Sliding scale regimens may include a bedtime high blood sugar correction.Sliding scales are less effective in covering a pre-meal high blood sugar, because the high blood glucose correction and food bolus cannot be split.The sliding scale method does not accommodate changes in insulin needs related to snacks or to stress and activity.Pre-mixed insulin doses are based on the blood sugar level before the mealĭisadvantages of the sliding scale regimen:.The bolus insulin is based on the blood sugar level before the meal or at bedtime.You take the same long-acting insulin dose no matter what the blood glucose level. The basal (background) insulin dose doesn’t change.The amount of carbohydrate to be eaten at each meal is pre-set.The general principles of sliding scale therapy are: Pre-mixed, or short-acting insulin analogs or Regular and NPH, given twice a day.Long-acting insulin (glargine/detemir or NPH), given once a day.Long-acting insulin (glargine/detemir or NPH), once or twice a day with short acting insulin (aspart, glulisine, lispro, Regular) before meals and at bedtime.Sliding scale insulin regimens approximate daily insulin requirements. The term “sliding scale” refers to the progressive increase in the pre-meal or nighttime insulin dose, based on pre-defined blood glucose ranges.
