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What are the disadvantages of using the diabetes sliding-scale chart?

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Disadvantages of using sliding-scale charts as a guide to insulin treatments for diabetics include insulin treatments rarely being adjusted to patients' individual needs, being reactive instead of proactive, and leaving patients with long periods of high glucose levels, according to pharmacist Mark Coggins for Today's Geriatric Medicine. Although over 40 years worth of research has brought into question the effectiveness of using insulin sliding-scale strategies to treat diabetes, these strategies are widely used.

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Even though studies show using these treatments not only fails to control hyperglycemia but also causes a significant increase in hypoglycemia in some patients, adjustments to treatments once they are set occur in only 18 percent of patients, diminishing the effectiveness of any treatment strategy, states Coggins. These treatments are not proactive in preventing wide fluctuations of glucose levels because of such rigidity, and even when adjusted, are found to be reactive as they address hyperglycemic conditions after they have occurred. Insulin administered in response to glucose levels alone can compound a previous dosing mistake.

These situations often leave patients having to deal with high glucose levels for long periods, explains Coggins. The fluctuations in glucose blood level, if significant enough, can cause more severe damage than the original condition.

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