the morning. I was to draw up a specific amount of R if her BGs were higher than 160, a higher amount of units of R if her BGs were over 200, and the sliding scale stopped at 300 to 350. If her AM BGs were over 350 we were instructed to take her to the ER.

Then her noontime reading she was to use the Novolin Aspart (ultra fast acting). again using the escalating units according to Dr's separate instructions for the Aspart.

What I recall is that Jem's sliding scales were SPECIFIC to her. The Endo calculated what she should be able to take, and when something in her condition changed I was to notify the Endo, and sometimes he'd re-calculate it and give us another different sliding scale.

So you'll need to get an Endo involved in your care to get a sliding scale specific to you. This is not something I'd recommend for you to try on your own.

dubyadd 2012-02-14 05:50:15 -0600 Report

You sure are right on that point jayabee. My Doc calls it self-titrating. I am on it for both my Lantus and Humalog. But the Doc said I was the ONLY patient in the entire clinic she would trust with doing this, due 2 different and fairly complicated adjustments and to the record keeping required. Too many of her patients just can't be bothered she said. Too bad because they are not that hard, but you do have to keep tract and pay attention and test your blood glucose.