Workbook 1

Question 1

Do we stop long-acting insulin whilst in DKA?

Answer 1

No. Continuation of the patient usual basal insulin as helps to facilitate an earlier switch from IV insulin back to the patient’s usual insulin regimen

Question 2

What should be done to basal insulin (long-acting) when a patient is receiving insulin via IV?

Answer 2

always continue basal insulin when patients are prescribed intravenous insulin infusions

Question 3

How to switch IV insulin into regular SC insulin?

Answer 3

When switching from IV insulin back to the patient’s regular SC regimen:

• give the usual bolus dose (short-acting) of insulin at the next meal
• IV infusion can then be stopped 30 minutes later

Question 4

Does metformin need to be stopped while NBM?

Answer 4

depend on local policy and the patients renal function (may sites withhold metformin around the peri-operative period if eGFR <60ml/minute)

Question 5

Do we continue oral antidiabetic meds in NBM/peri-operative period?

Answer 5

No, as increased risk of hypoglycemia during starvation

*metformin - depends on local policy and eGFR

Question 6

Prescribe insulin in hyperkalaemia treatment

Answer 6