Insulin/Glucose Management Simplified
for Mercy Hospital

Updated May 2011
Author: Frank Altman MD

Description: An easy method of providing intra-op glucose management in insulin dependent, and some oral-agent-managed diabetics.

For Maine Med and Scarborough Surgery Center Protocol, click here

Steps to follow:

  1. Print out 2-page order sheet (linked here)
  2. Mix Regular Insulin in 1000 cc D5 L/R (suggested 20 units/1000 cc).
    Add some KCl (suggested 10-20 Meq) and
    start at 100 cc/ hr (which is 2 units /hr)
  3. Check Glucoscan every hour in OR.
    If glucoscan >200mg%, give Regular Insulin bolus according to  grid on Page 2 of printout.
    If glucoscan <100mg%, decrease infusion to 75 ml/hr.
  4. By the time you get patient to PACU, you will most likely have determined patient's basal insulin requirement (units per hour) in this manner.
  5. Complete Order Sheet (above) for continued management on the floor until patient taking p.o. or transferred to "sliding scale" management.