Variable Rate Intravenous Insulin Infusion

The Variable Rate Intravenous Insulin Infusion (VRIII) guideline was rolled out across NHSGGC in March 2019 and replaces all guidance relating to 'insulin sliding scales'. The guideline should be used in:

  • surgical patients with diabetes undergoing operations e.g. fasting >24 hours, emergency surgery and poor glycaemic control.
  • medical patients with diabetes who have uncontrolled hyperglycaemia or who are unable to eat and drink due to prolonged fasting, nausea, vomiting or reduced consciousness.

The guideline should not be used in patients with:

The VRIII guideline and supporting material e.g. FAQ document, implementation memo, designated stock locations of VRIII IV fluids, is available:


Guideline reviewed: June 2022

Page updated: October 2023