Many clinical teams still use a humalog sliding scale to correct high blood glucose around meals. This guide explains how sliding scales are built, where they help, and where caution is needed. You’ll find example charts, calculation methods, and device-specific notes for insulin lispro, including U-100 and U-200 pens.
Use these examples as education only. A prescriber should personalize targets, correction factors, and timing based on your clinical profile. When in doubt, hold correction doses and contact your care team.
Key Takeaways
- When it’s used: correction-only dosing for prandial highs.
- Core inputs: target glucose, sensitivity factor, and current reading.
- Safety first: verify insulin strength and unit device each time.
- Use monitoring: recheck glucose and track patterns before changes.
Humalog Sliding Scale: How It Works
Sliding scale insulin is a reactive approach: you give rapid-acting insulin lispro (prandial insulin) based on the current glucose level, using a predefined chart. It does not adjust basal insulin or carbohydrate intake in real time. As a result, it may correct hyperglycemia but can miss prevention opportunities.
Major guidelines caution that correction-only strategies can be insufficient without basal-bolus planning. The American Diabetes Association notes that individualized regimens with basal and prandial components often improve control versus correction-only use. For background on benefits and trade-offs, see Sliding Scale Insulin Therapy for context and clinical caveats. For labeled properties like onset and duration, review the manufacturer’s prescribing information for insulin lispro.
Calculating Correction Doses
Correction dosing begins with three inputs: your current blood glucose (CBG), your individualized target, and your insulin sensitivity factor (ISF, the mg/dL drop from 1 unit of insulin). The general approach converts these into a single correction dose. Many teams also account for active insulin (insulin on board) to avoid stacking.
A common way to express this is the sliding scale insulin formula: Correction Dose = (CBG − Target) ÷ ISF. Example: if CBG is 240 mg/dL, target is 120 mg/dL, and ISF is 50 mg/dL per unit, the correction is (240 − 120) ÷ 50 = 2.4 units, typically rounded per clinic policy. For an overview of broader dose planning, see our Insulin Dosage Chart explainer for rationale and ranges.
Practical Dosing Charts and Examples
Clinicians often translate formulas into a small, readable chart for bedside or home use. A humalog dosing chart may differ between adults, adolescents, and people with high insulin sensitivity. Always confirm the insulin strength and the delivery device before administering any dose.
| Glucose (mg/dL) | Low Sensitivity | Moderate Sensitivity | High Sensitivity |
|---|---|---|---|
| 150–199 | 1 unit | 2 units | 0–1 unit |
| 200–249 | 2 units | 3 units | 1 unit |
| 250–299 | 3 units | 4 units | 2 units |
| 300–349 | 4 units | 5 units | 3 units |
| ≥350 | 5 units and recheck | 6 units and recheck | 4 units and recheck |
These examples are educational only and not medical directives. Your scale should be customized using your ISF, hypoglycemia risk, and meal plan. For post-meal dynamics with lispro, the article Humalog Vial Rapid Insulin discusses onset and peak times that influence correction timing.
Timing: Before Meals and Between Meals
Most teams apply a humalog sliding scale before meals, timed to match insulin lispro’s rapid onset. Typical practice is to correct shortly before eating, considering carbohydrates and premeal readings. Some settings allow conservative corrections between meals, but only with frequent monitoring and clear thresholds to hold.
Avoid stacking doses too closely. Before using a second correction within three to four hours, review active insulin and trend data. For a primer on rapid-acting options and timing nuances, see Prandial Insulin Types to compare onset and peak characteristics across agents.
Humalog KwikPen: Strengths, Devices, and Safety
Insulin lispro pens come in U-100 and U-200 strengths; both deliver in units, not milliliters. Never transfer insulin from a pen cartridge into a syringe. Verify the device label and set the dose in units displayed on the pen.
For pen-specific planning, some clinicians prepare a humalog kwikpen dosing chart that matches the patient’s insulin sensitivity and meal patterns. When choosing a device, review the Humalog KwikPen Portable Insulin Control guide for usability features. If you need product specifications such as pen dose increments, see the Humalog KwikPen listing for device details. For site rotation and technique, consult Humalog Injection Sites Instructions to reduce variability from injections.
Low-Dose Scales for Sensitive Patients
Smaller adults, older adults, and some people with type 1 diabetes may require conservative corrections. A low dose sliding scale insulin chart typically starts with narrower glucose bands and smaller unit steps. The goal is to avoid hypoglycemia while still addressing moderate hyperglycemia.
Example (educational): 150–199 mg/dL: 0–1 unit; 200–249 mg/dL: 1 unit; 250–299 mg/dL: 2 units; ≥300 mg/dL: 3 units and recheck. Never escalate quickly if meals are delayed or activity is planned. For coordinating correction doses with background insulin, see Basal Bolus Insulin Therapy to understand how basal coverage stabilizes the overall plan.
Monitoring, Safety, and When to Pause
Recheck glucose about two to three hours after a correction, unless directed otherwise. Hold correction doses if you are trending down rapidly, if you plan unaccustomed exercise, or if you have limited carbohydrate access. For hypoglycemia treatment, keep fast-acting carbohydrates available and follow clinic protocols.
Many institutions update policies to align with an insulin sliding scale guideline 2024 framework, emphasizing individualized targets, avoidance of sole sliding-scale therapy, and documentation of insulin on board. The ADA Standards of Care outline these principles clearly; see the ADA’s 2024 standards supplement for consensus statements. If comparing correction-only strategies to structured dosing, read Sliding Scale Insulin Therapy for discussion of benefits and limitations.
Comparing With Novolog and Fiasp
Insulin aspart and insulin lispro are both rapid-acting analogs with similar correction profiles. Institutions that use both may maintain parallel scales with matching targets, adjusting for individual sensitivity. A novolog sliding scale 2024 policy can mirror lispro dosing if ISF and meal timing are similar.
Drug labels document onset and duration ranges that guide timing decisions. For aspart details, see the FDA label for insulin aspart. For a comparison of agents and use-cases, visit Fiasp vs Humalog to understand formulation differences, and review Difference Between Fiasp Novolog for onset and peak contrasts.
When Regular Insulin Is Considered
Some care settings still use regular human insulin for corrections. Regular insulin has a slower onset and longer duration than lispro, which affects timing and stacking risk. If your protocol considers this alternative, verify training and monitoring sequences carefully.
For pharmacologic contrasts that affect correction timing, see Humulin vs Humalog for a side-by-side overview, and consult the product page for Humulin R 100U/mL specifications when comparing onset and offset details.
Practical Workflow and Documentation
Consistency helps avoid errors. Use a single, current chart; record the reading, dose, time, and meal context. Before repeating a correction, check for active insulin and confirm device strength. Consider mistiming, missed carbohydrates, or infusion-set issues (for pump users) before escalating doses.
Clinicians can standardize scales while keeping flexibility for ISF changes over time. For additional technique consistency, review Insulin Syringes Measurements if syringes are used, and consult Premixed Insulin for reasons not to substitute mixed products for rapid corrections. To explore meal insulin planning in context, see Prandial Insulin Types and the device-oriented overview Humalog KwikPen Portable Insulin Control.
Recap
Sliding-scale lispro can help correct highs around meals when individualized and closely monitored. Safer practice relies on accurate ISF, correct device strength, and careful timing. Use structured records, watch for patterns, and involve your care team when readings drift or hypoglycemia risk rises.
Tip: Keep only one current scale accessible. Replace printed copies when targets or ISF change to prevent errors.
This content is for informational purposes only and is not a substitute for professional medical advice.
