Description

Welcome to Qstream - Basics of blood glucose levels and insulin.

The NSW Diabetes Taskforce has developed a capability program for junior medical officers and nursing staff. The program is aimed towards staff responsible for the care of people with diabetes in hospital, in particular, those requiring insulin.

A certificate is issued on completion.

Objectives

• Calculate the dosage of basal and bolus insulin for a patient who is started on insulin in hospital.
• Use the NSW Adult Subcutaneous Insulin Prescribing Chart (the chart) to prescribe or administer insulin for a patient who is in hospital.
• Describe the steps to take when managing hyperglycaemia.
  • Review glucose levels over past few days.
  • Review current diabetes medications.
  • Review any contributing medications e.g. glucocorticoids.
  • Review how much supplemental (booster) insulin has been given.
  • Use the amount of supplemental (booster) insulin administered in the previous 24 hours to adjust regular insulin dose(s).
  • Assess preceding dose of insulin for any adjustment due to time of glucose excursion and adjust appropriate insulin dose.
• Describe the safety aspects of using the chart.
  • Do not write ‘U’ as an abbreviation for units (it is pre-printed) as it may be misread as a zero resulting in a 10-fold dosing error.
  • Be careful of similar sounding insulin brands, noting the correct one (Common prefixes: Novo-, Hum-).
  • Be aware of different pre-mixed insulin formulations and charting the correct mix e.g. Humalog Mix25, Humalog Mix50.
• Describe which type of insulin to adjust when:
  • fasting glucose is out of range
  • before evening meal glucose is out of range
  • bed time glucose is out of range.

Audience

This training program is designed for all nurses and junior medical officers and may qualify for up to 0.5 hrs of Continuous Professional Development