Control of blood glucose during nutritional support in ill patients.

The traditional "Sliding Scale" is an inefficient and unreliable way of controlling blood glucose levels in ill patients receiving nutritional support in the Intensive Care Unit. In these patients, it is necessary to reassess insulin requirements frequently in the light of changing clinical circumstances. A significant improvement in control can be achieved by using a dynamic scale of instructions for changing the insulin dose rather than one of arbitrary dose levels. This scale adapts to any changes that occur without needing to be rewritten. It avoids confusion due to a proliferation of prescription charts, and has been readily accepted by nursing staff.