Insulin drip to subcutaneous transition
Converts a stable insulin infusion to basal (and mealtime) subcutaneous insulin.
Inputs
2 of 3units/h
Conversion
Eating
When to use
- Stable glucose on an insulin infusion and ready to transition.
Pearls and pitfalls
- Give the first basal dose 2 hours before stopping the infusion (DKA consensus).
- Use the last 6 to 8 hours of stable rates, not the peak.
- Patients on dextrose or steroids may need different splits.
Why use
Prevents rebound hyperglycemia and ketosis at the transition.
24-h requirement = average rate (last 6–8 h) × 24; total daily dose = 60–80% of it; basal = 50% (or 80% if not eating)