Which statement best describes nursing considerations for sliding-scale insulin therapy?

• A. It ensures fixed basal coverage
• B. It prevents hyperglycemia
• C. It uses current glucose readings to determine doses without a fixed basal, leading to more hyperglycemia and frequent dosing
• D. It is always preferred over basal-bolus

Answer: (C)

Sliding-scale insulin therapy is a reactive approach: doses are determined by the current blood glucose reading, and there is no fixed basal insulin to provide ongoing, baseline coverage. Because there’s no steady baseline, glucose levels can fluctuate, and nurses may administer doses more frequently to correct rising readings. This approach focuses on responding to hyperglycemia after it appears rather than preventing it, which is why it’s commonly associated with more hyperglycemia and a need for frequent dosing. In practice, this is less physiologic and often less desirable than a basal-bolus regimen, which provides a steady insulin foundation and uses additional correction if needed. Nursing considerations include frequent glucose checks, timely administration per protocol, and awareness that this method can lead to greater glycemic variability and more workload, rather than offering consistent basal control.