Insulin Glargine Shown to be Effective at Controlling Glucose Levels During Surgery


In a recent study, scientists found that giving patients with Type II Diabetes Insulin Glargine during surgery was an effective means of controlling glucose levels while under anesthesiology.

Type II Diabetes is the most common type of endocrine disease and presents a number of problems for anesthesiologists. During surgery, the stress of the situation on the body and the types of anesthetics used often cause a hyperglycemic reaction among those who are diabetic. As a result, there are a number of increased health risks for those who are diabetic and undergo surgery or hospitalization.

Traditionally, doctors rely on a solution of Glucose, Insulin, and Potassium (GIK) that is administered intravenously during surgery. The advantage of using a GIK solution is that it allows insulin and glucose to be administered simultaneously and it is very easy to set up. However, if it is necessary to change the level of glucose or insulin, a new GIK Solution must be mixed up.

In this study, researchers used Insulin Glargine instead of a GIK solution to control glucose levels. Insulin Glargine acts as a basal insluin, which only needs to be taken once and lasts for an extended period of time. In the case of Insulin Glargine, it has been shown to sufficiently control glucose levels for up to 24 hours.

The study took 40 patients between 40 years and 80 years in age, who had similar medical backgrounds, including BMI, length of diabetes, and overall health. The patients, who all underwent surgeries for femoral artery bypass or
knee amputation where either given the standard GIK solution or Insulin Glargine.
Those that received insulin glargine were given one shot three hours prior to the operation, while those who were given GIK received a continuous intravenous solution during the surgery.

The researchers found that there was that both groups, those who received insulin glargine and those that received GIK solution, both groups experienced a stable glucose level during surgery and there were no cases of hyperglycemia during the operation.

While the results were very similar, this study shows that using insulin glargine may be a better choice as, because it is easier to adjust glucose levels. This is because if it becomes necessary to adjust glucose or insulin levels with a GIK solution, a new batch must be made.

Source: European Journal of Anaesthesiology; Aug2009, Vol. 26 Issue 8, p666-670, 5p

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