Insulin Sliding Scales are Prevalent in Long-Term Care
Diabetes is a prevalent chronic condition in long-term care (LTC) facilities. In fact, 1 out of 4 LTC resident in Ontario have diabetes <1>.
Usually insulin sliding scales are initiated at a hospital, and they are not discontinued when the individual is discharged and admitted into a LTC facility. According to a study by Pandya et al, Insulin sliding scales were highly prevalent in LTC <2> Moreover, the study showed that once insulin sliding scales were initiated, 83% continued to use them chronically (as seen in the image on the left) <2>. Considering there are no literature to support the use of insulin sliding scales (please turn to "Evidence Against Insulin Sliding Scale" under "About Insulin Sliding Scale" tab), the practice should be banned in LTC facilities. For more information on the barriers to change and what you can do as a pharmacist, please refer to "Barriers to Change & the role of the Pharmacist" page.
Usually insulin sliding scales are initiated at a hospital, and they are not discontinued when the individual is discharged and admitted into a LTC facility. According to a study by Pandya et al, Insulin sliding scales were highly prevalent in LTC <2> Moreover, the study showed that once insulin sliding scales were initiated, 83% continued to use them chronically (as seen in the image on the left) <2>. Considering there are no literature to support the use of insulin sliding scales (please turn to "Evidence Against Insulin Sliding Scale" under "About Insulin Sliding Scale" tab), the practice should be banned in LTC facilities. For more information on the barriers to change and what you can do as a pharmacist, please refer to "Barriers to Change & the role of the Pharmacist" page.
Image from: Study by Pandya et al. <2>
Reference:
1.Clement M, Leung F.Diabetes and the frail elderly in long term care.Can J Diabetes 2009.33(2):114-121
2.Pandya N, Thomptson S, Sambamoorhi U. The prevalence of persistence of sliding scale insulin use among newly admitted elderly nursing home residents with diabetes mellitus. JAMDA.2008; 9(9):663-669
1.Clement M, Leung F.Diabetes and the frail elderly in long term care.Can J Diabetes 2009.33(2):114-121
2.Pandya N, Thomptson S, Sambamoorhi U. The prevalence of persistence of sliding scale insulin use among newly admitted elderly nursing home residents with diabetes mellitus. JAMDA.2008; 9(9):663-669