Insulin in the management of the diabetic surgical patient: continuous intravenous infusion vs subcutaneous administration.
A prospective randomized study comparing constant intravenous infusion of regular, low-dose insulin versus conventional subcutaneous administration of neutral protein Hagedorn (NPH) insulin in insulin-requiring patients undergoing orthopedic procedures under general anesthesia was undertaken. The degree of diabetic control was better in those receiving constant 2 units/hour of regular insulin than in those receiving two thirds of daily maintenance doses of NPH insulin. However, in two of eight patients receiving 2 units/hour, decreased insulin infusion rates and increased dextrose infusion rates were required to avoid hypoglycemia. Preoperative NPH insulin and 1 unit/hour insulin administration resulted in equivalent diabetic control.
D000768:Anesthesia, General; D048909:Diabetes Complications; D003920:Diabetes Mellitus / Q000188:drug therapy; D005947:Glucose / Q000627:therapeutic use; D006801:Humans; D007003:Hypoglycemia / Q000517:prevention & control; D007263:Infusions, Parenteral; D007279:Injections, Subcutaneous; D007328:Insulin / Q000008:administration & dosage* / Q000627:therapeutic use; D011300:Preoperative Care; D011446:Prospective Studies; D013514:Surgical Procedures, Operative
D007328:Insulin; D005947:Glucose