Diabetes Care, Vol 11, Issue 1 52-58, Copyright © 1988 by American Diabetes Association
Perioperative management of diabetic subjects. Subcutaneous versus intravenous insulin administration during glucose-potassium infusion
A Pezzarossa, F Taddei, MC Cimicchi, E Rossini, S Contini, E Bonora, A Gnudi and E Uggeri
Istituto di Clinica Medica Generale, Universita degli Studi di Parma, Italy.
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.