Sliding scale insulin dosing only takes into account the patient's glucose level prior to the meal, so it essentially is retrospectively attempting to address hyperglycemia from a previous meal or previous underdosage of insulin. When administering insulin in response to a high blood glucose reading prior to a meal, the hyperglycemia has already happened. Further, the rapid-acting or short-acting insulin dosage does not consider the carbohydrate and sugar in the meal the patient is about to eat. In response to this criticism, many health system protocols consist of a fixed insulin dose to be administered to moderate the basal component and/or an insulin dose based on the nutritional value of the upcoming meal that is supplemented by a sliding scale dose of a rapid-acting insulin to be used as post-meal "correction" if hyperglycemia persists after the meal.
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