Patient/caregiver was educated on sliding-scale insulin therapy as follows:

  1. In the sliding-scale method, the dose of insulin to be taken is based on your blood sugar level, just before your meal. If the pre-meal blood sugar is high, you take higher dose of insulin.
  2. In this therapy model, blood sugar is taken about four times a day (every four to six hours, before every meal) and the dose of insulin to be taken is based on the blood sugar reading.
  3. Usually, fast acting insulins, such as, Apidra or Humalog or Novolog are given on sliding scale therapy.
  4. Sliding scale therapy always considers the performance of the previous insulin dose, reflected by the pre-meal blood sugar. This method of treatment does not account for insulin needed for the current meal.
  5. As the doses are administered four to six times a day and as fast acting insulins are used usually in this method, doses of insulin can get stacked up, resulting in very low blood sugar readings.
  6. Currently, the popular practice is to give the patient a long acting basal insulin that will control the blood sugars steadily over a period of 24 hours. Along with this, giving rapid acting mealtime insulin along with a correction dose to regulate blood sugar levels after meals will be more effective.