Value of continuous subcutaneous insulin infusion during perioperation of diaketic patients

    CHEN Fei, ZHANG Nanª²Yan, ZHAO Kuiª²Yan, WANG Li, SUN Huiª²Hui, GAO Bin, JI Qiuª²He

    Department of Endocrinology, Xijing Hospital, Fourth Military Medical University, Xi¬ðan 710033, China

    ¡¾Abstract¡¿ AIM: To assess the effect of continuous subcutaneous insulin infusion (CSII) during perioperation in diabetic patients. METHODS: Eightyª²seven diabetic patients in perioperation who need insulin therapy were randomly divided into CSII group (n=46, 2 T1DM and 44 T2DM) and multiple subcutaneous insulin infusion (MSII) group (n=41, 3 T1DM and 38 T2DM). The target of blood glucose control was 3.9-7.9 mmol/L. The time of blood glucose for achieving the target, and preoperative preparation time, length of stay, success rate of preoperative blood glucose control, glucose level at 3 rd day of insulin treatment, expense for preoperative glucose control and total expense of hospitalization were compared between the 2 groups. RESULTS: The time of blood glucose for achieving the target in CSII group[(2.2¡À1.6)d]was shorter than that in MSII group[(8.5¡À4.8) d, P<0.01];the time of preoperative preparation in CSII group [(4.6¡À3.2) d] was shorter than that in MSII group [(11.8¡À6.8) d, P<0.01]; the length of stay in CSII group[(19.6¡À9.4) d]was also shorter than that in MSII [(26.2¡À10.0) d, P<0.01];the success rate of preoperative blood glucose control in CSII group was 85.4%, higher than that in MSII (53.2%, P<0.01). Fasting glucose level at 3 rd day of insulin treatment in CSII group [(7.5¡À1.8) mmol/L] was lower than that in MSII [(10.5¡À2.6) mmol/L, P<0.01]. All of above results proved that CSII could help to obtain better glucose control. Although expense for preoperative glucose control in CSII group [(867.9¡À574.4) RMB] was higher than that in MSII [(497.9¡À283.6) RMB, P<0.01], total expense of hospitalization in CSII group [(25007¡À18048) RMB] was almost as much as that in MSII [(24919¡À21617)RMB, P>0.05). CONCLUSION: The application of CSII in preoperation of diabetic patients can bring better glucose control and shorten hospitalization time, therefore the total expense of hospitalization is not increased. ......