Peri-Operative Management of Insulin-Dependent Diabetic Patients. Use of Continuous Intravenous Infusion of Insulin-Glucose-Potassium Solution

Bowen, Derrick John; Nancekievill, M. L.; Proctor, E; Norman, W. J.

doi:10.1097/00132586-198306000-00028

Cited by 2 publications

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“…With this protocol, Bowen et al (14) found good results for up to 4 h, after which they felt the insulin dosage should be reassessed. Glucose levels in 2 of their 20 patients dropped below 50 mg/dl; glucose values at the end of the infusion ranged from 21 to 335 mg/dl.…”

Section: Resultsmentioning

confidence: 98%

Postoperative Management of Diabetes Mellitus: Steady-State Glucose Control With Bedside Algorithm for Insulin Adjustment

et al. 1987

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An algorithm was developed to determine whether an individualized insulin infusion could maintain plasma glucose in a desirable steady state after surgery. In 24 patients, insulin was provided according to a "glucose-feedback" formula to maintain plasma glucose between 120 and 180 mg/dl (6.7-10.0 mM). Initial plasma glucose was elevated, 218 +/- 16 mg/dl (mean +/- SE 12.1 +/- 0.9 mM), but reached the target range after 8 h and remained steady for the rest of the study period. Insulin requirements varied considerably, 0.5-5.0 U/h. Infusion rates were correlated with initial plasma glucose but not with previous insulin dose, HbA1c, or percent ideal body weight. Although insulin needs cannot be predicted, plasma glucose can be maintained in a desirable range after surgery via a simple formula suitable for implementation by general ward nurses.

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Section: Resultsmentioning

confidence: 98%

Postoperative Management of Diabetes Mellitus: Steady-State Glucose Control With Bedside Algorithm for Insulin Adjustment

et al. 1987

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“…Published regimens for management of blood glucose during labour have required intensive supervision. 2 Recently a regimen to be used by midwives without supervision was published although a retrospective analysis demonstrated that mean blood glucose at the time of delivery was higher than that regarded as ideal. 4 Recently described regimens for control of insulindependent diabetes during pregnancy tend to be similar, emphasizing frequent visits, home blood glucose rnonitoring and standard subcutaneous insulin administration, aiming to achieve normogl ycaem ia before meals.…”

Section: Introductionmentioning

confidence: 99%

Five Year Audit of Peripartum Blood Glucose Control in Type 1 Diabetic Patients

Njenga

Lind

Taylor

1993

Obstetrical & Gynecological Survey

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An audit was conducted of the degree of blood glucose control achieved during labour using a simple glucoselinsulin infusion regimen. Records were examined of 40 pregnancies in 37 women over a 5-year period. Mean blood glucose was 5.2 f 2.2 (SD) mmol-' 7 h before delivery and 4.7 f 1.8 mmol-' 1 h before delivery. Four women experienced mild symptomatic hypoglycaemia before delivery and two during the 6 h after delivery. Seven neonates had blood glucose levels of 2.2 mmol-' or less recorded at any time, but there was no relationship between neonatal hypoglycaemia and maternal hyperglycaemia during labour in the range of achieved maternal blood glucose levels. The mean HbA, at booking was 8.4 & 1.2 % (non-diabetic range 5.0-7.5 %) and fell to a steady plateau from 12 weeks gestation to delivery averaging 7.5 % (2SD above the non-diabetic mean). These data demonstrate the practical applicability of a simple regimen for control of blood glucose during labour in insulin-dependent diabetic women and suggest that less stringent aims of blood glucose control than originally adopted may be appropriate.

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Peri-Operative Management of Insulin-Dependent Diabetic Patients. Use of Continuous Intravenous Infusion of Insulin-Glucose-Potassium Solution

Cited by 2 publications

References 0 publications

Postoperative Management of Diabetes Mellitus: Steady-State Glucose Control With Bedside Algorithm for Insulin Adjustment

Postoperative Management of Diabetes Mellitus: Steady-State Glucose Control With Bedside Algorithm for Insulin Adjustment

Five Year Audit of Peripartum Blood Glucose Control in Type 1 Diabetic Patients

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