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Updated: Jun 16, 2026
12:08
Improving IV Insulin Administration in a Community Hospital
Published on: June 11, 2012
Tight glycaemic control: clinical implementation of protocols.
Frank Nobels1, Patrick Lecomte, Natascha Deprez
1Department of Endocrinology, Onze-Lieve-Vrouw Hospital, Moorselbaan 164, 9300 Aalst, Belgium. frank.nobels@olvz-aalst.be
Best Practice & Research. Clinical Anaesthesiology
|January 30, 2010
Summary
Managing blood glucose in hospitalized patients is complex. This guide provides anesthesiologists with a practical algorithm for intravenous insulin and strategies for subcutaneous insulin, fasting, and discharge, enhancing patient safety.
Area of Science:
- Endocrinology
- Anesthesiology
- Hospital Medicine
Background:
- Tight glycemic control in hospitalized patients is challenging due to numerous interfering factors and multidisciplinary involvement.
- Existing literature offers limited practical guidance for managing inpatient blood glucose levels effectively.
- Anesthesiologists require clear direction for organizing blood glucose control in acute, perioperative, and intensive care unit settings.
Purpose of the Study:
- To provide clinical anesthesiologists with practical guidance for inpatient blood glucose management.
- To present an effective, safe, and user-friendly algorithm for intravenous insulin administration.
- To offer advice on subcutaneous insulin use, fasting protocols, and transition to discharge care.
Main Methods:
- Development of a standardized algorithm for intravenous insulin administration.
- Inclusion of practical recommendations for subcutaneous basal-bolus insulin therapy.
- Discussion of essential safety considerations for inpatient glycemic management.
Main Results:
- A user-friendly intravenous insulin algorithm is presented, executable by regular nurses across various clinical situations.
- Practical strategies for optimizing subcutaneous insulin use and managing fasting orders are detailed.
- Key safety considerations for implementing tight glycemic control are highlighted.
Conclusions:
- The proposed algorithm and practical guidance facilitate effective and safe inpatient blood glucose management.
- This approach empowers regular nursing staff to administer intravenous insulin accurately.
- Comprehensive strategies support seamless transition of care, from acute settings to discharge.
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