Proposal for an optimized protocol for intravenous administration of insulin in diabetic patients undergoing...

The objective of this study was to evaluate the usefulness and impact of insulin administration before an F-FDG PET/computed tomography (CT) examination in diabetic patients in order to propose an optimized protocol that can reduce blood glucose levels without increasing muscular F-FDG uptake. A total of 130 patients underwent an F-FDG PET/CT. Twenty patients had glucose levels greater than 180 mg/dl and received endovenous insulin before F-FDG injection (group 1); 10 patients had glucose levels greater than 160 mg/dl and lower than 200 mg/dl and received no insulin (group 2); 100 patients were euglycemic (group 3). Biodistribution was adequate in 19 of 20 patients in group 1. Values of standardized uptake value in the gluteal muscle were 0.50±0.18 for group 1, 0.48±0.10 for group 2, and 0.49±0.08 for group 3; no significant differences in muscular F-FDG uptake could be found among the three groups. No adverse events were recorded. In conclusion, our protocol has been demonstrated to be safe and effective, with only a minor impact on glucose biodistribution and apparently without affecting PET accuracy.