Q The setting of parameters for control of hyperglycemia seems random. Is there a specific sliding scale for insuling drip or intermittent injection? Also, are there any recommendations for frequency of monitoring with either of these therapies?

A Denise Buonocore, MSN, ACNP-BC, CCRN, replies:

Evidence shows that tight glycemic control is of benefit in patients in the hospital setting. The parameters for control of hyperglycemia in the hospital setting have been outlined by 2 organizations, the American College of Endocrinology (ACE) and the American Diabetes Association (ADA). The current recommendation from the ADA for critically ill patients is that blood glucose levels should be kept as close to 110 mg/dL as possible and always lower than 180 mg/dL. These patients will usually require intravenous insulin. In noncritically ill patients premeal blood glucose levels should be kept as close to between 90 and 130 mg/dL...

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