i.v. glucose and insulin therapy
Last reviewed 01/2018
An example protocol is shown - protocols are likely to vary between hospitals and the locally agreed protocol should be followed:
- discontinue previous diabetic therapy
- give 1 litre of 10% dextrose 12 hourly with a 20 mmol potassium supplement
- the administration of insulin by infusion pump should be regulated according to the blood glucose level and should aim to keep glucose concentrations between 5 and 10mM:
- Blood sugar concentration; insulin infusion rate
- 5 mM; 1U/hr
- 5-10 mM; 2 U/hr
- 10-20 mM; 3 U/hr
- > 20 mM; 4 U/hr
- blood glucose should be measured regularly (and the insulin infusion rate altered accordingly):
- When to measure blood glucose; Frequency of measurement
- Preoperatively; At least once
- Intraoperatively; Hourly
- Postoperatively; 3-4 hourly
Intravenous glucose control should be continued until the patient is eating again. Thereafter the normal diabetic regime may be recommenced.