title: Safety of intravenous insulin aspart compared to regular human insulin in patients undergoing ICU monitoring post cardiac surgery: an Indian experience.
abstract: BACKGROUND
  Poor perioperative glycemic control increases risk of infection, cardiovascular accidents and mortality in patients undergoing surgery. Tight glycemic control by insulin therapy is known to yield better outcomes in such patients. Intravenous (IV) insulin therapy with or without adjunctive subcutaneous insulin therapy is the mainstay of managing hyperglycemia in perioperative period. This observational study assessed the safety of IV Insulin Aspart (IAsp) as compared to Regular Human Insulin (RHI) in patients undergone cardiac surgery at a tertiary care hospital.
  
  
  METHODS
  203 patients received IV IAsp (n = 103) and RHI (n = 100) respectively. Safety was assessed by frequency and severity of adverse events (AEs) & serious adverse events (SAEs) during hospitalization.
  
  
  RESULTS
  IAsp effectively controlled mean blood glucose levels to 159.87 ± 41.41 mg/dl similar to RHI (160.77 ± 44.39 mg/dl). No serious adverse event was reported. The incidence of hypoglycemia was similar in both the groups. The insulin infusion rate, time for which insulin infusion was withheld and mean blood glucose during hypoglycemia was significantly high in RHI group.
  
  
  CONCLUSIONS
  This study has shown similar safety of IV IAsp as compared to IV RHI in the post cardiac surgery patients. However physicians preferred IAsp as it offers advantage during transition. IV IAsp offers an effective and safe option for managing hyperglycemia in patients in ICU post cardiac procedures.
authors: Department of Diabetology, Asian Heart Institute, G/N Block, Bandra Kurla Complex, Bandra East, Mumbai, Maharashtra 400051 India.
authors: Manoj
authors: M
authors: Chawla
authors: Lead Medical for Asia Pacific region, Ferring Pharmaceuticals, 24th Floor, Sunshine Towers, Senapati Bapat Marg, Elphinstone (West), Mumbai, 400013 India.
authors: Harshad
authors: H
authors: Malve
authors: Department of Diabetology, Asian Heart Institute, G/N Block, Bandra Kurla Complex, Bandra East, Mumbai, Maharashtra 400051 India.
authors: Harshvi
authors: H
authors: Shah
authors: Department of Diabetology, Asian Heart Institute, G/N Block, Bandra Kurla Complex, Bandra East, Mumbai, Maharashtra 400051 India.
authors: Shwetal
authors: S
authors: Shinde
authors: Department of Diabetology, Asian Heart Institute, G/N Block, Bandra Kurla Complex, Bandra East, Mumbai, Maharashtra 400051 India.
authors: Anil
authors: A
authors: Bhoraskar
keywords: CABG; Cardiac surgery; Diabetes; Hyperglycemia; Intensive care