Intravenous Bolus-infusion Versus Sliding Scale of Insulin for Intra-operative Glycemic Control
Intraoperative Complications
About this trial
This is an interventional treatment trial for Intraoperative Complications focused on measuring Insulin, Intra operative, Sliding scale, Bolus- infusion
Eligibility Criteria
Inclusion Criteria:
- ASA physical status II patients
- aged 21-65 years
- known to have type1 or 2 diabetes mellitusw
- pre-operative fasting blood glucose level ˂ 350 mg/dl
- scheduled to undergo elective laparotomy surgeries
- expected to exceed 2 hours duration under general anesthesia
Exclusion Criteria:
- Patients' refusal
- diabetic ketoacidosis
- hyperglycemic hyperosmolar syndrome
- serum potassium ˂3.5 mEq/L
- HbA1c >8.5%.
Sites / Locations
- Ain-Shams University
Arms of the Study
Arm 1
Arm 2
Active Comparator
Active Comparator
Study group
Control group
Bolus-Infusion approach of rapidly acting crystalline insulin. The patient intra-operative blood glucose will be divided by 100. The resultant rapidly acting crystalline insulin units will be given intravenously over 10 minutes, and then continued as an intra-venous infusion per hour. The Capillary Blood Glucose (CBG) will be measured every 30 minutes and in the PACU with readjustment of the bolus-infusion dose as required
The sliding scale approach of rapidly acting crystalline insulin will be used according to the intra-operative blood glucose; 4 IU of insulin will be given when the CBG 180-250 mg/dl, 6 IU of insulin will be given when the CBG 251-300 mg/dl, 8 IU of insulin will be given when the CBG 301-350 mg/dl and 10 IU of insulin will be given when the CBG 351-400 mg/dl (5). The CBG will be measured every 30 minutes and in the PACU.