BM’s – stat. QRS 3 s.s., PR 3 to 5s.s. 1ml = 20 drops.

Low BM:  Under four – symph, then neuroglycopaenic. Metformin don’t matter.
Conscious? Hypostop/Lucozade. 
Unconscious? 50ml 10% IV Glucose. OR 0.5-1mg Glucagon IM.
Recheck BM’s 15 mins later. Then give sandwich or 5% glucose infusion. 

 

High BM’s – 10 Units ACTRAPID. Or sliding scale. If unwell: ABG, ketones in urine? 

DKA = Sliding scale insulin infusion + Massive N saline + K+ replacement. 
HONK = High BM + high serum osmolality – no ketones, no acidosis. 

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