Table 2.

Summary of Recommendations for the Management of PN-Associated Hyperglycemia

Guideline	Recommendations
ADA Standards of Medical Care in Diabetes—2022 (16)	For patients receiving PN, RHI may be added to the PN bag, particularly if >20 units of correctional insulin were required in the previous 24 hours. A standard dose of 1 unit per 10 g carbohydrate can be used to start, with subsequent daily adjustment. Supplement with correctional SQ insulin every 4–6 hours.
Endocrine Society Clinical Practice Guideline, 2012 (1)	Adding RHI to the PN bag can be a safe and effective option for patients receiving PN. Initial use of separate insulin infusion can help in estimating the TDD.
SHM Glycemic Control Implementation Guide, 2015 (39)	Separate insulin infusion is usually given parenterally along with PN, which allows for accurate dose finding. Then, RHI insulin can be added to subsequent nutrition bags.