COMPARISON OF 2 METHODS OF IV-INSULIN ADMINISTRATION IN THE DIABETIC PATIENT DURING THE PERIOPERATIVE PERIOD

We have examined the effects of two types of insulin therapy (continuo us iv. infusion (group A. 1.25 u. h(-1)) and direct iv. bolus administ ration of 10u. every 2h (group B: 10u./2h)) on the metabolic and endoc rine responses to surgery in 60 adult diabetic patients undergoing gen eral anaesthesia for elective procedures. Blood glucose concentrations were measured every 15 min from just before induction of anaesthesia until 2h after surgery. Plasma ketone bodies, lactate, pyruvate, insul in, C-peptide and counter-regulatory hormone concentrations were measu red also. Blood glucose concentrations were comparable in both groups, except at 60 min, because of fluctuating blood glucose concentrations in group B. in each group, one patient became hyperglycaemic. One cas e of hypoglycaemia occurred in group B. There were no statistically si gnificant differences for the other data except for C-peptide. We conc lude that, during the operative period, the administration of a direct iv. bolus of insulin 10u. every 2h is a simple and effective method t o control blood glucose concentrations; the method can be used when an insulin infusion pump is not available.