Why is nph insulin sometimes given every 6 hours in hospitals?

Answer 1

My experience is that NPH tends to be ordered by residents who are not that knowledgeable about diabetes. It's an "old school" insulin with unreliable peaks.

Answer 2

I don't think that NPH would be commonly given every 6 hours except in very special circumstances. I'm not an endocrinologist, but I am a hospitalist, and I take care of a lot of diabetics in the hospital, I have never given NPH 4 times a day, I give it twice, once in the morning and once before bed. A patient may get 4 (or more) shots of insulin a day, but usually they're mostly a short acting insulin (humalog and novalog are the most commonly used).
I can't say that it would never be done, sometimes people need a pretty wacky regimen to keep their sugar under control, but I would want an endocrinologist to be on board if I had to do something like that.

Answer 3

The ONLY reason I can think of is more control. The more often you give injections, the more often you have a chance to tweak the dosage.

NPH is usually given twice a day. If a patient would take 30 units at night and 30 units in the morning then you could try to get better control by using a baseline of 15 units of NPH every 6 hours.

That kinda stinks though. If you are going to give 4 shots a day, then why not use a long acting at the normal time and mix it with a short acting? Possibly the lantus-type insulin is not on the patients formulary. Anywho, you could still use regular with the NPH.

When I was in school, I did have a professor say that you could stop all long acting insulin and control a patients blood sugar using regular insulin 4 times a day. That was the way I did it in the practical (my rotation test), then promptly forgot it and tried to get the patient on a proper long and short acting dosage before they left the hospital when I was a resident (warning them that they may have to drop the dosage because their stress level probably would drop after they left.)

Answer 4

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Answer 5

Hospital stays are stressful. Doctors monitoring blood glucose levels watch to see that it doesn't get too high. When it starts up, they give the intermediate insulin to control it. NPH is an intermediate insulin. it lasts up to 8 hours.

Answer 6

it depends on how much the person will need to keep the sugar level down i have no idea what else it could be. so that is what they are doing is checking all the time and it could be very high.

Answer 7

1. it depends on what type of insulin, the patient has
2. it depends on wat is the sugar reading of the patient