How to stop a Variable Rate Intravenous Insulin Infusion (VRIII)

• If clinically indicated to stop VRIII, then it can be stopped if long-acting insulin is on board. 
• If no long-acting insulin already on board, give usual long-acting insulin and stop VRIII after 2 hours. 
• If switching back to mixed insulin (e.g. Humulin® M3), it must be done either at breakfast or dinner, and stop VRIII after 2 hours. 
• If new insulin is to start, calculate total dose over past 24 hours and give 75% in appropriate subcutaneous regimen (e.g. basal bolus, twice daily mixed etc, refer via TrakCare to inpatient diabetes team). 

Please see the full VRIII guideline for additional information. 

Guideline reviewed: February 2025

Page updated: November 2025