Once-daily Insulin Glargine Versus 6-hour Sliding Scale Regular Insulin for Control of Hyperglycemia After a Bariatric Surgical Procedure: a Randomized Clinical Trial.
From: Department of Internal Medicine, Section of Endocrinology, Rush University Medical Center, Chicago, Illinois 60612, USA.
Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists
- Publish Date:
- ISSN: 1934-2403
- Volume: 13
- Issue: 3
- Pages: 225-31
- Medium: Internet
- Language: English
- Citation (JAMA): Datta Swati, Qaadir Arshia, Villanueva Griselda, et al. Once-daily Insulin Glargine Versus 6-hour Sliding Scale Regular Insulin for Control of Hyperglycemia After a Bariatric Surgical Procedure: a Randomized Clinical Trial.. ;13:225-31
Abstract
OBJECTIVE: To determine whether once-daily insulin glargine could provide better glycemic control after an abdominal surgical procedure than the traditional use of sliding scale regular insulin (SSRI). METHODS: Because 20% to 30% of patients undergoing gastric bypass have a history of overt diabetes and another 5% to 10% are estimated to have impaired glucose tolerance, we chose to study these patients. We treated 81 patients with postoperative blood glucose levels of more than 144 mg/dL after a Roux-en-Y gastric bypass surgical procedure. They were randomized to receive either SSRI or insulin glargine either directly or after initial intravenous insulin infusion in the intensive care unit (ICU). RESULTS: Overall, the mean blood glucose level after SSRI therapy was 154 +/- 33 mg/dL, and the mean blood glucose value after insulin glargine treatment was 134 +/- 30 mg/dL (P<0.01). The mean blood glucose level for patients first treated with intravenous insulin infusion in the ICU was 125 mg/dL, in comparison with 145 mg/dL in the non-ICU patients whose treatment began directly with 0.3 U/kg of insulin glargine. Of 926 blood glucose measurements, only 3 were less than 60 mg/dL. CONCLUSION: In this study, control of postoperative hyperglycemia was significantly better with use of insulin glargine in comparison with SSRI therapy, and hypoglycemia was very infrequent.
Mesh Headings (Keywords): Adult, Blood Glucose, Female, Gastric Bypass, Humans, Hyperglycemia, Hypoglycemic Agents, Insulin, Intensive Care Units, Male, Middle Aged, Obesity, Postoperative Period
Check for Full Text / PubMed Unique Identifier (PMID): 17599852
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