Question

Insulin

# What does a sliding scale refer to in the context of insulin?

Sliding scale means that you take a medication based on your need. Depending on what your blood glucose is, you may need more or less insulin. Your prescription would not be a set amount of insulin, it would be based on your values at a given time.

• AWilliam Lee Dubois, Endocrinology Diabetes & Metabolism, answered
A sliding scale is a slightly old fashioned (but functional) approach to fixing high blood sugars. The scale has two columns, the first shows ranges of blood sugar; and the second shows units of insulin. So for instance—and I just pulled these numbers out of thin air so for Peat's sake, don’t use them—the scale might look like this:
• For blood sugar of 151 to 200 take 2 units of insulin
• For blood sugar of 201 to 250 take 3 units of insulin
• For blood sugar of 251 to 300 take 4 units of insulin
A sliding scale is a slightly old fashioned (but functional) approach to fixing high blood sugars. The scale has two columns, the first shows ranges of blood sugar; and the second shows units of insulin. So for instance—and I just pulled these numbers out of thin air so for Peat’s sake, don’t use them—the scale might look like this:
• For blood sugar of 151 to 200 take 2 units of insulin
• For blood sugar of 201 to 250 take 3 units of insulin
• For blood sugar of 251 to 300 take 4 units of insulin
It's called a sliding scale because as the blood sugar numbers increase, so too do the units of insulin. The amount of insulin you need is variable—it slides—depending on your blood sugar.

Everyone needs a different, personalized scale that takes into account both their insulin sensitivity and insulin resistance. The bigger problem with sliding scale is that it is trying to close the gate after the horse has gotten out of the barn and the barn has burnt to the ground. It is a reactive therapy, trying to fix problems after they happen. More modern approaches focus on trying to calculate insulin needs beforehand. Key to this modern approach is "carb counting," a method of estimating the blood sugar impact of a meal proactively and taking insulin to cover the meal before the first bite.
Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.