If someone had a blood glucose of 26, would you give 25 units of levemir?

Question

Any doctors or other nurses out there to answer this? I didn't give it and was told by the patient's guardian to give it anyway. I didn't. What would you do?

Answer 1

Are you talking mg/dl or mmol/l?

If mg/dl that is very low and I wouldn't give a person any insulin until they were treated for low blood sugar. However once he/she were back in range, he/she would need the levemir injection. Levemir is a long acting insulin that will work in the person's body for up to 24 hours. If that person does not get this injection and is a type 1 diabetic, he/she runs the risk of going very high in a short amount of time and can go into diabetic ketoacidosis.

If it is mmol/l that is a very high blood sugar. The person will need his/her levemir injection. He/she will also need some sort of quick acting insulin to bring his/her blood sugar back in an acceptable range.

Answer 2

I think the blood sugar level of 26 is high (if you are nursing in the UK or Europe). if it is in the US that is way below the normal level. since I am nursing in the UK, I will definitely give the 25 units of levemir to the patient with a blood sugar of 26. That is just way too high. I will also monitor the blood sugar an hour after if it has come down. If not, I will give the patient a short-acting insulin like actrapid to lower the high blood sugar level. If i am in the US, i will give the patient IV dextrose 50% to quickly bring the blood sugar up. Orange juice will be too slow at this moment. Monitor the patients blood sugar 30 minutes later.

by the way, can u tell us if u are working in the US or in Europe? US uses mg/dl and Europe uses mmol.

Answer 3

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Answer 4

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Answer 5

If someone had a blood glucose of 26 mg/dL they should have been symptomatic and action should have been taken to elevate their glucose. If they were not symptomatic it is likely that the glucose reading was in error. In either case it would be potentially deadly to administer detemir / Levemir to an individual with a blood glucose of 26 mg/dL. There is an important question here - and that is - was the reading 26 mg/dL or 26 mmol/L. Glucose as mg/dL is unique to the United States. The remainder of the world uses International Units or mmol/L. 26 mmol/L = 468 mg/dL. So if the reading was 26 mmol/L rather than 26 mg/dL then administering detemir would have been appropriate. Of course detemir is basal insulin and if the reading was 26 mmol/L or 468 mg/dL administering detemir only would not have been appropriate. A more rapid acting insulin would have to have been used as well - such as aspart / Novolog or lispro / Humalog.

Answer 6

Whoa Whoa Whoa!!!!

Is the bloodsugar 26mg/dL, which is very low, or 26mmol/L, which is very high (a little under 470mg/dL?)

Anyways, if the bloodsugar is low, never give insulin. If it is high, giving long acting insulin is VERY dangerous. A shorter acting insulin like R, humolog or lispro should be given.

A blood sugar of 470 needs to be dropped by an insulin that starts acting within the hour and will stop in a few hours in case something goes wrong. Using an insulin that is long acting takes too long to go into effect and is too hard to fine tune.

I haven't used this particular insulin to treat patients, but 25 units seems like a lot (if it is U100) to drop the insulin into the 100s. I would start with about 14 units or R or shorter acting insulin and test every hour or so and try to titer more insulin without causing the patient to go too low.

Keep in mind that each person reacts to insulin differently, but in this case the patient's doctor should probably have been contacted.

Answer 7

This Site Might Help You.

RE:
If someone had a blood glucose of 26, would you give 25 units of levemir?
Any doctors or other nurses out there to answer this? I didn't give it and was told by the patient's guardian to give it anyway. I didn't. What would you do?

Answer 8

If you are in nursing or medical school I would STRONGLY advise that you study and review the ENDOCRINE system. A good nurse or doctor saves lives by not only knowing the signs and symptoms of the diagnosis but the underlying pathophysiology. By having this information dictates the treatment regimen and to correctly assess and provide the best care possible with the best patient outcomes. When the blood glucose levels rises and the Ph drops it indicates that the body is extremely acidic. The person is in diabetic ketoacidosis which is a medical emergency. Sometimes the admitting doctor has a wrong diagnosis and it depends on very good nurses who knows disease processes to assess, evaluate, document, inform doctor of these and to provide nursing based plan of care. People's lives depend upon it.

Answer 9

the normal blood sugar range is inbetween 70 and 110 or 120... so if a person is below 70 feed them some thing that has carbohydrates like fruit... if higher than the norm of 120 something else might be warranted.

i am so glad you chose not to give the levemir and to leave it up to someone who is experienced in dealing with a diabetic... very wise.

Answer 10

if someone has a blood glucose level of 26, they'd be very close to being comatose. injecting levemir could kill the person, as it is insulin and would cause the blood glucose level to bottom out. i would've gone to the e.r. with a blood sugar level that low, the person would probably require i.v. glucose and close monitoring for a few days...as well as an adjustment in insulin dosage.
EDITS: i just assumed it was mg/dl...didn't even think about the mmol/l...so i learned some new stuff today...thanx for the education ;o]