Efficacy of insulin glargine in perioperative glucose control in type 2 diabetic patients

Insulin glargine as a basal insulin exhibits constant absorption with no pronounced peaks in blood insulin levels and 24-h duration of action. We checked the effect of insulin glargine through the comparison of insulin glargine with glucose-insulin-potassium (GIK) on perioperative glucose control in insulin-treated type 2 diabetic patients.

Thirty insulin-treated type 2 diabetic patients, 40-80 years of age, were subjected to femoral artery bypass or knee amputation under general anaesthesia. The insulin glargine group (n = 15) was treated with insulin glargine (two-thirds of the total daily insulin dose required) subcutaneous administration with 5% dextrose solution infusion. The GIK group (n = 15) was treated with GIK infusion (125 ml h). Blood glucose levels were checked every 30 min during anaesthesia and 1 h after extubation. Potassium was checked every 1 h during anaesthesia and 2-4 h after extubation. Statistical analysis was performed with unpaired t test.

There were no significant differences in the time course of blood glucose levels during operation and postoperative period between the two groups (P < 0.05). There was no hypoglycaemic episode in the perioperative period and no significant differences in potassium levels between the two groups.

Insulin glargine was as effective as GIK regimen for perioperative glycaemic control during major surgery in insulin-dependent type 2 diabetic patients.