Sunday September 9, 2007



Q; What is the pitfall of converting insulin drip to long acting insuling lantus (insulin glargine [rDNA origin] injection) ?


A; Lantus takes 72 to 120 hours to get effectively on board and provide insulin coverage. Also, it is alleged that pain at LANTUS injected site is higher compared to NPH injection site.

But in case if you decide to use lantus, to convert insulin drip to non-intravenous insulin coverage in ICU, the rule of thumb is to determine the total insulin required in last 24 hours and give half as lantus and the other half as short-acting insulin divided into per 3 meals.

Conversion from NPH to lantus: Determine the total insulin need of NPH in last 24 hours and reduce by 20%. Like, if total requirement is 100 NPH, the lantus dose would be 80 units.



Editors' comment: In ICUs, what is potentially an unstable setting, it is advisable to use long acting insulin with caution.