The document presents a group presentation from the Nightingale School of Nursing focusing on sliding scale insulin therapy for managing blood sugar levels in diabetic patients. It covers key topics such as the types of insulin, operational mechanics of the therapy, blood sugar ranges, and common issues encountered, specifically emphasizing that the therapy helps maintain stable blood sugar to prevent complications. The presentation concludes with references and a Q&A session.

1. NIGTHINGALE SCHOOL OF NURSING
ANATOMY III
•GROUP PRESENTATION
ON SLIDING SCALE
• TUTOR: MR. STEPHEN OBENG ASANTE
• DATE: 12TH
NOVEMBER,2019

2. GROUP 6 MEMBERS
 IBRAHIM RIYADH
 ESHUN GLADYS
 ACQUAH. Q. VICTORIA
 QUANSAH. O. DEBORAH
 CYNTHIA TETTEH
 KUMI PARMELA
 DADOTO MARTHA MAVIS
 LONDON NORA
 BAIDOO. A. THERESAH
 ASIMEH LINDA
 DASSAH JENIFFER

3. SLIDING SCALE

4. AT THE END OF THIS PRESENTATION, STUDENTS MUST
BE ABLE TO KNOW SOME KNOWLEDGE ABOUT :
WHAT WE MEANT BY SLIDING SCLAE
 TYPES OF INSULIN
 HOW SLIDING SCALE INSULIN THERAPY WORKS
 BLOOD SUGAR RANGES
 SLIDING SCALE CHART
 PROBLEMS WHEN USING SLIDING SCALE
 CLINICAL CORRELATION
 CONCLUSION
 REFERENCES
 QUESTIONS AND ANSWERS

5. INTRODUCTION:
SLIDING SCALE INSULIN THERAPY IS A METHOD USED TO CONTROL BLOOD SUGAR LEVELS IN
DIABETIC PATIENTS. WITH THIS METHOD, THE DOSE IS BASED ON THE PATIENT'S BLOOD SUGAR
LEVEL JUST BEFORE MEAL. THE HIGHER THE BLOOD SUGAR, THE MORE INSULIN NEEDED.

6. TYPES OF INSULIN:
• RAPID-ACTING
• SHORT-ACTING
• INTERMEDIATE -ACTING
• LONG-ACTING
• PRE-MIXED INSULIN

7. HOW SLIDING SCALE INSULIN THERAPY WORKS
IN MOST SLIDING-SCALE INSULIN THERAPY REGIMENS, YOUR BLOOD SUGAR IS TAKEN USING A
GLUCOMETER. THIS IS DONE ABOUT FOUR TIMES A DAY (EVERY FIVE TO SIX HOURS, OR BEFORE
MEAL AND AT BEDTIME). THE AMOUR OF INSULIN YOU GET AT MEAL TIME IS BASED ON YOUR
BLOOD SUGAR MEASUREMENT.

8. BLOOD SUGAR RANGES:
• FASTING BLOOD SUGAR: 3.8 -5.5 MMOL/L
• RANDOM BLOOD SUGAR: 5.5 -7.8 MMOL/L
• PREDIABETES: 5.5 – 6.9 MMOL/L (FBS)
• DIABETES: >7 MMOL/L (FBS)

9. SLIDING SCALE CHART
BLOOD GLUCOSE
(mg/dl)
BLOOD GLUCOSE
(mmol/L)
INSULIN
(units)
61- 150 3.4 – 8.3 0
151 – 200 8.4 – 11.1 3
201 – 250 11.2 – 13.9 5
251 – 300 13.9 – 16.7 8
301 -350 16.7 – 19.4 10
351 – 400 19.5 – 22.2 12
>400 >22.2 15

10. PROBLEMS WHEN USING SLIDING SCALE
• POOR BLOOD SUGAR CONTROL:
• NO PERSONALIZATION
DIET
WEIGHT FACTORING

11. CLINICAL CORRELATION
• HYPERGLYCEMIA
• HYPOGLYCEMIA
• DIABETES MELLITUS

12. CONCLUSION
SLIDING-SCALE INSULIN THERAPY (SSI) IS MOSTLY USED IN HOSPITALS DUE TO ITS SIMPLE WAY TO
CONTROL BLOOD SUGAR. THIS HELPS KEEP PATIENT BLOOD SUGAR IN A NORMAL RANGE,
PREVENT HIGH BLOOD SUGAR LEVELS AND ALSO PREVENT COMPLICATIONS.

13. REFRENCES:
• AMERICAN DIABETES ASSOCIATION (2014). "DIAGNOSIS AND CLASSIFICATION OF DIABETES MELLITUS". DIABETES CARE. 37: S81–S90. DOI: 10.2337/DC14-
S081. PMC 3632174. PMID 24357215.
• PAIS I, HALLSCHMID M, JAUCH-CHARA K, ET AL. (2007). "MOOD AND COGNITIVE FUNCTIONS DURING ACUTE EUGLYCAEMIA AND MILD HYPERGLYCAEMIA IN
TYPE 2 DIABETIC PATIENTS". EXP. CLIN. ENDOCRINOL. DIABETES. 115 (1): 42–46. DOI: 10.1055/S-2007-957348. PMID 17286234.
• SOMMERFIELD AJ, DEARY IJ, FRIER BM (2004). "ACUTE HYPERGLYCEMIA ALTERS MOOD STATE AND IMPAIRS COGNITIVE PERFORMANCE IN PEOPLE WITH TYPE 2
DIABETES". DIABETES CARE. 27 (10): 2335–40. DOI:10.2337/DIACARE.27.10.2335. PMID 15451897.
• GEIJSELAERS, STEFAN L.C.; SEP, SIMONE J.S.; CLAESSENS, DANNY; SCHRAM, MIRANDA T.; VAN BOXTEL, MARTIN P.J.; HENRY, RONALD M.A.; VERHEY, FRANS R.J.;
KROON, ABRAHAM A.; DAGNELIE, PIETER C.; SCHALKWIJK, CASPER G.; VAN DER KALLEN, CARLA J.H.; BIESSELS, GEERT JAN; STEHOUWER, COEN D.A. (2017).
"THE ROLE OF HYPERGLYCEMIA, INSULIN RESISTANCE, AND BLOOD PRESSURE IN DIABETES-ASSOCIATED DIFFERENCES IN COGNITIVE PERFORMANCE—THE
MAASTRICHT STUDY". DIABETES CARE. 40 (11): 1537–1547. DOI: 10.2337/DC17-0330. PMID 28842522.
• KRAEMER, FREDRIC B.; SHEN, WEN-JUN (2002). "HORMONE-SENSITIVE LIPASE". JOURNAL OF LIPID RESEARCH. 43 (10): 1585–1594.
DOI:10.1194/JLR.R200009-JLR200. ISSN 0022-2275. PMID 12364542.
• "CHRONIC HYPERGLYCEMIA MAY LEAD TO CARDIAC DAMAGE". JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY. 2012-02-03. RETRIEVED 3
FEBRUARY 2012.
• MILLER, MILLER’S ANESTHESIA, 7TH EDITION, PP. 1716, 2674, 2809.
• CETIN M, YETGIN S, KARA A, ET AL. (1994). "HYPERGLYCEMIA, KETOACIDOSIS AND OTHER COMPLICATIONS OF L-ASPARAGINASE IN CHILDREN WITH ACUTE
LYMPHOBLASTIC LEUKEMIA". J MED. 25 (3–4): 219–29. PMI 7996065.

14. QUESTIONS AND ANSWERS