A Comparison of Two Intravenous Insulin Regimens Among Surgical Patients With Insulin-Dependent Diabetes Mellitus

Abstract

We compared two intravenous insulin regimens among 58 consecutive surgical patients who required perioperative insulin infusions. Patients were randomized to either a standard glucose-insulin-potassium (GIK) infusion or a more complex, tailored two-pump protocol. Both methods provided similar overall glycemic control. However, the two-pump regimen resulted in a significantly greater proportion of finger-prick results in the target range both preoperatively (47.4% vs 60.1 %) and postoperatively (52.0% vs 66.4%). The length of stay (15 vs 16 days), duration of infusion (15 vs 16 hours, and number of medical and nursing incidents (18% vs 20%) were similar: Although the two-punip protocol required more changes to the administration rate (2 vs 10), this method was preferred by the nursing staff over the GIK regimen, resulted in more stable glucose control, and is likely to be associated with fewer clinical errors.

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