How do I install the Es Continue Scheduled Insulin Modified skill?

Run npx skillmds@latest add dromlakhani/es-continue-scheduled-insulin-modified in your terminal (requires Node.js), paste this page's agent-chat prompt into Claude, Cursor, or any MCP-connected agent, or download the SKILL.md file and copy it into your agent's skills directory.

Is Es Continue Scheduled Insulin Modified safe to use?

This skill has not completed SkillMD's automated safety review yet. Independent scanners report: SkillSpector: PASS, Skill Scanner: PASS. Capability flags: makes network calls. SkillMD never runs a skill's scripts for you; review the SKILL.md before installing.

Which AI agents work with Es Continue Scheduled Insulin Modified?

This skill is tagged as working with Claude Code, Claude.ai, OpenAI Codex. SKILL.md is an open format, so most agents that read a skills directory can load it too.

Is Es Continue Scheduled Insulin Modified free to use?

Yes. Installing skills from SkillMD is free, and the skill stays under its author's original license.

Who published Es Continue Scheduled Insulin Modified?

dromlakhani (@dromlakhani) published this skill. Their other Agent Skills are listed on their SkillMD profile.

Es Continue Scheduled Insulin Modified by dromlakhani

Name: Es Continue Scheduled Insulin Modified
Rating: 4.2 (5 reviews)
Author: dromlakhani

Es Continue Scheduled Insulin Modified

Recommend continuation of the pre‑admission scheduled insulin regimen, adjusted for nutritional status and severity of illness, to keep glucose between 100‑180 mg/dL in hospitalized adults with insulin‑treated diabetes. Triggered by clinician questions such as “Patient was on insulin before admission, how should we adjust their regimen in hospital?” or similar.

dromlakhani Updated Sep 8, 2026 10 repo stars

File contents

Continue scheduled insulin regimen modified for nutritional status and severity of illness in patients with insulin-treated diabetes prior to admission

STEP 1 — Gather Information

Collect the patient’s pre‑admission insulin regimen (type, dose, schedule), current nutritional intake (percentage of meals, NPO, enteral feeds), markers of illness severity (e.g., infection, steroids, organ dysfunction), and recent point‑of‑care glucose values.

STEP 2 — Rule In / Rule Out

If the patient has insulin‑treated diabetes prior to admission and is hospitalized for a noncritical illness → proceed to Step 3; otherwise, consider alternative glycemic strategies (e.g., correctional insulin alone) and discontinue this pathway.

STEP 3 — Classify or Stratify

Stratify by nutritional status (≥75% meals, 25‑75% meals, <25% meals/NPO/enteral) and illness severity (mild vs moderate/severe); for basal‑heavy regimens (≥0.6 U/kg/day basal) with reduced intake or catabolic illness, plan to reduce basal insulin dose by 10‑20%.

STEP 4 — Decide

Continue the scheduled insulin regimen with the calculated dose adjustments; prescribe glucose monitoring before meals and at bedtime; adjust prandial or correctional insulin as needed to maintain glucose targets of 100‑180 mg/dL.

Clinical Guardrails / Mimics / Pitfalls

Avoid using sliding‑scale insulin alone; do not increase basal insulin in patients with reduced oral intake; monitor closely for hypoglycemia, especially in renal impairment or when NPO; do not discontinue basal insulin abruptly; reassess doses daily based on glucose trends and clinical changes.

Concrete Clinical Example

A 68‑year‑old woman with type 2 diabetes on basal‑bolus insulin (glargine 24 U nightly, aspart 6 U TID) is admitted for mild cellulitis (noncritical). She eats about half her meals. Continue glargine at 20 U (≈‑15 %) and aspart 6 U with meals; check AC and HS glucose; aim for 100‑180 mg/dL.

Source: Management of Hyperglycemia in Hospitalized Adult Patients in Non-Critical Care Settings: An Endocrine Society Clinical Practice Guideline, Endocrine Society, 2022, https://doi.org/10.1210/clinem/dgac278

---name: es-continue-scheduled-insulin-modifieddescription: Recommend continuation of the pre‑admission scheduled insulin regimen, adjusted for nutritional status and severity of illness, to keep glucose between 100‑180 mg/dL in hospitalized adults with insulin‑treated diabetes. Triggered by clinician questions such as “Patient was on insulin before admission, how should we adjust their regimen in hospital?” or similar.---# Continue scheduled insulin regimen modified for nutritional status and severity of illness in patients with insulin-treated diabetes prior to admission## STEP 1 — Gather InformationCollect the patient’s pre‑admission insulin regimen (type, dose, schedule), current nutritional intake (percentage of meals, NPO, enteral feeds), markers of illness severity (e.g., infection, steroids, organ dysfunction), and recent point‑of‑care glucose values.## STEP 2 — Rule In / Rule OutIf the patient has insulin‑treated diabetes prior to admission and is hospitalized for a noncritical illness → proceed to Step 3; otherwise, consider alternative glycemic strategies (e.g., correctional insulin alone) and discontinue this pathway.## STEP 3 — Classify or StratifyStratify by nutritional status (≥75% meals, 25‑75% meals, <25% meals/NPO/enteral) and illness severity (mild vs moderate/severe); for basal‑heavy regimens (≥0.6 U/kg/day basal) with reduced intake or catabolic illness, plan to reduce basal insulin dose by 10‑20%.## STEP 4 — DecideContinue the scheduled insulin regimen with the calculated dose adjustments; prescribe glucose monitoring before meals and at bedtime; adjust prandial or correctional insulin as needed to maintain glucose targets of 100‑180 mg/dL.## Clinical Guardrails / Mimics / PitfallsAvoid using sliding‑scale insulin alone; do not increase basal insulin in patients with reduced oral intake; monitor closely for hypoglycemia, especially in renal impairment or when NPO; do not discontinue basal insulin abruptly; reassess doses daily based on glucose trends and clinical changes.## Concrete Clinical ExampleA 68‑year‑old woman with type 2 diabetes on basal‑bolus insulin (glargine 24 U nightly, aspart 6 U TID) is admitted for mild cellulitis (noncritical). She eats about half her meals. Continue glargine at 20 U (≈‑15 %) and aspart 6 U with meals; check AC and HS glucose; aim for 100‑180 mg/dL.**Source:** Management of Hyperglycemia in Hospitalized Adult Patients in Non-Critical Care Settings: An Endocrine Society Clinical Practice Guideline, Endocrine Society, 2022, https://doi.org/10.1210/clinem/dgac278

Frequently asked questions