Management of hyperglycaemia during intermittent enteral feeding (12-20 hours)

Commence Variable Rate Intravenous Insulin Infusion (VRIII) for 24 hours 
To calculate Total Daily Dose (TDD):

Calculate total IV insulin used in 24 hour period and subtract 25%

1. Give 2/3 of TDD as Humulin® M3 at start of feed 

2. Stop VRIII 2 hours after Humulin® M3 was administered
3. Give remaining 1/3 of TDD as Humulin® I at 12 hours into the feed
Increase or decrease by 10-20% to reach target CBG (6-10mmol/L, unless otherwise specified)

 

Guideline reviewed: February 2025

Page updated: November 2025