HHNK or HHNS

In these disorders with the blood sugar, is it possible to bring the BG down too fast? I had a patient come in at 0800 with a BG of 825. By 17:30 he was down to 186. Is this okay? His drip was titrated anywhere from 10-20 units/per hour.
It is possible to bring it down too fast...blood sugar should be decreased by ~75-100mg/dL/hr because any faster and you risk cerebral edema. It took 9.5 hours for this patient to go from a BS of 825 to 186, which is a reduction in the blood sugar of about 87mg/dL each hour.

Could you post that formula?

Anyone?

There is no specific "formula," just simple math. Let's say you want to bring the blood sugar down by 75mg/dL each hour. Patient's blood sugar is 825, so after the first hour it would be 750mg/dL (825-75 = 750). There should be a protocol in place that is used to determine how to titrate the insulin gtt based on the patient's blood sugar. If you notice too rapid of a drop in blood sugar, then you need to speak with the physician.

Thx! Unfortunately our facility is lacking in protocols.

Quote from transducenThx! Unfortunately our facility is lacking in protocols.