Perioperative Management of Diabetic Subjects: Subcutaneous Versus Intravenous Insulin Administration During Glucose-Potassium Infusion
- Antonio Pezzarossa, MD,
- Francesco Taddei, MD,
- M Cristina Cimicchi, MD,
- Elisabetta Rossini, MD,
- Sandro Contini, MD,
- Enzo Bonora, MD,
- Angelo Gnudi, MD and
- Enzo Uggeri, MD
- Chair of Endocrinology, Istituto di Clinica Medica Generale, Universita degli Studi di Parma, II Service of Anesthesia, Istituto di Chirurgica Patologica, Parma General Hospital Parma, Italy
- Address for correspondence and reprint requests to Dr. Antonio Pezzarossa, Cattedra di Endocrinologia, Istituto di Clinica Medica Generale, Universita degli Studi di Parma, Via Gramsci 14, 43100 Parma, Italy.
Abstract
The purpose of this study was to validate methods for the perioperative management of diabetic patients that meet the prerequisites of simplicity, applicability in the absence of a diabetologist, and flexibility, to rapidly meet changing metabolic requirements. The patients were divided into two groups that were comparable for age, sex distribution, type of diabetes, and type of surgical procedures. The results show that intravenous insulin administration achieved better glycemic control during the intraoperative period, whereas it did not offer advantages over the subcutaneous route during the pre- and postoperative periods. The satisfactory degree of steady glycemic control achieved and the absence of hypoglycemic episodes indicate that the separate administration of insulin and glucose plus electrolytes is an effective and safe management modality for diabetic patients undergoing major surgery.
- Copyright © 1988 by the American Diabetes Association
