UMEM Educational Pearls

  • Hold metformin if the patient is at risk for dehydration (eg. vomiting, diarrhea) due to the risk of lactic acidosis
  • Medications that stimulate insulin secretion (eg. sulfonylureas, repaglinide, or nateglinide) should be held if the patient is at risk for hypoglycemia
  • Patients usually should continue their basal insulin, but may decrease or hold their bolus dosing.
  • Finger sticks should be checked every 2-4 hours for those on insulin, or 2-4 times per day for type II diabetics not on insulin.


Diabetes. Pharmacist's Letter March 2013;29(3):13-4.