Blood Glucose (mg/dl)	Action
Less than 50	Stop Insulin If not alert or if NPO, give 15 ml of D50W IV and if <40 give, 25 ml of D50W IV If alert and taking PO, give 8 oz of juice PO or 6 glucose tablets PO Recheck BG every 30 min until greater than 80 mg/dl If next BG is < 50 mg/dl, double amount of previous treatment, and if next BG is 50–65 mg/dl, repeat treatment When BG is greater than 90 mg/dl, restart insulin rate at 50% of previous rate and recheck BG in 30 min
50 to 64	Stop Insulin If previous BG greater than 100 mg/dl or if symptomatic from hypoglycemia. If NPO, give 15 ml of D50W IV or if taking PO, give 4–6 oz of juice or 3 glucose tablets PO Recheck BG every 30 min until greater than 80 mg/dl If next BG remains 50–64 mg/dl, repeat previous treatment When BG greater than 90 mg/dl, restart insulin rate at 50% of previous rate and recheck BG in 30 min
65 to 79	If greater than last test, decrease rate by 0.2 IU/h If lower than last BG by more than 30 mg/dl, stop drip and recheck BG in 30 min (see bold order) If lower than last BG by 15–30 mg/dl, decrease rate by 50% and recheck BG in 30 min If lower than last BG by 7–14 mg/dl, decrease rate by 0.5 IU/h If equal to last BG or lower than last BG by less than 7 mg/dl, decrease rate by 0.3 IU/h If infusion turned off, recheck BG in 30 min. When BG greater than 90 mg/dl, restart at 50% of previous rate and recheck BG in 30 min. Recheck BG every 30 min until greater than 80 mg/dl
80 to 120 Target range may titrate drip in ICU to maintain this range.	If higher than last BG by more than 10 mg/dl, increase rate by 0.5 IU/h If lower than last BG by more than 40 mg/dl, stop drip and recheck BG in 30 min (see bold order) If lower than last BG by 21–40 mg/dl, decrease rate by 50% and recheck BG in 30 min If lower than last BG by 10–20 mg/dl, decrease rate by 0.5 IU/h If infusion turned off, recheck BG 30 min. If/when BG greater than 120 mg/dl, restart at 50% of previous rate. If within 10 mg/dl of last BG, same rate unless the following applies: for any BG in this range (even if within 10 mg/dl of last test), the following always applies: If BG has consistently decreased each of last 4 measurements, decrease rate by an additional 0.3 IU/hIf BG has consistently increased each of last 4 measurements, increase rate by an additional 0.2 IU/h
121 to 135	If higher than last BG by more than 50 mg/dl, increase rate by 2 IU/h If higher than last BG by 20–50 mg/dl, increase rate by 1 IU/h If higher than last BG by 0–20 mg/dl, increase rate by 0.5 IU/h If lower than last BG by 1–20 mg/dl, same rate If lower than last BG by 21–40 mg/dl, decrease rate by 1 IU/h If lower than last BG by 41–60 mg/dl, decrease rate by 50% and recheck BG in 30 min If lower than last BG by more than 60 mg/dl, stop drip and recheck BG in 30 min (see bold order) If infusion turned off, recheck BG 30 min. If/when BG greater than 125 mg/dl, restart at 50% of previous rate.
136 to 150	If higher than last BG by more than 30 mg/dl, increase rate by 2 IU/h and bolus with 3 IU IV If higher than last BG by 0–30 mg/dl, increase rate by 1 IU/h and bolus with 2 IU IV If lower than last BG by 1–20, increase rate by 1 IU/h and bolus with 2 IU IV If lower than last BG by 21–50 mg/dl, same rate If lower than last BG by 51–80 mg/dl, decrease rate by 50% and recheck BG in 30 min If lower than last BG by more than 80 mg/dl, stop drip and recheck BG in 30 min (see bold order) If infusion turned off, recheck BG 30 min. If/when BG greater than 125 mg/dl, restart at 50% of previous rate.
151 to 180	If lower than last BG by more than 80 mg/dl, decrease rate by 50% If lower than last BG by 30 –80 mg/dl, continue same rate If lower than last BG by 0–30, increase insulin rate by 1 IU/h and bolus with 2 IU IV If higher than last BG by 1–20 mg/dl, increase insulin rate by 2 IU/h and bolus with 4 IU IV If higher than last BG by more than 20 mg/dl, increase insulin rate by 3 IU/h and bolus 6 IU IV Recheck BG in 30 min and repeat BG every 30 min until less than 150 mg/dl
181 to 240	If lower than last BG by more than 100 mg/dl, decrease rate by 50% If lower than last BG by 50–100 mg/dl, continue same rate If lower than last BG by less than 50 mg/dl or higher than last BG, bolus with 6 IU regular insulin IV and increase insulin rate by 2 IU/h If BG remains 181–240 mg/dl and has not decreased after 3 consecutive increases in insulin: Give double previous IV bolus dose up to a maximum of 24 units and double insulin drip rate up to a maximum of 20 IU/h If on 20 IU/h and no response after 4 maximum boluses–call MD for further orders Recheck BG in 30 min and repeat BG every 30 min until less than 150 mg/dl
Greater than 240	If lower than last BG by more than 150 mg/dl, decrease rate by 50% If lower than last BG by 101–150 mg/dl : Same rate If lower than last BG by 0–100 mg/dl or if higher than last BG: bolus with 10 units regular insulin IV and double insulin rate up to a maximum of 30 IU/h If BG remains greater than 240 mg/dl and has not decreased after 3 consecutive increases in insulin: Give double previous IV bolus dose up to a maximum of 40 units and double insulin drip rate up to a maximum of 30 IU/h If on 30 IU/h and no response after 4 maximum boluses–call MD for further orders Recheck BG in 30 min and repeat BG every 30 min until less than 150 mg/dl
If BG is greater than 300 for 4 consecutive readings, call MD for additional IV bolus orders.