Things to understand about insulin: Insulin is usually prescribed for a client who makes no insulin on his/her own, or makes insulin but is insulin resistant meaning it takes much more insulin to maintain a normal blood sugar. Insulin is prescribed in two ways:

Routine insulin dose is prescribed by the doctor based on body weight of the client and is usually divided into two doses (half in am half in pm) or (a 2/3 in am 1/3 in pm) regimen. Typically this is a intermediate or long acting type of insulin by itself or with a small amount of rapid or short acting insulin added. This should maintain their blood sugar in a normal range. If a patient is currently NPO or will definitely not be eating soon (actively vomiting) hold and get further direction.

Routine doses of Lantus insulin are given at bedtime. This type of insulin has a steady effect for 24 hours. It is likely to be held when the patient is NPO after midnight

Sliding scale Insulin is given on a particular schedule based on the patient's fingerstick blood sugar in addition to routine insulin. The blood sugar is checked on a particular schedule most commonly AC & HS. Depending on the blood sugar you will give a certain amount of insulin. It is always a rapid or short term acting insulin (Regular or Lispro insulin) and is prescribed usually for three reasons: to enhance the already prescribed long acting insulin, to provide temporary short term coverage for a diabetic client (helps the MD to establish trends), or to provide a non-diabetic with coverage for elevated blood sugars related to other conditions (i.e. steroids, TPN). With TPN the sliding scale may be Q 6 hours because they are receiving it around the clock at a steady rate and are usually not having meals.

Insulin administration should always be discussed with the primary nurse before giving. In fact most facilities require that two licensed people verify insulin dosages, which could be your instructor and the nurse. The instructor and primary nurse should be in agreement before you proceed.