Insulin in the management of the diabetic surgical patient: continuous intravenous infusion vs subcutaneous administration
U. Taitelman, E. A. Reece and A. N. Bessman
A prospective randomized study comparing constant intravenous infusion of
regular, low-dose insulin versus conventional subcutaneous administration
of neutral protein Hagedorn (NPH) insulin in insulin-requiring patients
undergoing orthopedic procedures under general anesthesia was undertaken.
The degree of diabetic control was better in those receiving constant 2
units/hour of regular insulin than in those receiving two thirds of daily
maintenance doses of NPH insulin. However, in two of eight patients
receiving 2 units/hour, decreased insulin infusion rates and increased
dextrose infusion rates were required to avoid hypoglycemia. Preoperative
NPH insulin and 1 unit/hour insulin administration resulted in equivalent
diabetic control.
