Performance of a 2-step insulin infusion protocol with adjustment of insulin doses for Asians in the medical intensive care unit following cardiothoracic surgery

Background Most previous insulin infusion protocols are titrated for Westerners and are not simple to follow. In this study, we tested the efficacy and safety of our simple insulin infusion protocol utilizing lower insulin doses for Asians. Methods A total of 152 patients with type 2 diabetes underg...

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Published in:Diabetology international 2019-01, Vol.10 (1), p.12-23
Main Authors: Ogiso, Kazuma, Koriyama, Nobuyuki, Obo, Takahiko, Tokito, Akinori, Ueno, Takayuki, Nishio, Yoshihiko
Format: Article
Language:English
Subjects:
Algorithms
Blood glucose
Diabetes
Diabetes mellitus
Diabetes mellitus (non-insulin dependent)
Endocrinology
Heart surgery
Hypoglycemia
Insulin
Intravenous administration
Medicine
Medicine & Public Health
Metabolic Diseases
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Summary:Background Most previous insulin infusion protocols are titrated for Westerners and are not simple to follow. In this study, we tested the efficacy and safety of our simple insulin infusion protocol utilizing lower insulin doses for Asians. Methods A total of 152 patients with type 2 diabetes undergoing cardiothoracic surgery were included. After surgery, blood glucose (BG) was initially managed according to our algorithm protocol, and subsequently by the post-algorithm protocol. Insulin infusion rates in the algorithm protocol were titrated in two steps according to (1) current BG levels and (2) the difference between current and previous BG levels. In the post-algorithm protocol, insulin lispro was injected subcutaneously in addition to intravenous insulin infusion according to BG levels. The efficacy was assessed as achievement rates of two target BG ranges (140–199 and 80–199 mg/dL), and safety was assessed as hypoglycemia (
ISSN:2190-1678
2190-1686
DOI:10.1007/s13340-018-0358-y