Should you use IV insulin to treat non-ketotic patients with high blood sugar?
So the study talks about risks of IV insulin, but if the patient has a blood sugar of 600, what IS the safest treatment option? And is there a magic number to send them home?
This is the million dollar question. I actually did a survey on this over 25 year ago and published it as an abstract - residency directors across the country had enormous practice variation. The key is to make sure they are not acidotic, that they have normal mental status, give them PO fluids, start them on oral meds or increase the ones they are on and get follow-up. Having said that there is probably a number that all of us would say, to heck with it I am going to bring them down a little, I just don't know what that number is :) and no doubt it is different for all of us. At the country hospitals in LA we see this so often we get pretty underwhelmed and send these patients home if they meet the above criteria even with BIG numbers.
What you do matters.