Insulin Orders & Protocols: IV Insulin Infusions

Examples of Intravenous Insulin Infusion Order Forms and Transition to Subcutaneous Regimens

Markovitz Protocol of IV Insulin
Markovitz LJ, Wiechmann RJ, Harris N, et al. Endocr Pract. 2002;8:10-18.
Oldest published protocol of column method but with goal of 120-199 mg/dL.
View the Markovitz Protocol of IV Insulin

University Of Washington Protocol
Trence DL, Kelly JL, Hirsch IB. J Clin Endocrinol Metab. 2003;88:2430-2437
View the University of Washington Protocol

Atlanta Medical Center Protocol
Osburne RC, Cook CB, Stockton L, et al. Diabetes Educ. 2006;32:394-403.
View the Atlanta Medical Center Protocol

North Carolina Protocol
Braithwaite SS, Edkins R, MacGregor KL, et al. Diabetes Technol Ther. 2006;8:476-488.
View the North Carolina Protocol

Portland Diabetic Project Protocol
Furnary AP, Wu Y, Bookin SO. Effect of hyperglycemia and continuous intravenous insulin infusions on outcomes of cardiac surgical procedures: the Portland Diabetic Project. Endocr Pract. 204;10(suppl 2):21-33.
View the Portland Diabetic Project Protocol

The Leuven Algorithm
Van den Berghe G, Wouters P, Weekers F, et al. N Engl J Med. 2001;345:1359-1367.
View The Leuven Algorithm

Northwestern University Inpatient Intravenous Insulin Protocol
DeSantis AJ, Schmeltz LR, Schmidt K, et al. Endocr Pract. 2006;12:491-505.
Recently published, the Northwestern protocol uses three tables to adjust rates. Goal of 80-110 mg/dL is reached in 10.6 hours. Hypoglycemia < 60 mg/dL is reported to be 1.6%.
View the Northwestern University Inpatient Intravenous Insulin Protocol

Northwestern University Transition from IV to SC Insulin Protocol
DeSantis AJ, Schmeltz LR, Schmidt K, et al. Endocr Pract. 2006;12:491-505.
View the Northwestern University Transition from IV to SC Insulin Protocol

Transition from IV Insulin to Sub Q Insulin Protocol (unpublished)
View Transition from IV Insulin to Sub Q Insulin Protocol

Banner Good Samaritan Medical Center CABG IV Insulin Protocol (unpublished)
Submitted by Dr. Cheryl O'Malley; shows transition to subcutaneous insulin built into IV infusion order set.
View the Banner Good Samaritan Medical Center CABG IV Insulin Protocol

Continuous IV Insulin Infusions
Portland Protocol: et al Furnary, submitted by Kevin Larsen.
View Continuous IV Insulin Infusion for Floor Patients.
View Continuous IV Insulin Infusion for ICU Patients.

Yale Insulin Drip Protocols
Submitted by Silvio Inzucchi.
View Yale “New” Insulin Drip Protocol (target 90-119).
View Yale Insulin Drip Protocol (target 100-139).

Adult Variable-Rate IV Insulin Infusion Protocol for Hyperglycemia
University of Missouri HealthCare.
View Adult Variable-Rate IV Insulin Infusion Protocol for Hyperglycemia.

Critical Care Adult Insulin Infusion
Southwestern Washington Medical Center, submitted by Chris Hogness.
View Critical Care Adult Insulin Infusion.

For Glucoses, Tight Theory a Tough Practice
Maine Medical Center Portland. Described by Cheryll St. Onge RN,BSN,MS from Maine Medical Center, Portland, in an article by Anne Paxton. Freely accessed at the College of American Pathologists.
View the article and protocol: For Glucoses, Tight Theory a Tough Practice.