depends on the frequency of checks and dosing. for qc and hs, then usually you are less aggressive with you dosing. an example would be subtracting some arbitrary number (200) from the actual sugar (say, 300), dividing that by an integer (say, 15) and using that number as your insulin dose. This obviously is intended for less critical patients.
in the OR, I use this formula (BG-80) X Factor (where Factor = 0.03 for non diabetics, 0.05 for diabetics). I then bolus this amount and set the infusion to that rate. this is pretty close to our cardiac protocol, it may be exactly the same, but it works well across ORs. I would imagine it would be fine in the ICU as well.
Example: Glucose of 180 on a non diabetic hepatectomy: (180-80) X 0.03 = 3 unit bolus and 3 units/hour infusion. At the next hour, when I check, it is 140, so the formula gives (140-80) X 0.03 = 1.8. I will then bolus 1.8 units and turn down the infusion to 1.8 units/hour. This usually results in pretty tight glucose control by the third hour. In our ICUs the nurses use insulin infusions and they have protocols that determine their dose based on the previous 2 hours of values, I think, but we never modify those doses.
