Insulin‐dependent diabetes during the peri‐operative period An nssessment of continuous glucose‐insulin‐potaium infusion, and traditional treatment

Abstract

Twenty seven insulin‐dependent diabetics, and six non‐diabetic subjects undergoing elective surgery have been studied. Twelve diabetics received continuous glucose‐insulin‐potassium (GIK) infiion for at least 4 hours after surgery terminated. Six diabetic patients having morning surgery received a proportion of their morning insulin dose with intravenous glucose (25 g) before surgery and the remaining jve operated on in the afternoon received their morning insulin with breakfast. Non‐GIK groups were combined and compared with GIK. Postoperative diabetic treatment was the same in both groups. Plasma glucose changes were studied in all patients and other metabolites whenever possible. Mean pre‐operative glucose, non‐esterjedfatty acid, and 3‐hydroxybutyrate concentrations were similar in GIK and non‐GIK groups. Four hours postoperatively plasma glucose, and 3‐hydroxybutyrate values were lower in the GIK group than in the non GIK group (p < 0.05) as were mean plasma non‐esterfed fatty acid levels. Plasma glucose concentration was also lower in GIK subjects at 72 hours postoperatively (p < 0.01). At other times measured metabolic variables were similar in both GIK and non GIK groups. Copyright © 1984, Wiley Blackwell. All rights reserved