Sliding Scales and Ratios
Diabetes Lab eTraining Slide 18

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Sliding scales determine how much extra insulin a person needs at routine times of the day.

Sample sliding scale from doctor:

  • BS <100 = no additional insulin
  • 100-150 = 0.5u
  • 151-200 = 1u
  • 201-250 = 1.5u
  • Etc.

Sliding Scales & Ratios

  • The physician will also prescribe a carbohydrate to insulin ratio.  This is to determine how much additional insulin is administered for meals.
    • For instance, for every 15 grams of carbohydrates eaten, give an additional unit of insulin (1:15 ratio)
    • For every 10 grams of carbohydrates eaten, give an additional unit of insulin (1:10 ratio)
  • Then add the sliding scale coverage + the lunchtime ratio calculation together to determine insulin needs

Example

Rosa’s lunchtime blood sugar was 176.  For lunch she is eating roasted chicken, mashed potatoes and gravy, a nectarine, and chocolate milk.  How much insulin should she get at school?

  • Mashed potatoes and gravy = 25 CHO
  • Roasted chicken = 12 CHO
  • Nectarine = 14 CHO
  • Chocolate milk = 16 CHO
  • She has a 1:15 insulin to carbohydrate ratio
  • Sliding scale
  • BS <100 = no additional insulin
  • 100-150 = 0.5u
  • 151-200 = 1u
  • 201-250 = 1.5u
  • Etc.

Answer

Known information:

  • Her blood sugar was 176
  • Her lunchtime carbs were 67 CHO
  • (67/15 = 4.46)
  • With her sliding scale, she gets 1 unit insulin
  • Add 4.5u more insulin for lunch food

Total insulin given at lunch is 5.5 u

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